World Journal of Dentistry

Register      Login

VOLUME 5 , ISSUE 4 ( October-December, 2014 ) > List of Articles


Clinical Evaluation of Gutkha chewing and Pattern of Bone Loss in Periodontitis

Harshal Liladhar Chaudhari, Nipun Ashok, Veena Kalburgi, Haziel Dina Jenifer

Citation Information : Chaudhari HL, Ashok N, Kalburgi V, Jenifer HD. Clinical Evaluation of Gutkha chewing and Pattern of Bone Loss in Periodontitis. World J Dent 2014; 5 (4):199-203.

DOI: 10.5005/jp-journals-10015-1289

Published Online: 01-12-2014

Copyright Statement:  Copyright © 2014; The Author(s).



Tobacco in the form of Gutkha is commonly used in India. The present study was done to analyze the extent and pattern of alveolar bone loss (ABL) among gutkha chewers who were having chronic periodontitis.

Materials and methods

A total of 55 habitual gutkha chewers within the age range of 18 to 35 years with chronic periodontitis, who were otherwise healthy were recruited for the study. Fourteen full mouth intraoral periapical (IOPA) radiographs were taken for each individual (a total of 770 radiographs) with the help of radiovisiography. Kodak dental software was used to analyze and measure the alveolar bone loss at each proximal site and data were computed as percentage alveolar bone loss.


Almost all the subjects had poor oral hygiene status. Clinical parameters of periodontal examination represented by clinical attachment level, probing depth, gingival bleeding index had positive correlation with frequency and duration of gutkha chewing. The study population had a mean alveolar bone loss of 17%. Mean bone loss was more severe in mandible 18.3% ± 2.6, when compared with maxillary arch 15.7% ± 3.7.


Maximum bone loss was observed with molars and incisors. Alveolar bone loss was more frequently found in mandibular arch as compared to maxillary arch.

How to cite this article

Warad S, Chaudhari HL, Ashok N, Kalburgi V, Kalburgi NB, Jenifer HD. Clinical Evaluation of Gutkha chewing and Pattern of Bone Loss in Periodontitis. World J Dent 2014;5(4):199-203.

PDF Share
  1. Tobacco smoking and periodontal health in a Saudi Arabian population. J Periodontol 2005; 76:1919-1926.
  2. Potential mechanism of susceptibility to periodontitis in tobacco smokers. J Periodontal Res 1999;34:363-369.
  3. Tobacco use and oral hygiene as risk indicators for periodontitis. Community Dent Oral Epidemiol 2002;30:115-123.
  4. Cigarette smoking in a periodontal practice. J Periodontol 1992;63:100-106.
  5. Smokeless tobacco use and periodontal health in a rural male population. J Periodontol 2010;81:848-854.
  6. Effect of chewing a mixture of areca nut and tobacco on periodontal tissues and oral hygiene status. J Oral Sci 2008;50(1):57-62.
  7. Nut and tobacco chewing. (letter). Br Dental J 2004 Sep 25;197(6):1
  8. Inhibition of the migration, attachment, spreading, growth and collagen synthesis of human gingival fibroblasts by arecoline, a major areca alkaloid, in vitro. J Oral Pathol Med 1996;25:371-375.
  9. Evaluation of risk factor in smokeless tobacco-associated oral lesions. Oral Surg Oral Med Oral Pathol 1991;72:326-331.
  10. Oral submucous fibrosis: study of 1000 cases from central India. J Oral Pathol Med 2007;36(1):12-17.
  11. Smokeless tobacco and severe active periodontal disease, NHANES III. J Dent Res 2005;84(8):705-710.
  12. The effect of smokeless tobacco on clinical parameters of inflammation and gingival crevicular fluid prostaglandin E2, Interleukin-1α, and interleukin-1β. J Periodontol 1995;66:177-183.
  13. Periodontal effects associated with the use of smokeless tobacco. J Periodontol 1990;61:438-443.
  14. Periodontal condition in male adolescents using smokeless tobacco (moist snuff). J Clin Periodontol 2006;33:863-868.
  15. Stimulatory effect of areca nut extracts on prostaglandin E2 production by human polymorphonuclear leukocytes. J Periodontol 2010;81:758-766.
  16. Areca nut extracts modulated expression of alkaline phosphatase and receptor activator of nuclear factor-kB ligand in osteoblasts. J Clin Periodontal 2005;32:353-359.
  17. Effect of areca nut extract on the apoptosis pathways in human neutrophils. J Periodontal Res 2010;45:412-420.
  18. The gingival index, plaque index and the retention index systems. J Periodontol 1967;38:610-616.
  19. Selection of most accurate method of conventional radiography for the assessment of periodontal osseous destruction. J Clin Periodontol 1997;24: 557-567.
  20. Radiographic alveolar bone loss in patients undergoing periodontal maintenance. Bull Tokyo Dent Coll 2008;49(3): 99-106.
  21. Radiographic quantification of alveolar bone level changes comparison of 3 currently used methods. J Clin Periodontol 1986;13:810-813.
  22. Effect of smokeless tobacco on the periodontal, mucosal and caries status of adolescent males. J Oral Pathol 1985;14:169-181.
  23. The relationship between attachment level loss and alveolar bone loss. J Clin Periodontal 1984;11:348-359.
  24. Comparison of panoramic and intraoral radiography and pocket probing for the measurement of the marginal bone level. J Clin Periodontol 1992;19:326-332.
  25. Efficacy of dental radiographic practices: options for image receptors, examination selection, and patient selection. JADA 1989 Aug; 119:259-268.
  26. Radiographic methods in evaluation of periodontal therapy. J Periodontol 1992;63:1078-1084.
  27. Alveolar bone loss as related to oral hygiene and age. J Periodontol 1959;30:7-16.
  28. Radiographic assessment of marginal bone loss. Odontol Revy 1969;20:165-179.
  29. Comparison of radiovisiography with radiographic film in root length determination. Int Endod J 1995;18:25-29.
  30. Smoking and pattern of bone loss in early onset periodontitis. J Periodontol 1999;70:394-401.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.