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Clinical |
Department of Removable Prosthodontics1 and Department of Periodontology,2 Faculty of Dentistry, Istanbul University; Department of Nephrology,3 Haseki Training and Research Hospital; Department of Nephrology4 and Department of Public Health,5 Faculty of Medicine, Istanbul University, Istanbul, Turkey
Correspondence to: I. Kurtulus, Department of Periodontology, Faculty of Dentistry, Istanbul University, 34093, Capa, Istanbul, Turkey. idil_kurtulus{at}yahoo.com
Background/Aims: End-stage renal disease (ESRD)
patients have an increased risk of atherosclerotic complications. In both
hemodialysis (HD) patients and the general population, it has become evident
that inflammation plays an important role in the pathogenesis of
atherosclerotic complications. Oral and dental problems in ESRD patients could
be an important source of inflammation, thus treatment of these problems is
important to protect these patients from potential infections. The decayed,
missing, and filled teeth (DMFT) index is an indicator of oral and dental
health status. Our aim was to analyze and compare salivary flow rate (SFR),
salivary pH (SpH), salivary buffering capacity (SBC), and DMFT index and
plaque index (PI) values in PD patients to HD patients and healthy controls
(C) and establish the relationship between these parameters and C-reactive
protein (CRP). Methods: 76 PD patients, 100 HD patients, and 111 Cs
were included in the study. SFR (milliliters/minute) was measured in
stimulated whole saliva, SpH was measured using the Merck indicator, and SBC
was measured according to the method of Ericsson: 1 mL whole saliva was added
to 3 mL 0.005 N HCl and a stream of air was passed through this mixture for 20
minutes. Finally, DMFT index and PI values were calculated. Results: No statistically significant differences were
found in age or gender distribution among PD, HD, and C groups. There was also
no significant difference in time on dialysis between PD and HD groups. SFR
was significantly lower in the PD and HD groups than in the C group (1.30
± 0.83 and 0.70 ± 0.32 vs 1.64 ± 0.45 mL/min) and lower
in the HD than in the PD group (p < 0.001). SpH (8.35 ±
0.43 and 8.12 ± 0.74 vs 7.16 ± 0.76) and SBC (7.39 ± 0.47
and 6.82 ± 0.70 vs 5.08 ± 0.73) were significantly higher in the
PD and HD groups than in the C group and higher in the PD than in the HD group
(p < 0.05 and p < 0.001 respectively). The numbers of
filled teeth were significantly higher in the PD than in the HD and C groups
(p < 0.001). DMFT index was significantly higher in the PD than in
the HD group (p < 0.001). Finally, PI values were significantly
higher in the PD and HD groups than in the C group (p < 0.001) and
higher in the HD than in the PD group, although this was not statistically
significant. In the present study, we also found higher CRP values in HD than
in PD patients and a positive correlation between CRP and PI values in PD
patients. Conclusions: PD patients have higher SFR, SpH, and SBC
values than HD patients; however, higher DMFT index and higher numbers of
filled teeth were observed in PD patients. Compared to healthy controls,
patients on dialysis had worse dental and periodontal findings, which might
have a role in microinflammation in this group of patients.
KEY WORDS: Saliva; chronic renal insufficiency; decayed, missing, filled teeth; DMFT index.
Received 25 July 2007; accepted 7 August 2008.
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