## 4 Discussion
\begin{table}
\begin{tabular}{c c c c c} \hline \hline
**Parameters** & **Control** & **Hypertensive** & **Diabetic** & \(p\)**-Value** \\ \hline Periodontitis severity & & & & \\ None & 18 (90\%) & 2 (10\%) & 1 (5\%) & \\ Slight & 2 (10\%) & 5 (25\%) & 6 (30\%) & \\ Moderate & 0 (0\%) & 8 (40\%) & 9 (45\%) & \textless{}0.001 ** \\ Severe & 0 (0\%) & 5 (25\%) & 4 (20\%) & \\ PESA (mm\({}^{2}\)) & 1722.5 \(\pm\) 135.7 & 3157.09 \(\pm\) 242.33 & 2789.3 \(\pm\) 201.7 & \textless{}0.001 ** \\ PISA (mm\({}^{2}\)) & 96.9 \(\pm\) 14.91 & 1029 \(\pm\) 234.6 & 799.4 \(\pm\) 155.05 & \textless{}0.001 ** \\ \hline \hline \end{tabular}  
* * level of significance at 1%. Values of PISA and PESA computed using One-Way ANOVA test. Severity of periodontitis calculated on the basis of CDC/AAP classification; PESA—Periodontal epithelial surface area; PISA—Periodontal inflammatory surface area.  
\end{table} 
Table 4: Severity of periodontitis based on CDC/AAP classification, PESA, and PISA values. of the present study [14]. Periodontitis has also been implicated as a possible contributing factor to hypertension. The CAL and PPD significantly differed among the groups. The hypertensive and diabetic groups showed an increased prevalence of CAL and PPD, which is indicative of chronic periodontitis. These findings are similar to previous investigations showing an increased association of diabetes and hypertensives with increased incidence of periodontitis [48]. Furthermore, the values of PISA indicate that oral health was significantly hampered due to T2 DM and HTN. The values were higher in T2 DM subjects, which shows that DM has a significant negative impact on the oral health of a person. These findings are similar to a recent study that determined that a greater estimate of PISA was significantly linked with DM [33]. PISA values were higher in HTN patients as well, which is also similar to the study conducted by [PERSON] et al., who determined high PISA values in HTN patients [49]. These inflammatory conditions produce a change in salivary inflammatory markers and affect the function of several other components. This was confirmed by the changes produced in mucin, amylase, and TPL levels in the saliva of T2 DM and HTN subjects in this study. Mucins in saliva are a heterogeneous group of glycoproteins produced by the salivary glands. They play an important role in maintaining the viscoelastic properties and help in the clearance of microbes. Mucin levels were raised in both diabetic and hypertensive patients. The highest levels of mucin were observed in the hypertensive group. High mucin levels are indicative of increased viscosity of saliva with low SFR. The study conducted by [PERSON] et al. reported that mucin levels can be used to predict the hereditary predisposition for the development of diabetes [48]. The study further reported that although there is an increase in levels of mucins in diabetic patients, instead of imparting a protective action on oral cavity, it causes a strong feeling of dry mouth. This is mainly due to increased formation of MUC5B and MUC7 proteins, which overcomes the effects of MUC1 in the oral cavity, which forms the protective layer within the oral cavity. The levels of TPL were also raised in T2 DM and HTN subjects; however, diabetics showed the highest levels among the groups. Contradictory results have been observed in previously conducted studies. Some studies reported a higher level while some stated a reduction in the levels of TPL in diabetics [50; 51]. It has also been suggested that there is no significant difference in TPL among diabetics and healthy individuals. The TPL levels indicate the presence of chronic inflammation, and raised levels might be responsible for the presence of chronic inflammation of the periodontitis in T2 DM and HTN patients [52]. In their research, [PERSON] et al. reported that the TPL levels were increased in the saliva of the diabetics, but their levels were significantly decreased in serum [53]; however, periodontal health of the patients was not evaluated.