COMPARATIVE ANALYSIS OF PERIODONTAL STATUS IN HEMODYALYSIS PATIENTS – A CLINICAL APPROACH

Alina Maria Andronovici, Irina Draga Căruntu, Loredana Hurjui, Cristiana Vlad, Liliana Foia

ABSTRACT

Introduction. Both periodontal disease and chronic kidney disease (CKD) are inflammatory disorders that considerably affect the patients’ overall health and life quality. Periodontal disease occurs somehow more often in CKD people, but it remains indeterminate whether periodontal disease is an independent risk factor in this population or what the true nature of their relationship is. Objectives. Our study focused on investigating the relationship between CKD and periodontitis, and the influence of the latter’s presence and severity on the former, through evaluation of the periodontal status in predialysis and dialysis CKD and healthy subjects with periodontitis. Materials and method.  The patients included in our study were divided in two groups, study (n=59) with end-stage CKD and periodontitis, and control (n=20), with periodontitis but without renal impairment. All the subjects underwent dental and periodontal evaluation, using parameters common in clinical examination (Periodontal Disease Index –PDI, dental mobility, bleeding on probing – BOP, inflammatory hyperplasia, gingival recession, probing depth – PD and clinical attachment loss – CAL). Both groups also answered questions about their meal plan and oral hygiene habits and their access to dental care. Results. There were visible differences between the groups when considering social and economic status and access to dental and periodontal services, which is relevant for the distribution of periodontal disease severity between groups (56% from the study group had severe periodontitis, with only 10% in the control group). The study group also had more missing teeth, deeper periodontal pockets and more signs of inflammation. It is still unclear if this is due only to low social and economic status or is it a consequence of CKD and hemodialysis. Conclusions. There is a link between the two entities, but it is still unclear if this is due just to the pathophysiology of periodontitis and CKD, or are the external and local factors involved. Further investigation is needed to clarify this issue and to be able to produce viable prevention and treatment programs for people with end-stage CKD

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