The Scientific World Journal
Volume 2019 (2019), Article ID 2357013, 8 pages
https://doi.org/10.1155/2019/2357013

Research Article

Epidemiological Profile of the Pathologies of the Oral Cavity in a Peruvian Population: A 9-Year Retrospective Study of 18,639 Patients

Ángelo Sabogal,¹ Jhonn Asencios,¹ Ada Robles,² Eloy Gamboa,² José Rosas,² Jorge Ríos,² and Frank Mayta-Tovalino2,3

¹School of Stomatology, Universidad Privada San Juan Bautista, Lima, Peru
²Professor of the Stomatology School, Universidad Privada San Juan Bautista, Lima, Peru
³Research Professor and Academic Coordinator of the Master of Public Health Degree, Universidad Privada San Juan Bautista (Head: Prof. Dr. Frank Mayta-Tovalino), Lima, Peru

Correspondence should be addressed to Frank Mayta-Tovalino; estadistico2.0@gmail.com

Received 23 October 2018; Revised 24 December 2018; Accepted 3 January 2019; Published 3 February 2019

Academic Editor: Stefania Staibano

Copyright © 2019 Ángelo Sabogal et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract.

Aim. To determine the epidemiological profile of oral diseases in a marginal urban Peruvian population. Methods. A 9-year retrospective study was conducted, analysing 18,639 clinical records from the María Auxiliadora Hospital between 2006 and 2015 with diagnoses of oral lesions using ICD-10 criteria. Clinical records were analysed for sex, tumour, periapical abscess and sinus, cysts of the oral region, other lesions of the oral mucosa and cavity, gingivitis and periodontal disease, dentofacial anomalies, diseases of pulp, etc. Results. Of 18,639 cases, the prevalence was higher in women for the following pathologies: unspecified dental caries (30.6%); impacted tooth in the category of disorders of tooth development and eruption (2.0%); pulpitis (6.8%) in the category of diseases of pulp and periapical tissues; temporomandibular joint (TMJ) disorders (1.5%) in the category of dentofacial anomalies; acute gingivitis (7.5%); radicular cyst (0.3%) in the category of cysts of the oral region; and periapical abscess without sinus (2.0%). Conclusions. We found a significant association between sex and different types of dental caries, disturbances in tooth eruption, diseases of pulp and periapical tissues, and dentofacial anomalies. The study also shows a statistically significant association between sex and gingivitis, periodontal disease, and periodontal abscess and sinus.

1. Introduction

The jaws and maxillofacial region are affected by pathologies including lesions that vary in location, histopathogenesis, and aetiology involving bone and soft tissues, with manifestations requiring additional clinical examinations and where pharmacological treatments prevent or at least minimise extensive surgical procedures with mutilations [1]. Normal dentition develops from the dental lamina, which is sensitive to disturbances, and the enamel does not regenerate after injury. Multiple factors affect the development of teeth, resulting in different lesions with hypoplasia, dysplasia, hypomineralisation, etc. [2]. For instance, some lesions derive from the enamel organ, dental lamina or epithelial rests of Malassez, and remnants from odontogenic epithelium affecting teeth and periodontal tissues [3–5]. These lesions include dental caries, cysts, tumours, and infections, which are the diseases with the highest prevalence and the main reason for consultation in dentistry in the population. They are divided into lesions of odontogenic and nonodontogenic origin; these anomalies are genetically inherited while others are acquired such as tumours and cysts [6–8].

On the other hand, some lesions arise in the jaws, are not tooth-related, and have no aetiological or histopathogenetic relationship with the ectoderm, facial tissues, etc. These lesions appear as an inflammatory reaction or lesions of unknown aetiology, where lesions of the oral mucosa and cavity prevail; tumours and infections are also part of this group according to another study [9].

There are few studies that describe the most prevalent oral diseases in a Peruvian population, which has great genetic biodiversity in Latin America. Therefore, the objective of this research is important because this 9-year retrospective study examined the prevalence of oral lesions in a marginal urban Peruvian population.

2. Participants and Methods

2.1. Participants of the Study

A cross-sectional, retrospective, and observational study was conducted during the years 2006 to 2015. We identified 18,639 electronic clinical records which were evaluated from the Department of Dentistry of the María Auxiliadora Hospital in Lima (Peru), registering the patients examined and diagnosed with different types of oral lesions, to know what the regional prevalence was of these pathologies in the Peruvian inhabitants of scarce economic resources.

2.2. Procedure

Oral lesions were identified using ICD-10 criteria (International Statistical Classification of Diseases and Related Health Problems). Variables such as sex, caries, disorders of tooth development and eruption, other diseases of hard tissues of teeth, and diseases of pulp and periapical tissues were collected for oral lesions of hard tissues. Similarly, variables such as gingivitis, and periodontal disease, other lesions of the oral mucosa and cavity, cysts of the oral region, periodontal abscess and sinus, and tumours were taken for odontogenic and nonodontogenic lesions of soft tissues.

The procedure for this research followed Strengthening the Reporting of Observational studies in Epidemiology (STROBE) guidelines. In addition, it was authorised by the Ethics Committee of Universidad Privada San Juan Bautista (approval code CEPB-FCS 0006).

2.3. Statistical Analysis

For the statistical analysis, we used frequency measurements and the chi-square test, establishing a level of significance of p <0.05. All statistical tests were performed with Stata software (version 12.0, USA)

3. Results

3.1. Study Population

Out of 18,639 electronic clinical records over 9 years, when evaluating the prevalence of oral lesions of hard tissues for the category of caries, 7,045 cases of unspecified dental caries (37.7%) were observed, followed by 1,221 cases of dentine caries (6.5%), being more common in females (30.6% and 3.8%, respectively). In addition, 125 cases of caries limited to enamel were found, among other pathologies, with a prevalence of <1% of the population. Regarding disorders of tooth development and eruption, there were 661 cases of impacted teeth (3.5%), being more common in females (2.0%); there were also 175 cases with disturbances in tooth eruption, 107 cases with disturbances in tooth formation, and other pathologies with a prevalence of <1% of the population. Regarding diseases of pulp and periapical tissues, there were 1,919 cases of pulpitis (10.2%), followed by 1,440 cases of retained dental root (7.7%) and 512 cases of pulp necrosis (2.7%), being more common in females (6.8%, 5.2%, and 1.4%, respectively), as well as other pathologies with a prevalence of <1% of the population. In relation to dentofacial anomalies, there were 341 cases of TMJ disorders (1.8%), being more common in females (1.5%); additionally, there were 113 cases of malocclusion, 47 cases of tooth position anomalies, and other pathologies with a prevalence of <1% of the population. There was a statistically significant association between sex and these evaluated categories (p <0.05). In the category of other diseases of hard tissues of teeth, there were 46 cases of other jaw diseases, 24 cases of deposits (accretions) on teeth, and other pathologies with a prevalence of <1% of the population. However, there was no statistically significant association between sex and this evaluated category (p >0.05) (Tables 1 and 2).

Table 1: Classification and distribution of oral lesions (hard tissues).

Diagnosis
Abbrev.
No.

Caries
Not present
NP
10235
54.9

Dentine caries
CD
1221
6.5

Caries limited to enamel
CLE
125
0.6

Dental caries, unspecified
DCU
7045
37.7

Arrested dental caries
ADC
8
0.0

Other dental caries
ODC
3
0.0

Caries in pits and fissures
CPF
2
0.0

Disorders of tooth development and eruption
Not present
NP
17444
93.5

Embedded tooth
EmbT
82
0.4

Impacted tooth
ImpT
661
3.5

Teething syndrome
TS
51
0.2

Disorders of tooth development, unspecified
DTDU
17
0.0

Hereditary disturbances in tooth structure, not elsewhere classified
HDTSNEC
9
0.0

Disturbances in tooth eruption
DTE
175
0.9

Supernumerary tooth
SpnT
77
0.4

Disturbances in tooth formation
DTF
107
0.5

Staining of teeth
ST
12
0.0

Atrophy of edentulous alveolar ridge
AEAR
4
0.0

Other diseases of hard tissues of teeth
Not present
NP
18476
99.1

Excessive attrition of teeth
EAT
10
00

Hypercementosis
Hpcmt
12
00

Deposits (accretions) on teeth
DAT
24
0.1

Certain disorders of gingiva and edentulous alveolar ridge
CDGEAR
18
0.0

Other diseases of jaws
ODJ
46
0.2

Pathological resorption of teeth
PRT
5
0.0

Complete tooth loss
CLT
15
0.0

Congenital absence of teeth
CAT
8
0.0

Exfoliation of teeth due to systemic causes
ETDSC
6
0.0

Other specified disorders of teeth and supporting structures
OSDTSS
19
0.1

Diseases of pulp and periapical tissues
Not present
NP
14631
78.4

Pulpitis
Plpts
1919
10.2

Necrosis of pulp
NOP
512
2.7

Pulp degeneration
PD
17
0.0

Acute apical periodontitis of pulpal origin
AAPPlO
32
0.1

Abnormal hard tissue formation in pulp
AHTFP
21
0.0

Chronic apical periodontitis
CAP
29
0.1

Retained dental root
RDR
1440
7.7

Other and unspecified diseases of pulp and periapical tissues
OUDPPT
38
0.2

Dentofacial anomalies
Not present
NP
18077
96.9

Malocclusion
Mlcs
113
0.0

TMJ disorders
TMJD
341
1.8

Anomalies of tooth position
ATP
47
0.2

Anomalies of jaw-cranial base relationship
AJCBR
15
0.0

Major anomalies of jaw size
MAJS
11
0.0

Abnormalities of size and form of teeth
ASFT
10
0.0

Dentofacial functional abnormalities
DfclFA
4
0.0

Anomalies of dental arch relationship
ADAR
14
0.0

Developmental disturbances of jaws
DDJ
1
0.0

Table 2: Nine-year retrospective study of the prevalence of hard tissue lesions.

Sex

Total

p

Female

Male

N
%
n
%
N
%

Caries
NP
6861
36.8
3374
17.9
10235
54.9
0.000

CD
722
3.8
499
2.6
1221
6.5

CLE
70
0.3
55
0.2
125
0.6

DCU
5711
30.6
1334
7.1
7045
37.7

ADC
6
0.0
2
0.0
8
0.0

ODC
2
0.0
0
0.0
2
0.0

CPF
1
0.0
1
0.0
2
0.0

Disorders of tooth development and eruption
NP
12708
68.1
4736
25.4
17444
93.5
0.000

EmbT
55
0.2
27
0.1
82
0.4

ImpT
391
2.0
270
1.4
661
3.5

TS
29
0.1
22
0.1
51
0.2

DTDU
8
0.0
9
0.0
17
0.0

HDTSNEC
5
0.0
4
0.0
9
0.0

DTE
88
0.4
87
0.4
175
0.9

SpnT
25
0.1
52
0.2
77
0.4

DTF
55
0.2
52
0.2
107
0.5

ST
8
0.0
4
0.0
12
0.0

AEAR
2
0.0
2
0.0
4
0.0

Other diseases of hard tissues of teeth
NP
13262
71.1
5214
27.9
18476
99.1
0.159

EAT
8
0.0
2
0.0
10
00

Hpcmt
11
0.0
1
0.0
12
00

DAT
11
0.0
13
0.0
24
0.1

CDGEAR
12
0.0
6
0.0
18
0.0

ODJ
31
0.1
15
0.0
46
0.2

PRT
4
0.0
1
0.0
5
0.0

CLT
10
0.0
5
0.0
15
0.0

CAT
7
0.0
1
0.0
8
0.0

ETDSC
6
0.0
0
0.0
6
0.0

OSDTSS
13
00
6
0.0
19
0.1

Diseases of pulp and periapical tissues
NP
59
57.7
3872
20.7
14631
78.4
0.000

Plpts
1269
6.8
650
3.4
1919
10.2

NOP
279
1.4
242
1.2
512
2.7

PD
15
0.0
2
0.0
17
0.0

AAPPlO
22
0.1
10
0.0
32
0.1

AHTFP
15
0.0
6
0.0
21
0.0

CAP
19
0.1
10
0.0
29
0.1

RDR
981
5.2
459
2.4
1440
7.7

OUDPPT
24
0.1
14
0.0
38
0.2

Dentofacial anomalies
NP
12957
69.5
512
2.7
18077
96.9
0.000

Mlcs
67
0.3
46
0.2
113
0.0

TMJD
284
1.5
57
0.3
341
1.8

ATP
28
0.1
19
0.1
47
0.2

AJCBR
8
0.0
7
0.0
15
0.0

MAJS
8
0.0
3
0.0
11
0.0

ASFT
7
0.0
3
0.0
10
0.0

DfclFA
2
0.0
2
0.0
4
0.0

ADAR
10
0.0
4
0.0
14
0.0

DDJ
0
0.0
1
0.0
1
0.0

DfclAU
3
0.0
3
0.0
6
00

Pearson chi-square test; significance level p <0.05.

3.2. Prevalence

When evaluating the prevalence of different oral pathologies of soft tissues, in the category of gingivitis and periodontal disease, there were 1,648 cases of acute gingivitis (8.8%), followed by 677 cases of chronic periodontitis (3.6%) and 417 cases of chronic gingivitis (2.2%), being more common in females (7.5%, 2.3%, and 1.6%, respectively), as well as other pathologies with a prevalence of <1% of the population. Regarding cysts of the oral region, there were 93 cases of radicular cyst, 37 cases of developmental odontogenic cysts, and other pathologies with a prevalence <1% of the population, being more common in females. With regard to periodontal abscess and sinus, there were 712 cases of periapical abscess without sinus (3.8%), being more common in females (2.0%), followed by 153 cases of cellulitis and mouth abscess and other pathologies with a prevalence of <1% of the population. There was a statistically significant association between these evaluated categories and sex (p <0.05). In the category of other lesions of oral mucosa and cavity, there were 34 cases of other and unspecified lesions of the oral mucosa, in addition to other pathologies with a prevalence of <1% of the population. Similarly, in the category of tumours, there were only 3 cases of central giant cell granuloma, with a prevalence of <1% of the population. However, these two evaluated categories showed no statistically significant association with sex, p >0.05 (Tables 3 and 4).

Table 3: Classification and distribution of oral pathologies (soft tissues).

Diagnosis
Abbrev.
No.

Gingivitis and periodontal disease
Not present
NP
15549
83.4

Acute gingivitis
AG
1648
8.8

Chronic gingivitis
CG
417
2.2

Acute periodontitis
AP
151
0.8

Chronic periodontitis
CP
677
3.6

Gingival enlargement
GE
73
0.3

Periodontal disease, unspecified
PDU
6
0.0

Stomatitis
Stoma
31
0.1

Mucocele of salivary gland
MSG
29
0.1

Alveolitis
Alvlts
52
0.2

Periodontitis
Perio
6
0.0

Other lesions of oral mucosa and cavity
Not present
NP
18564
99.5

Leukoplakia and other disturbances of oral epithelium, including tongue
LODOEIT
9
0.0

Other and unspecified lesions of oral mucosa
OULOM
34
0.1

Sialadenitis
Sialo
4
0.0

Oral submucous fibrosis
OSF
9
0.0

Other diseases of lip and oral mucosa
ODLOM
4
0.0

Irritative hyperplasia of oral mucosa
IHOM
2
0.0

Hairy leukoplakia
HL
2
0.0

Gingival and edentulous alveolar ridge lesions associated with trauma
GEARLAT
4
00

Granuloma and granuloma-like lesions of oral mucosa
GGLLOM
3
00

Glossitis
Glos
4
0.0

Cysts of the oral region
Not present
NP
18491
99.2

Radicular cyst
RC
93
0.4

Developmental odontogenic cysts
DOC
37
0.1

Other cysts of the oral region, not elsewhere classified
OCORNEC
3
0.0

Other cysts of the jaw
OCJ
15
0.0

Periapical abscess and sinus
Not present
NP
17694
94.9

Periapical abscess with sinus
PAWS
77
0.41

Periapical abscess without sinus
PAWtS
712
3.8

Cellulitis and abscess of mouth
CAM
153
0.8

Cellulitis of face
CF
1
0.0

Abscess of salivary gland
ASG
2
0.0

Tumour
Not present
NP
18636
99.9

Giant cell granuloma, central
GCGC
3
0.0

Table 4: Nine-year retrospective study of the prevalence of oral pathologies (soft tissues).

Female

Male

Total

p

N
n
N

Gingivitis and periodontal disease
NP
11008
59.0
4541
24.3
15549
83.4
0.000

AG
1401
7.5
247
1.3
1648
8.8

CG
304
1.6
113
0.6
417
2.2

AP
89
0.4
62
0.3
151
0.8

CP
438
2.3
239
1.2
677
3.6

GE
50
0.2
23
0.1
73
0.3

PDU
3
0.0
3
0.0
6
0.0

Stoma
19
0.1
12
0.0
31
0.1

MSG
12
0.0
17
0.0
29
0.1

Alvlts
46
0.2
6
0.0
52
0.2

Perio
3
0.0
3
0.0
6
0.0

Other lesions of oral mucosa and cavity
NP
13320
71.5
5235
28.0
18564
99.5
0.313

LODOEIT
6
0.0
3
0.0
9
0.0

OULOM
18
0.0
16
0.0
34
0.1

Sialo
3
0.0
1
0.2
4
0.0

OSF
5
0.0
4
0.2
9
0.0

ODLOM
4
0.0
0
0.0
4
0.0

IHOM
1
0.0
1
0.0
2
0.0

HL
1
0.0
1
0.0
2
0.0

GEARLAT
2
0.0
2
0.0
4
00

GGLLOM
2
0.0
1
0.0
3
00

Glos
2
0.0
2
0.0
4
0.0

Cysts of the oral region
NP
13284
71.5
5207
27.9
18491
99.2
0.046

RC
58
0.3
35
0.0
93
0.4

DOC
21
0.1
16
0.0
37
0.1

OCORNEC
2
0.0
1
0.0
3
0.0

OCJ
9
0.0
6
0.0
15
0.0

Periapical abscess and sinus
NP
12855
68.9
4839
25.9
17694
94.9
0.000

PAWS
31
0.1
46
0.2
77
0.41

PAWtS
389
2.0
323
1.7
712
3.8

CAM
97
0.5
56
0.3
153
0.8

CF
1
0.0
0
0.0
1
0.0

ASG
1
0.0
1
0.0
2
0.0

Tumour
NP
13372
71.1
5264
28.2
18636
99.9
0.494

GCGC
1
0.0
2
0.0
3
0.0

Pearson chi-square test; significance level p <0.05.

4. Discussion

Oral pathologies are reasons for consultation, and according to the WHO, biofilm is an ecosystem that causes odontogenic infections. Different authors consider these lesions the major and most common oral pathologies in all age groups, being a reason for professional intervention [6–8]. The available literature indicates that the misdiagnosis of these lesions results in various diseases such as periodontitis, osteitis, and other lesions; also, nonodontogenic lesions cause diseases such as mucosal and gland infections and tumours [6, 10, 11].

Out of a total of 18,639 electronic clinical records from a Peruvian hospital, this study showed 8,404 cases of caries (45.1%), of which 1,221 cases (37.7%) corresponded to unspecified dental caries, being more common in females (30.6%), which is in agreement with the empirical evidence from studies in Germany and the USA, where there was a greater prevalence in females [12]. In another study [13], the prevalence of caries was 93.19% greater in females, with a sex ratio of 0.77. Previously, a high prevalence of caries (69%) was observed in university students in Hong Kong using the DMFT index, where female prevalence was higher than that of males like other studies [14, 15].

Regarding disorders of tooth development and eruption, there were 661 (3.5%) cases of an impacted tooth, being more common in women (n=391; 2.0%), with a male-to-female ratio of 1:1.3. This is similar to the results of a study in Turkey, where there were 1,117 cases (9.2%) with one or more impacted teeth and a male-to-female ratio of 1:1.4. However, these results contradict what was found in Tanzania, where a male-to-female ratio of 1.2:1 was recorded [16].

With respect to diseases of pulp and periapical tissues, the most common lesion was pulpitis (10.2%), followed by retained dental root (7.7%), pulp necrosis (2.7%), and other pathologies, such as acute and chronic apical periodontitis, with a prevalence of <1% of the population, being more common in females for all conditions. This differs from a study of 4,209 emergency patients in a university hospital, where 2,058 suffered odontogenic infections: most (45.0%) had apical periodontitis, 20.8% had abscesses, 17.3% had marginal periodontitis, 16.3% had pulpitis, and 5.8% had pericoronitis, with men being more affected than women [17].

In relation to dentofacial anomalies, the most prevalent condition was a TMJ disorder (1.8%), being more common in females (1.5%), which was consistent with findings from Finland where 18.5% of 1,962 patients presented with a TMJ disorder, being more common in females [18]. Also, within this category, there was a higher prevalence of females with tooth position anomalies and abnormalities of the size and form of teeth, which is in agreement with a previous study where 1,172 radiographs of 581 men and 586 women were reviewed, finding abnormalities of form, position, and number with 213 teeth anomalies, being more common in women [8].

In the category of gingivitis and periodontal disease, there were 1,648 cases of acute gingivitis (8.8%), followed by chronic periodontitis (3.6%) and chronic gingivitis (2.2%), being more common in females, unlike what was found in Jordan, where 76% were cases of gingivitis, 5.5% were chronic periodontitis, and 2.2% were severe periodontitis, the latter being more common in men than in women, with a male-to-female ratio [19] of 1.6:1. Our results are also contrast with previous studies where there was a higher prevalence of gingivitis in men [20, 21]. They also contradict the higher prevalence of periodontitis found in the adult male population in the USA [22].

Regarding cysts of the oral region, there were 93 cases of radicular cyst, 37 cases of developmental odontogenic cysts, and other pathologies with a prevalence of <1% of the population, being more common in females. These results differ from a study on the prevalence of odontogenic cysts in Sicily, where the most common lesions were radicular cysts (84.5%), followed by dentigerous odontogenic cysts (11.4%), with radicular inflammatory cysts being more common in males [23].

There are limitations such as a lack of literature related to the subject to verify results in some categories (diseases of hard tissues of teeth and other lesions of oral mucosa). The study results provide data and establish the prevalence of a disease and the most affected population, resulting in the predominance of females for almost all conditions. This study is important for its contribution to the institution for monitoring and reporting, aiming to conduct prevention campaigns and thus compare the results with future studies.

5. Conclusions

In conclusion, according to this 9-year retrospective study in a Peruvian hospital, females predominated in almost all pathologies, and a statistically significant association was found between sex and types of caries, disorders of tooth development and eruption, diseases of pulp and periapical tissues, and dentofacial anomalies.

A statistically significant association was also found between sex and gingivitis and periodontal disease as well as periodontal abscess and sinus. This study is pioneering because it determined the most prevalent oral pathologies at one of the main national hospitals in Peru, and its results are useful for oral and maxillofacial surgeons and pathologists.

Data Availability

The data used in the statistical analysis of this study will be available upon authorization of the corresponding managers of the university.

Conflicts of Interest

The authors declare that they have no conflicts of interest.

Acknowledgments

The authors want to thank the Universidad Privada San Juan Bautista and Hospital Maria Auxiliadora for its constant and disinterested support for the execution of the present retrospective study. Finally, the authors wish to thank the research group “Hunaq" for their incessant motivation in the execution of the present investigation.

References

W. H. Schreuder, A. W. Coumou, P. A. H. W. Kessler, and J. De Lange, “Alternative pharmacologic therapy for aggressive central giant cell granuloma: Denosumab,” Journal of Oral and Maxillofacial Surgery, vol. 72, no. 7, pp. 1301–1309, 2014.

M. Atar and E. J. Körperich, “Systemic disorders and their influence on the development of dental hard tissues: a literature review,” Journal of Dentistry, vol. 38, no. 4, pp. 296–306, 2010.

M. Mascitti, A. Santarelli, A. Zizzi, M. Procaccini, L. L. Muzio, and C. Rubini, “Expression of p73 and TRAIL in odontogenic cysts and tumors,” Journal of Oral Science, vol. 58, no. 4, pp. 459–464, 2016.

A. V. Jones, G. T. Craig, and C. D. Franklin, “Range and demographics of odontogenic cysts diagnosed in a UK population over a 30-year period,” Journal of Oral Pathology & Medicine, vol. 35, no. 8, pp. 500–507, 2006.

J. Philip, L. Eversole, and G. Wysocki, Patologia oral y maxilofacial contemporánea [Contemporary oral and maxillofacial pathology], Harcourt Brace, Spain, 1989.

A. Bascones, J. Aguirre, A. Bermejo et al., “Consensus statement on antimicrobial treatment of odontogenic bacterial infections,” Revista Medicina Oral Patología Oral y Cirugía Bucal, vol. 9, pp. 363–376, 2014.

R. Lopez, L. Aguilar, and M. Gimenez, “Management of odontogenic infection of pulpal and periodontal origin,” Revista Medicina Oral Patología Oral y Cirugía Bucal, vol. 12, pp. 154–159, 2007.

E. A. Saberi and S. Ebrahimipour, “Evaluation of developmental dental anomalies in digital panoramic radiographs in Southeast Iranian Population,” Journal of International Society of Preventive and Community Dentistry, vol. 6, no. 4, pp. 291–295, 2016.

A. Acikgoz, E. Uzun-Bulut, B. Ozden et al., “Prevalence and distribution of odontogenic and nonodontogenic cysts in a Turkish population,” Revista Medicina Oral Patología Oral y Cirugía Bucal, vol. 6, pp. 108–115, 2011.

R. Scott and J. Dillon, “Non-odontogenic Cyst of the jaws and treatment in the pediatric population,” Oral and Maxillofacial Surgery Clinics of North America, vol. 28, pp. 31–44, 2016.

D. J. Theodorou, S. J. Theodorou, and D. J. Sartoris, “Primary non-odontogenic tumors of the jawbones: An overview of essential radiographic findings,” Clinical Imaging, vol. 27, no. 1, pp. 59–70, 2003.

C. Gleissner, “How does gender influence oral health?” Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz, vol. 57, no. 9, pp. 1099–1106, 2014.

Y. Ouedraogo, W. A. D. Kabore, T. Konsem et al., “Tooth decay: epidemiological and therapeutic aspects in dental service of University Teaching Hospital Yalgado Ouedraogo and Municipal Centre of Oral Health,” Odonto-Stomatologie Tropicale, vol. 38, no. 152, pp. 49–55, 2015.

C. H. Chu, A. Ng, A. M. Chau et al., “Dental Erosion and Caries Status of Chinese University Students,” Oral Health & Preventive Dentistry, vol. 13, pp. 237–244, 2005.

K. Gündüz, A. Acikgöz, and E. Egrioglu, “Radiologic investigation of prevalence, associated pathologies and dental anomalies of non-third molar impacted teeth in Turkish oral patients,” Chinese Journal of Dental Research, vol. 13, no. 237-244, 2011.

F. Msagati, E. N. M. Simon, and S. Owibingire, “Pattern of occurrence and treatment of impacted teeth at the Muhimbili National Hospital, Dar es Salaam, Tanzania,” BMC Oral Health, vol. 13, no. 1, p. 37, 2013.

B. Mahmoodi, J. Weusmann, A. Azaripour et al., “Odontogenic Infections: A 1-year Retrospective Study,” The Journal of Contemporary Dental Practice, vol. 16, pp. 253–258, 2014.

P. Jussila, H. Kiviahde, R. Näpänkangas et al., “Prevalence of temporomandibular disorders in the northern Finland birth cohort 1966,” Journal of Oral and Facial Pain and Headache, vol. 31, no. 2, pp. 159–164, 2017.

K. T. Ababneh, Z. M. F. Abu Hwaij, and Y. S. Khader, “Prevalence and risk indicators of gingivitis and periodontitis in a Multi-Centre study in North Jordan: A cross sectional study,” BMC Oral Health, vol. 12, no. 1, 2012.

Y. Li, S. Lee, P. Hujoel et al., “Prevalence and severity of gingivitis in American adults,” American Journal of Dentistry, vol. 23, pp. 9–13, 2010.

M. M. Idrees, S. N. Azzeghaiby, M. M. Hammad, and O. B. Kujan, “Prevalence and severity of plaque-induced gingivitis in a saudi adult population,” Saudi Medical Journal, vol. 35, no. 11, pp. 1373–1377, 2014.

P. I. Eke, B. A. Dye, L. Wei et al., “Update on prevalence of periodontitis in adults in the United States: NHANES 2009 to 2012,” Journal of Periodontology, vol. 86, no. 5, pp. 611–622, 2015.

S. Tortorici, E. Amodio, M. F. Massenti, M. L. Buzzanca, F. Burruano, and F. Vitale, “Prevalence and distribution of odontogenic cysts in Sicily: 1986-2005,” Journal of Oral Science, vol. 50, no. 1, pp. 15–18, 2008.