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ORIGINAL RESEARCH
Year : 2020  |  Volume : 11  |  Issue : 2  |  Page : 47-51

Correlation of ABO and Rh Blood Group with Dental Malocclusion in Population of Mysuru


Department of Orthodontics and Dentofacial Orthopaedics, JSS Dental College and Hospital, JSS AHER, Mysuru, Karnataka, India

Date of Submission18-Jan-2020
Date of Decision29-Mar-2020
Date of Acceptance07-Apr-2020
Date of Web Publication10-Jun-2020

Correspondence Address:
2nd year Post Graduate Paridhi Gupta
Department of Orthodontics and Dentofacial Orthopaedics ,JSS Dental College and Hospital, JSS AHER Mysore 570015, Karnataka
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/denthyp.denthyp_8_20

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  Abstract 


Introduction: Several studies have found that certain diseases are associated with ABO blood groups. The aim of the present study was to investigate the correlation of ABO Rh blood group with dental malocclusion in the population of Mysuru. Materials and Methods: In this study patients of 15–28 years of age will be selected, irrespective of gender from the hospital, Mysuru. It is an observational study with a duration of 3–4months. A total of 278 subjects between the age group of 15-28 years who visited the JSS hospital, Mysuru were recruited for this study. The maxillary and mandibular molar relation of teeth in maximum intercuspation using Angle’s classification were recorded. Blood group was evaluated using the ABO blood grouping system. Mean, Standard deviation, frequency, percentage were used for descriptive statistics. Chi-square test was used for inferential statistics. Statistical Package of Social Science (SPSS), version 16 was used for statistical analysis. Results: Out of 278 people ‘O’ blood group was found to be most commonly associated with Angle’s Class I malocclusion (71.3%). Class II div I and div II was found to be more common in ‘A’ blood group (42.68%) and (4.9%) respectively. Class III being most common in ‘B’ blood group (6.5%). Conclusions: A significant correlation exists between blood group and malocclusion. The prevalence of malocclusions being highest in blood group O, followed by A, B and AB in Mysuru. Class II div I malocclusion was more prevalent in ‘A’ followed by ‘B’ blood group.

Keywords: ABO blood group, correlation, malocclusion, Mysuru population, Rh factor


How to cite this article:
Gupta P, Avinash B, Rao RN. Correlation of ABO and Rh Blood Group with Dental Malocclusion in Population of Mysuru. Dent Hypotheses 2020;11:47-51

How to cite this URL:
Gupta P, Avinash B, Rao RN. Correlation of ABO and Rh Blood Group with Dental Malocclusion in Population of Mysuru. Dent Hypotheses [serial online] 2020 [cited 2020 Jul 11];11:47-51. Available from: http://www.dentalhypotheses.com/text.asp?2020/11/2/47/286352




  Introduction Top


Andrews in 1972 stated that malocclusion is a significant deviation from what is defined as normal or ideal occlusion.

Malocclusions have a multi-factorial origin and can hardly be attributed to a single specific cause.[1]

Causes include:
  1. General factors
    1. Genetic and hereditary components
    2. Nutritional deficiencies
    3. Abnormal pressure habits
  2. Local factors
    1. Supernumerary teeth
    2. Tooth decay
    3. Premature loss of primary teeth etc.


In 1901, Landsteiner first explained the presence of serologic variation between individuals and classified people into four groups depending on their RBC cell membrane agglutinogen (antigens). The presence or absence of these antigens gives rise to four blood groups: A, B, AB, and O which are present on the 9th chromosome and inherited co-dominantly.[2]

With the discovery of ABO blood groups and some enzyme polymorphs, zygosity of twins could be determined which would be helpful in twin studies concerning the role of heritability of malocclusion.[3],[4]

Various studies showed that some diseases like periodontal disease,[5] salivary gland tumours,[6] chickenpox,[7] malaria,[8] oral cancer,[9] haematological malignancies,[10] ischemic heart disease,[11] cholera[12] were found to have a significant association with blood groups.

The Prevalence of malocclusion in India has been reported to be 20–43%. Kaur et al. reported that among the south Indian population it is around 87.79%.[13] With such an immense rate the need of the hour is to find the population at risk of malocclusion in order to minimize the morbid consequences such as airway obstruction, unerupted teeth, poor periodontal health and disrupted psychological well-being.


  Materials and Methods Top


A total of 278 subjects in the age group of 15–28 years who visited the hospital, Mysuru were recruited for this study. Clearance from the institutional ethical committee was obtained before starting the study. Separate pro-forma was used to record the patient’s name, age, sex, blood group and the malocclusion.

The inclusion and exclusion criteria for participants:

Inclusion criteria

  1. All permanent teeth present in each arch (except third molars), and in a sufficient state of eruption i.e. when the cusp tip or complete crown is visible in the oral cavity
  2. Patients between 15 and 28 years of age


Exclusion criteria

  1. Systemic disease or congenital syndrome


Study design

  1. Observational type of study design
  2. Participants were selected at random using systematic sampling in which first person was selected at random and from then onward every fifth person was recruited for the study.
  3. Sample Size = 278.
  4. Formula for sample size estimation:


where, n = desired sample size (when the population>10,000)

Z = standard normal deviate; for this study considered at 2.57,[13] which correspond to 99% confidence level.

p = proportion in the target population estimated to have a particular characteristic. Prevalence of malocclusion in India 0.89.[13]

q = 1-p (proportion in the target population not having the particular characteristics), for this study 0.11.

d = degree of accuracy required, for this study set at 0.05.

After obtaining the consent form from each subject, all individuals were evaluated by a single operator, and occlusal relationships were recorded in centric occlusion, which was achieved by asking the subject to swallow and then to bite on his/her teeth together. The cheeks were fully retracted to obtain a direct lateral view of the dentition on each side [Figure 1].
Figure 1 Evaluation of occlusal relationship.

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Blood Investigation

Venous blood was directly drawn to the EDTA vacutainer from the medial cubital vein of the patient using aseptic technique. The sample was analyzed using an automated machine for detecting the blood group in the pathology department of the college and hospital.

Statistical Analysis

Statistical Package of Social Science (SPSS), version 16 was used for statistical analysis. Mean, Standard deviation, frequency, percentage were used for descriptive statistics. Chi-square test was used for inferential statistics.


  Results Top


The antero-posterior relationships of the maxillary and mandibular first molars in maximum intercuspation by Angle’s classification[14] were evaluated and patients were divided as follows:
  1. Class I malocclusion (Angle’s class 1): 168 subjects (62 males and 106 females).
  2. Class II Division 1 malocclusion (Angle’s Class II Div 1): 79 subjects (40 males and 39 females).
  3. Class II Division 2 malocclusion (Angle’s Class II Div 2): 7 subjects (4 males and 3 females).
  4. Class III malocclusion (Angle’s class III): 12 subjects (2 males and 10 females).


Out of 278 people Angle’s class I malocclusion was found in 168 subjects. Angle’s Class II div I and div II was found in 79 and 7 subjects respectively. Class III was seen in 12 subjects. 12 subjects had mutilated malocclusion [Table 1].
Table 1 Frequency distribution of malocclusion in screened population of Mysuru

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Out of 278 people ‘O’ blood group was found to be most commonly associated with Angle’s Class I malocclusion (71.3%). Class II div I and div II was found to be more common in ‘A’ blood group (42.68%) and (4.9%) respectively. Class III was found equally in A, B and O [Table 2].
Table 2 Frequency distribution and percentage of various blood groups amongst different types of malocclusion

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Out of 278 people, maximum people had O blood group (44%), 30% had A blood group 22% had B blood group [Table 3].
Table 3 Frequency distribution of blood group amongst the screened population for malocclusion

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  Discussion Top


ABO blood group system is controlled by a different set of alleles for different antigens, i.e. A, B and O. A and B antigen alleles show co-dominance with each other whereas act as a dominant allele in comparison to O. Presence or absence of these antigens on the erythrocytes determines the blood group in individuals. Antigens on the cell membrane are accompanied by presence or absence of the antibody in the plasma that is directed against other antigens, therefore people with blood group A, have anti B antibody, people with blood group B, have anti A antibody, people with blood group O have both of them and people with blood group AB have none.

Correlation of developing malocclusion with specific blood group can be hypothesized to abnormal expression of blood group ABO antigens on the alveolar bone or tooth. However, further molecular studies need to be done to find the specific cause and molecular basis of the association of malocclusion with blood group.

It can, in future help in identifying the population at risk for development of malocclusion at the time of birth based on blood group and hence can help in prevention or early diagnosis and treatment of the same, reducing the economic burden.

The current study revealed a significant correlation between malocclusion and ABO blood grouping. Overall ‘O’ blood group was most prevalent amongst people with malocclusion, which is in accordance with the findings of Al-Khatieeb et al.[15] however, we found Blood group ‘A’ to be associated with class II div I and class II div II patients which doesn’t support his findings. Population of Jaipur demonstrated that the prevalence of malocclusions being highest in blood group B, followed by A, O and AB.[16] This difference could be due to geographic diversity of the population and racial variation.

The establishment of relationship between oral and systemic diseases has been the forefront of research in medicine. Periodontitis has been associated with a number of systemic diseases like diabetes,[17] cardiovascular disease[18] and endothelial dysfunction.[19],[20] Isola et al. conducted a study to find the association between endothelial progenitor cell (EPC) levels and periodontitis. EPC are a type of stem cells derived from the bone marrow and the possess the ability to express surface antigens to maintain vascular integrity and repair the endothelium.[21] Gaetano Isola and co workers reported that patients with periodontitis exhibited an increased EPC count and endothelial dysfunction risk demonstrating a two way relationship between periodontitis and CVD. An ecosystem of various bacteria, fungi and viruses within the oral cavity forms the oral microbiota. Any imbalance of the microbial equilibrium leads to poor health and the oral cavity acts as a gateway for the micro-organisms to spread to other body parts. Mohammed et al. described the correlation between oral dysbiosis and the increased risk of pancreatic and liver diseases particularly with P. gingivalis and how oral microbes can be used for diagnosis of systemic diseases.[22]

Patini et al. identified new periodontal pathogens apart from the red complex. The presence of Desulfobulbus spp., Filifactor alocis and TM7 spp. associated with the biology of periodontitis. Hence, the control of oral bacteria is of great clinical relevance to prevent periodontitis.[23] The role of reactive oxygen species (ROS) in periodontitis and metabolic syndrome has also been evaluated.[24]

Blood groups perform a biological role, they have been used as genetic markers to study their correlations with various diseases. Further research needs to be done to find a correlation between the two and also on the molecular basis responsible for the same if at all the correlation exists.

Compliance with ethical standards

  1. Disclosure of potential conflicts of interest: None
  2. Research involving human participants: Approved by the institutional ethics committee
  3. Informed consent: Informed consent was obtained from all individual participants included in the study.


Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee (JSS Medical College institutional ethical committee with reference number JSSMC/IEC/2308/13 NCT/ 2019-20) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.


  Conclusion Top


The figure illustrates that by identifying the population at risk and taking preventive measures consequences can be reduced [Figure 2].
Figure 2 Systematic view of events representation the need of screening patients.

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The study revealed a significant correlation between ABO blood group and malocclusion. The prevalence of Angle’s Class I malocclusion being highest in blood group O (P < 0.001) followed by A, B and AB. Class II div I was more prevalent in ‘A’ (P < 0.001) followed by ‘B’ blood group. Correlation of Class III was found to be insignificant [Table 4]. No significant correlation could be established between the Rh factor and malocclusion.
Table 4 Correlation of malocclusion with blood group

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Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Sharma R, Preethi PN, Nagarathna C, Navin HK. Association of ABO Blood Groups with Malocclusion in Population of Jaipur, India: A Prospective Study. Int J Sci Stud 2015;2:45-51.  Back to cited text no. 1
    
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Demir T, Tezel A, Orbak R, Eltas A, Kara C, Kavrut F. The effect of ABO blood types on periodontal status. Eur J Dent 2007;1:139-43.  Back to cited text no. 5
    
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Chakravartti MR, Chakravartti R. ABO blood groups and chicken pox in an Indian population. Acta Geneticae Medicae et Gemellologiae 1977;26:297-8.  Back to cited text no. 7
    
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Singh N, Shukla MM, Uniyal VP, Sharma VP. ABO blood groups among malaria cases from district Mandla, Madhya Pradesh. Indian J Malariol 1995;32:59-63.  Back to cited text no. 8
    
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Raaghavan VM, Bailoor DN, Jhansirani P. Incidence of ABO blood groups in oral cancer in south Kanara district. J Indian Dent Assoc 1986;58:305-8.  Back to cited text no. 9
    
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Janardhana V, Propert DN, Green RE. ABO blood groups in hematologic malignancies. Cancer Genet Cytogenet 1991;51:113-20.  Back to cited text no. 10
    
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Glass RI, Holmgren J, Haley CE, Khan MR, Svennerholm AM, Stoll BJ et al. Predisposition for cholera of individuals with O blood group. Possible evolutionary significance. Am J Epidemiol 1985;121:791-6.  Back to cited text no. 12
    
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Kaur H, Pavithra US, Abraham R. Prevalence of malocclusion among adolescents in South Indian population. J Int Soc Prevent Communit Dent 2013;3:97-102.  Back to cited text no. 13
[PUBMED]  [Full text]  
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Angle EH. Classification of malocclusion. Dental Cosmos 1899;41:248-64.  Back to cited text no. 14
    
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Al-Khatieeb MM, Sami K Al-Joubori, Shaymaa Shaker. Association of ABO blood group and Rhesus factor with dental malocclusion in a population of Baghdad, Iraq. Int J Med Res Health Sci 2018;7:165-9.  Back to cited text no. 15
    
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Sharma R, Preethi PN, Nagarathna C, Navin HK. Association of ABO blood groups with malocclusion in population of Jaipur, India: a prospective study. Int J Sci Stud 2015;2:45-51.  Back to cited text no. 16
    
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Liccardo D, Cannavo A, Spagnuolo G, Ferrara N, Cittadini A, Rengo C et al. periodontal disease: a risk factor for diabetes and cardiovascular disease. Int J Mol Sci 2019;20:1414.  Back to cited text no. 17
    
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Isola G, Giudice AL, Polizzi A, Alibrandi A, Patini R, Ferlito S. Periodontitis and tooth loss have negative systemic impact on circulating progenitor cell levels: a clinical study. Genes 2019;10:1022.  Back to cited text no. 21
    
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Mohammed H, Varoni EM, Cochis A, Cordaro M, Gallenzi P, Patini R et al. Oral dysbiosis in pancreatic cancer and liver cirrhosis: a review of the literature. Biomedicines 2018;6:115.  Back to cited text no. 22
    
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Patini R, Staderini E, Lajolo C, Lopetuso L, Mohammed H, Rimondini L et al. Relationship between oral microbiota and periodontal disease: a systematic review. Eur Rev Med Pharmacol Sci 2018;22:5775-88.  Back to cited text no. 23
    
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    Figures

  [Figure 1], [Figure 2]
 
 
    Tables

  [Table 1], [Table 2], [Table 3], [Table 4]



 

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