CLINICAL FEATURES, AGE AND SEX DISTRIBUTIONS, RISK FACTORS AND THE TYPE OF BACTERIA ISOLATED IN PERIODONTITIS PATIENTS IN SANA'A, YEMEN
Authors: AL-Haddad Khaled A , Al-Najhi Mohammed Mohammed Ali , Abbas Al-Kasem Mohammed , Al-Akwa Ameen Abdullah Yahya , Al-Shamahy Hassan Abdulwahab , Al-labani Mohammed A 
Published: March 2021

Background: Periodontitis is an inflammation caused by plaque in the surrounding dental structures. It is a major factor in adult tooth loss. There is lack of information on associated clinical features, risk factors and microbial etiology of periodontitis in Sana’a, Yemen.
Aim: The study focused on associated clinical features, risk factors and the separation and classification of bacteria in periodontitis and associated risk factors amongst patients attending dental clinics is Sana’a city. 
Methods: First, 296 patients were admitted to the dental clinic at the Republican University Hospital and private dental clinics in Sana'a during a period of nearly one year, which began in December 2019 AD and ended in November 2020 AD, when they were diagnosed with dental diseases, then 49 of them were selected who are suffering from periodontitis, of whom 22 are males and 27 are females. Sterile paper points were used for the sample collection. Standard culture and biochemical techniques were used for the isolation and identification. Structured questionnaires were used to record clinical features, demographic variables and other risk factors of periodontitis.
Results: A total of 130 microorganisms were isolated from 49 patients with periodontitis. Male patients accounted for 14.4% and females 18.9% of the all 296 patients who attended our clinics.  There was no important association between sex and periodontitis occurrence while there was significant association the younger age groups (45.4% in <26 years of age). The most common signs and symptoms were swollen or puffy gums (91.9%), bleed easily gums (96%), halitosis (96%), painful chewing (87.8%), pus between teeth and gums (71.4%), loose teeth or loss of teeth (44.9%), gingival recession (83.7%), spitting out blood when brushing or flossing teeth (79.6%), and tender gums (93.9%).
Conclusion: This study is new in Sana'a city. The clinical features of preiodentitis in Yemen and the risk factors are similar to those reported in the literature elsewhere, but the isolated bacteria differ in frequency from those reported elsewhere, as some upper respiratory tract pathogens such as Streptococcus pyogenes are commonly isolated in this study. Knowledge of the clinical features, bacterial causes of gum disease, and risk factors is the key to successful periodontal therapy.
                   
Peer Review History:
Received 8 January 2021; Revised 5 February; Accepted 25 February, Available online 15 March 2021
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Received file:                Reviewer's Comments:
Average Peer review marks at initial stage: 6.0/10
Average Peer review marks at publication stage: 7.5/10
Reviewer(s) detail:
Dr. Tamer Elhabibi,
Suez Canal University, Egypt, tamer_hassan@pharm.suez.edu.eg
Dr. Rawaa Souhil Al-Kayali,
Aleppo University, Syria, rawah67@hotmail.com
Rola Jadallah, 
Arab American University, Palestine, rola@aauj.edu
Prof. Dr. Gorkem Dulger,
Duzce University, Turkey, gorkemdulger@yandex.com
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