title: The impacts of adenotonsillar hypertrophy on periodontal health in children: a prospective controlled pilot study.
abstract: OBJECTIVE
  To evaluate the impacts of obstructive adenotonsillar disease on periodontal health and to assess the efficacy of adenotonsillectomy in the prevention of chronic periodontitis in children.
  
  
  METHODS
  This prospective and controlled clinical study was conducted between August 2012 and February 2013 with 35 pediatric patients who had permanent anterior dentition. The study group included twenty patients (n = 20) who had complaints of chronic mouth breathing and snoring and were diagnosed with obstructive adenotonsillar disease. These patients underwent adenoidectomy with or without tonsillectomy. We performed periodontal examinations to assess the periodontal health status in these children before and two months after surgery. The periodontal measures included plaque index (PI), pocket depth (PD) and gingival index scores (GI). Subsequently, these periodontal measures were compared with healthy control group who had no adenotonsillar disease (n = 15).
  
  
  RESULTS
  Among the study group six patients underwent adenoidectomy and 14 patients underwent adenoidectomy combined with either tonsillectomy or tonsillotomy. The preoperative PI, PD and GI scores of the study group were 1.27 ± 0.39, 1.34 ± 0.31 and 0.97 ± 0.37 respectively. These scores were significantly higher compared to the control group (p < 0.001). These periodontal index scores were significantly improved after surgery (p = 0.008 for PI and p < 0.001 for both PD and GI). In addition, we found no difference in postoperative values of PD and GI between the study group and control group.
  
  
  CONCLUSIONS
  We concluded that obstructive adenotonsillar disease adversely affects periodontal health in children and surgical management of obstruction improves the clinical findings. However, more comprehensive research is required to elucidate the association between adenotonsillar hypertrophy and periodontal disease.
authors.affiliation: Department of Otolaryngology, University of Uludag, Bursa, Turkey. uygardemir@hotmail.com
authors.forename: Uygar Levent
authors.initials: UL
authors.lastname: Demir
authors.forename: Burcu
authors.initials: B
authors.lastname: Cetinkaya
authors.forename: Sait
authors.initials: S
authors.lastname: Karaca
authors.forename: Deniz
authors.initials: D
authors.lastname: Sigirli
mesh_terms: D000233:Adenoidectomy / Q000379:methods*; D000234:Adenoids / Q000473:pathology / Q000601:surgery*; D000293:Adolescent; D002648:Child; D055113:Chronic Periodontitis / Q000209:etiology / Q000517:prevention & control*; D018450:Disease Progression; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006984:Hypertrophy / Q000175:diagnosis / Q000601:surgery; D007828:Laryngoscopy; D008297:Male; D010865:Pilot Projects; D011379:Prognosis; D011446:Prospective Studies; D014068:Tonsillectomy / Q000379:methods*; D014069:Tonsillitis / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D016896:Treatment Outcome