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Yang F, Shu CJ, Wang CJ, Chen K. Meta-analysis of the association between chronic periodontitis and chronic kidney disease. World J Clin Cases 2024; 12:5094-5107. [DOI: 10.12998/wjcc.v12.i22.5094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2024] [Revised: 06/03/2024] [Accepted: 06/17/2024] [Indexed: 06/30/2024] Open
Abstract
BACKGROUND Many scholars have performed several clinical studies have investigated the association between chronic periodontitis (CP) and chronic kidney disease (CKD). However, there are still differences between these research results, and there is no unified conclusion. Therefore, a systematic review is required to understand this issue fully.
AIM To explore the correlation between CP and CKD.
METHODS Literature on the correlation between CP and CKD, as well as the clinical attachment level (CAL) and pocket probing depth (PPD) of CKD and non-CKD, were retrieved from PubMed, Embase, the Cochrane Library, and Web of Science repositories until January 2024. After the effective data were extracted, data processing and statistics were performed using Stata 12.0.
RESULTS Of the 22 studies, 13 were related to CP and CKD, and 9 reported CAL and PPD in patients with CKD and healthy controls. Meta-analysis of the correlation between CP and CKD revealed that CKD probability in people with CP was 1. 54 times that of healthy individuals [relative risk = 1.54, 95% confidence interval (CI): 1.40–1.70], and CP incidence in patients with CKD was 1. 98 times that of healthy individuals [overall risk (OR) = 1.98, 95%CI: 1.53–2.57]. Meta-analysis of CAL and PPD evaluations between CKD patients and healthy individuals showed that CAL and PPD levels were higher in CKD patients [standard mean difference (SMD) of CAL = 0.65, 95%CI: 0.29–1.01; SMD of PPD = 0.33, 95%CI: 0.02–0.63].
CONCLUSION A bidirectional association exists between CP and CKD. CKD risk is increased in CP patients and vice versa. Periodontal tissue or tooth loss risks increase over time in CKD patients.
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Affiliation(s)
- Fu Yang
- Department of Stomatology, Yuyao People’s Hospital of Zhejiang Province, Yuyao 315400, Zhejiang Province, China
| | - Cheng-Jun Shu
- Department of Stomatology, Yuyao People’s Hospital of Zhejiang Province, Yuyao 315400, Zhejiang Province, China
| | - Cai-Jun Wang
- Department of Stomatology, Yuyao People’s Hospital of Zhejiang Province, Yuyao 315400, Zhejiang Province, China
| | - Ke Chen
- Department of Stomatology, Yuyao People’s Hospital of Zhejiang Province, Yuyao 315400, Zhejiang Province, China
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Dembowska E, Jaroń A, Gabrysz-Trybek E, Bladowska J, Trybek G. Oral Mucosa Status in Patients with End-Stage Chronic Kidney Disease Undergoing Hemodialysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:835. [PMID: 36613157 PMCID: PMC9819349 DOI: 10.3390/ijerph20010835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Revised: 12/22/2022] [Accepted: 12/30/2022] [Indexed: 06/17/2023]
Abstract
There are reports in the literature of interrelationships between chronic kidney disease and periodontitis pathophysiology; similar risk factors play a role in these conditions. Due to chronic kidney disease (CKD), patients on hemodialysis (HD) are more susceptible to developing pathological processes in the gingiva, periodontium, and oral mucosa. This study aimed to evaluate the condition of the oral cavity, with particular attention to lesions of the oral mucosa of patients with end-stage renal disease in Poland, West Pomeranian Voivodship. A case-control study assessed oral health in 200 Polish subjects, including 100 dialysis-station patients who constituted the study group (HD) and 100 healthy patients who formed the control group (K). The physical examination consisted of a general medical and dental history. Evaluation of the oral mucosa included detailed noting of the type of lesions, nature of complaints, and their location. The results showed a higher prevalence of oral lesions highlighting oral mucosal pathology in patients with HD than in group K. Most common symptoms reported by patients with CKD (HD) were xerostomia, taste disorders, and burning mouth. These findings highlight the need to implement comprehensive multispecialty care in patients with chronic systemic diseases.
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Affiliation(s)
- Elżbieta Dembowska
- Specialized Center of Dentistry-Elzbieta Dembowska, al. Bohaterow Warszawy 11b/5, 70-370 Szczecin, Poland
| | - Aleksandra Jaroń
- 4th Military Clinical Hospital in Wroclaw, ul. Rudolfa Weigla 5, 50-981 Wroclaw, Poland
- Department of Oral Surgery, Pomeranian Medical University in Szczecin, 70-111 Szczecin, Poland
| | - Ewa Gabrysz-Trybek
- Individual Specialist Medical Practice Ewa Gabrysz-Trybek, 70-111 Szczecin, Poland
| | - Joanna Bladowska
- Department of General and Interventional Radiology and Neuroradiology, Wroclaw Medical University, M. Curie-Skłodowskiej 68, 50-369 Wrocław, Poland
| | - Grzegorz Trybek
- 4th Military Clinical Hospital in Wroclaw, ul. Rudolfa Weigla 5, 50-981 Wroclaw, Poland
- Department of Oral Surgery, Pomeranian Medical University in Szczecin, 70-111 Szczecin, Poland
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3
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The Evaluation of the Periodontal Status of Hemodialysis Patients with End-Stage Renal Disease. J Clin Med 2022; 11:jcm11040975. [PMID: 35207246 PMCID: PMC8877353 DOI: 10.3390/jcm11040975] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 02/07/2022] [Accepted: 02/11/2022] [Indexed: 02/01/2023] Open
Abstract
Chronic kidney disease (CKD) is an increasingly common condition observed in developing countries. Similarly, a high prevalence of gingivitis and periodontitis is observed. There are reports in the literature about the interrelationship between chronic kidney disease and periodontitis pathophysiology. This dissertation attempts to: assess the extent of gingivitis and periodontitis in a group of patients with the end-stage renal disease treated with hemodialysis compared to healthy subjects. The study included 200 subjects: 100 hemodialysis patients (HD) and 100 healthy control subjects (K). Periodontal status was assessed by measuring pocket depth (PD) clinical level of connective tissue attachment (CAL). Gingival inflammation indices Gingival Index (GI) and Bleeding on Probing (BOP) were also performed. PD with a depth of more than 6mm was found in 25% of the HD group and 5% of the K group. CAL ≥ 5 mm was found in 55% of HD and 24% of the K group. As defined by Page and Eke, severe periodontitis was found in 21% of HD, and 4% of K. Moderate gingivitis was noted in 55% of HD and 5% of the K group. The mean values of the BOP index in the HD group were 32.08% and in the K group 3.09%. The HD group had a higher incidence and severity of gingivitis and periodontitis than the control group.
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Zhong W, Peng Y, Yue E, Huang B, Zhang W, Zhao Z, Jiang J, Wang Q, Zhao H. Gingival crevicular fluid levels of SLIT3 are increased in periodontal disease. Oral Dis 2019; 26:182-192. [PMID: 31696592 DOI: 10.1111/odi.13227] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Revised: 10/25/2019] [Accepted: 10/30/2019] [Indexed: 12/01/2022]
Abstract
This study aims to investigate the levels of SLIT3 in gingival crevicular fluid (GCF) of healthy and periodontal disease subjects, and their correlations to periodontal disease. A total of 45 periodontal patients and 45 periodontally healthy volunteers were enrolled. The clinical parameters, radiographic bone loss and the levels of SLIT3, receptor activator of NF-κB ligand (RANKL) and osteoprotegerin (OPG) in GCF were measured. The prevalences of Porphyromonas gingivalis, Treponema denticola, and Tannerella forsythia in subgingival plaque were also analyzed. The expression of SLIT3 and RANKL was detected in the periodontium of experimental periodontitis in rats and lipopolysaccharide (LPS)-induced mouse macrophage. The total amounts and concentrations of SLIT3 and RANKL were significantly higher in periodontitis than those in healthy, while the level of OPG was significantly lower (p < .05). Significant positive correlations were observed between the level of GCF SLIT3 and clinical attachment level and radiographic bone loss (p < .05). There existed a significant positive correlation between SLIT3 and RANKL (p < .05). Increased expression of SLIT3 and RANKL was observed in the periodontium of periodontal rats. SLIT3 expression was induced by LPS stimulation in macrophages. These results suggest that SLIT3 may act as a diagnostic indicator of periodontal disease and should be further investigated.
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Affiliation(s)
- Wei Zhong
- Department of Stomatology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Youmei Peng
- Henan Key Laboratory for Pharmacology of Liver Diseases, Institute of Medical and Pharmaceutical Sciences, Zhengzhou University, Zhengzhou, China
| | - Erli Yue
- Department of Stomatology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Bin Huang
- Department of Stomatology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Wei Zhang
- Department of Stomatology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Zhe Zhao
- Department of Stomatology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Jinhua Jiang
- Henan Key Laboratory for Pharmacology of Liver Diseases, Institute of Medical and Pharmaceutical Sciences, Zhengzhou University, Zhengzhou, China
| | - Qingduan Wang
- Henan Key Laboratory for Pharmacology of Liver Diseases, Institute of Medical and Pharmaceutical Sciences, Zhengzhou University, Zhengzhou, China
| | - Hongyu Zhao
- Department of Stomatology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
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5
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Periodontal Disease in Patients Receiving Dialysis. Int J Mol Sci 2019; 20:ijms20153805. [PMID: 31382656 PMCID: PMC6695931 DOI: 10.3390/ijms20153805] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2019] [Revised: 08/01/2019] [Accepted: 08/01/2019] [Indexed: 12/13/2022] Open
Abstract
Chronic kidney disease (CKD) is characterized by kidney damage with proteinuria, hematuria, and progressive loss of kidney function. The final stage of CKD is known as end-stage renal disease, which usually indicates that approximately 90% of normal renal function is lost, and necessitates renal replacement therapy for survival. The most widespread renal replacement therapy is dialysis, which includes peritoneal dialysis (PD) and hemodialysis (HD). However, despite the development of novel medical instruments and agents, both dialysis procedures have complications and disadvantages, such as cardiovascular disease due to excessive blood fluid and infections caused by impaired immunity. Periodontal disease is chronic inflammation induced by various pathogens and its frequency and severity in patients undergoing dialysis are higher compared to those in healthy individuals. Therefore, several investigators have paid special attention to the impact of periodontal disease on inflammation-, nutrient-, and bone metabolism-related markers; the immune system; and complications in patients undergoing dialysis. Furthermore, the influence of diabetes on the prevalence and severity of manifestations of periodontal disease, and the properties of saliva in HD patients with periodontitis have been reported. Conversely, there are few reviews discussing periodontal disease in patients with dialysis. In this review, we discuss the available studies and review the pathological roles and clinical significance of periodontal disease in patients receiving PD or HD. In addition, this review underlines the importance of oral health and adequate periodontal treatment to maintain quality of life and prolong survival in these patients.
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Kapellas K, Singh A, Bertotti M, Nascimento GG, Jamieson LM. Periodontal and chronic kidney disease association: A systematic review and meta-analysis. Nephrology (Carlton) 2019; 24:202-212. [PMID: 29359889 DOI: 10.1111/nep.13225] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/17/2018] [Indexed: 12/19/2022]
Abstract
AIM Chronic kidney disease (CKD) and kidney failure is increasing globally and evidence from observational studies suggest periodontal disease may contribute to kidney functional decline. METHODS Electronic searches of the PubMed, EMBASE, Web of Science, Scopus and Cochrane Library databases were conducted for the purposes of conducting a systematic review. Hand searching of reference lists was also performed. Meta-analysis of observational studies involving periodontal disease and chronic kidney disease in adults was performed. RESULTS A total of 17 studies was selected from an initial 4055 abstracts. Pooled estimates indicated the odds of having CKD were 60% higher among patients with periodontitis: pooled OR 1.60 (95% CI 1.44-1.79, I2 35.2%, P = 0.11) compared to those without. Conversely, a similar magnitude but non-significant higher odds of having periodontal disease was found among people with CKD 1.69 (95% CI: 0.84, 3.40, I2 = 89.8%, P < 0.00) versus non-CKD. Meta-regression revealed study quality based on the Newcastle-Ottawa Scale and statistical adjustment for potential confounders explained almost 35% of the heterogeneity in the studies investigating the association between CKD and periodontitis. CONCLUSIONS Moderate evidence for a positive association between periodontitis and CKD exists. Evidence for the opposite direction is extremely weak based on significant heterogeneity between studies.
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Affiliation(s)
- Kostas Kapellas
- Australian Research Centre for Population Oral Health, The University of Adelaide, Adelaide, South Australia, Australia
| | - Ankur Singh
- Australian Research Centre for Population Oral Health, The University of Adelaide, Adelaide, South Australia, Australia.,Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Maitê Bertotti
- School of Dentistry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Gustavo G Nascimento
- Department of Dentistry and Oral Health, Aarhus Universitet Institut for Odontologi, Aarhus, Denmark
| | - Lisa M Jamieson
- Australian Research Centre for Population Oral Health, The University of Adelaide, Adelaide, South Australia, Australia
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Chopra A, Sivaraman K. An update on possible pathogenic mechanisms of periodontal pathogens on renal dysfunction. Crit Rev Microbiol 2019; 45:514-538. [PMID: 30729832 DOI: 10.1080/1040841x.2018.1553847] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Periodontitis is a potential source of permanent systemic inflammation that initiates renal dysfunction and contributes to the development of chronic kidney diseases (CKDs). Although numerous studies have confirmed the bidirectional role of periodontal infection and renal inflammation, no literature has yet highlighted the sophisticated pathogenic mechanisms by which periodontal pathogens, particularly Porphynomonas Gingivalis, induce renal dysfunction and contributed in the development of CKDs. The present review aims to critically analyze and highlight the novel pathogenesis of periodontitis induced CKDs.
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Affiliation(s)
- Aditi Chopra
- Department of Periodontology, Manipal College of Dental Sciences, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Karthik Sivaraman
- Department of Prosthodontics, Manipal College of Dental Sciences, Manipal Academy of Higher Education, Manipal, Karnataka, India
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Durand R, Roufegarinejad A, Chandad F, Rompré PH, Voyer R, Michalowicz BS, Emami E. Dental caries are positively associated with periodontal disease severity. Clin Oral Investig 2019; 23:3811-3819. [PMID: 30693397 DOI: 10.1007/s00784-019-02810-6] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2018] [Accepted: 01/11/2019] [Indexed: 12/29/2022]
Abstract
OBJECTIVES To examine associations between periodontal disease severity and clinical and microbiological measures of caries in adults. MATERIALS AND METHODS A cross-sectional study of 94 healthy adults ((mean ± SD) 55.4 ± 13.0 years) was conducted. Data were collected by means of questionnaire and a clinical examination that included the Decayed, Missing, Filled teeth Surfaces (DMFS) index, probing depth (PD), clinical attachment level (CAL), and gingival bleeding and plaque scores. Supra- and subgingival plaque samples were collected to assess the presence of Streptococcus mutans and six periodontal pathogens. Participants were subsequently categorized using Center for Disease Control and Prevention/American Academy of Periodontology (CDC-AAP) definitions and tertiles of percentage of sites with CAL ≥ 3mm. RESULTS Significant positive associations were found between the periodontal disease severity (CDC-AAP) and the DMFS (aOR = 1.03; 95% CI 1.01-1.05) and DS indices (aOR = 1.18; 95% CI 1.05-1.32) as well as between the tertiles of percentage of sites with CAL ≥ 3 mm and DMFS (aOR = 1.03; 95% CI 1.00-1.05) and DS indices (aOR = 1.12; 95% CI 1.00-1.25). A significant positive association was also found between oral levels of F. nucleatum and S. mutans (aOR = 6.03; 95% CI 1.55-23.45). CONCLUSIONS A small but positive association was found between clinical measures of caries and periodontal disease severity. Further research is warranted to examine the association between these two common oral diseases. CLINICAL RELEVANCE Periodontal diseases and caries are the two most common oral diseases. There was a positive association between clinical and microbiological markers of both diseases. Therefore, strategies in oral health education should involve both caries and periodontitis prevention.
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Affiliation(s)
- Robert Durand
- Département de santé buccale, Faculté de médecine dentaire, Université de Montréal, C.P. 6128, succursale Centre-Ville, Montréal, QC, H3C 3J7, Canada.
| | | | - Fatiha Chandad
- Groupe de recherche en écologie buccale, Faculté de médecine dentaire, Université Laval, Québec, Canada
| | - Pierre H Rompré
- Département de stomatologie, Faculté de médecine dentaire, Université de Montréal, Montréal, Canada
| | - René Voyer
- Département de santé buccale, Faculté de médecine dentaire, Université de Montréal, C.P. 6128, succursale Centre-Ville, Montréal, QC, H3C 3J7, Canada
| | | | - Elham Emami
- Département de dentisterie de restauration, Faculté de médecine dentaire, Université de Montréal, Montréal, Canada
- Faculty of Dentistry, McGill University, Montréal, Canada
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9
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Limeira FIR, Yamauti M, Moreira AN, Galdino TM, de Magalhães CS, Abreu LG. Dental caries and developmental defects of enamel in individuals with chronic kidney disease: Systematic review and meta-analysis. Oral Dis 2018; 25:1446-1464. [PMID: 30338628 DOI: 10.1111/odi.12993] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Revised: 10/07/2018] [Accepted: 10/09/2018] [Indexed: 12/20/2022]
Abstract
OBJECTIVE To evaluate studies assessing the prevalence of dental caries and developmental defects of enamel (DDE) in individuals with chronic kidney disease (CKD) in comparison with individuals without CKD. MATERIALS AND METHODS Electronic searches were performed in PubMed, Web of Science, Scopus, Medline via Ovid, and ProQuest databases from their inception date until February 2018. Two review authors independently selected the studies, extracted data, and assessed the methodological quality. Meta-analysis was performed. RESULTS Twenty-seven studies were included in this study. For permanent teeth, 14 studies found that individuals without CKD had higher dental caries scores than those with CKD. However, only five studies presented results with a statistically significant difference between groups. Among the studies evaluating primary teeth, five showed that individuals without CKD had higher dental caries scores than those with CKD. Five studies showed that individuals with CKD had a significantly higher prevalence of DDE than individuals without CKD. The meta-analyses showed that individuals without CKD had significantly higher scores of dental caries teeth and surfaces than individuals with CKD. For DDE, no statistical difference between groups was observed. CONCLUSIONS Individuals with CKD present lower dental caries scores and a higher prevalence of DDE in comparison with individuals without CKD.
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Affiliation(s)
| | - Monica Yamauti
- Department of Restorative Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Allyson Nogueira Moreira
- Department of Restorative Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Tuélita Marques Galdino
- Post-Graduate Program in Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Cláudia Silami de Magalhães
- Department of Restorative Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Lucas Guimarães Abreu
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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10
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Andrade MRTC, Curvelo JADR, de Moraes DC, Portela M, Ferreira-Pereira A, Soares RMDA, Primo LG. Salivary pH and colonization by oral Candida in children and adolescents submitted to haemodialysis. Int J Paediatr Dent 2018; 28:533-539. [PMID: 29974548 DOI: 10.1111/ipd.12403] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Fungal infections are a serious problem among haemodialysis patients. AIM The aims of this study were to estimate the frequency of oral Candida species among children and adolescents undergoing haemodialysis (HD), to identify the isolated species, and to study the relationship between haemodialysis duration, amounts of colony-forming units, and salivary pH. DESIGN A matched sample of 52 patients undergoing HD and 52 healthy individuals were selected. The samples were obtained from the dorsum of the tongue, and the colonies were identified through a substrate assimilation test. Stimulated whole saliva was collected from each patient for evaluation of salivary pH. RESULTS The frequency of oral Candida species was 34.6% (18/52) and 46.20% (24/52) in the HD and control groups (P = 0.23), respectively. Candida parapsilosis complex was the most frequently isolated fungi species in the HD group (P = 0.03). A HD therapy duration of more than 1 year was statistically correlated with a higher number of colony-forming units (P = 0.03) but was not statistically related to salivary pH. CONCLUSIONS Candida parapsilosis complex was the most frequently isolated fungal species in the young HD patients, and the duration therapy was associated with higher oral colonization.
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Affiliation(s)
| | | | - Daniel Clemente de Moraes
- Institute of Microbiology Professor Paulo de Goés, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brasil
| | - Maristela Portela
- Department of Clinics and Pediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal Fluminense, Niteroi, RJ, Brasil
| | - Antonio Ferreira-Pereira
- Institute of Microbiology Professor Paulo de Goés, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brasil
| | | | - Laura Guimarães Primo
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brasil
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Zhao D, Khawaja AT, Jin L, Li KY, Tonetti M, Pelekos G. The directional and non-directional associations of periodontitis with chronic kidney disease: A systematic review and meta-analysis of observational studies. J Periodontal Res 2018; 53:682-704. [PMID: 29777531 DOI: 10.1111/jre.12565] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/28/2018] [Indexed: 12/11/2022]
Abstract
This systematic review aimed to assess the current evidence on the directional and non-directional associations of periodontitis with chronic kidney disease (CKD). Electronic search for observational studies on the association of periodontitis with CKD was performed in MEDLINE, EMBASE, PubMed, Open GREY and Cochrane library up to June 5, 2017. Two reviewers conducted study selection, data collection and assessment of methodological quality using the original and modified Newcastle-Ottawa Scale. Cohort, case-control and cross-sectional studies were included, which clearly defined periodontitis and CKD or reported acceptable clinical parameters of these 2 diseases in adults. Meta-analysis was employed to estimate the pooled odds ratio on the non-directional association and the incidence rate ratio (IRR) for the directional association. Among 2530 potential eligible articles, 47 were finally included. Most of them investigated a non-directional association of periodontitis with CKD, including 7 case-control studies and 38 cross-sectional studies; 24 studies had statistical analysis on the non-directional association and 75% of them reported significant results, which were supported further by the meta-analysis (random: odds ratio = 2.12, P < .001; χ2 = 25.74, I2 = 88.3%). None of the studies focused on the directional association of CKD (as the exposure) with periodontitis (as the outcome), whereas 2 retrospective cohort studies explored a directional association of periodontitis (as the exposure) with CKD (as the outcome) (random: IRR=2.10, P > .05; fixed: IRR=1.76, P < .05; χ2 = 4.65, I2 = 78.3%). Overall, the high heterogeneity of studies limits the significance of these results. There is substantial evidence on the non-directional association of periodontitis with CKD, while there are limited studies on the directional association. Well-designed prospective studies with longer follow-ups in representative communities are needed to clarify the directional association and enhance the quality of the evidence on this topic.
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Affiliation(s)
- D Zhao
- Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - A T Khawaja
- Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - L Jin
- Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - K-Y Li
- Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - M Tonetti
- Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - G Pelekos
- Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
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12
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Parente IT, Lima ZR, Teixeira LH, Lisboa MR, de Melo IM, Santos PR, Goes P. Gingivitis, increased probing depth, clinical attachment loss and tooth loss among patients with end-stage chronic kidney disease: a case-control study. J Public Health (Oxf) 2017. [DOI: 10.1007/s10389-017-0833-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
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Kim YJ, Moura LMD, Caldas CP, Perozini C, Ruivo GF, Pallos D. Evaluation of periodontal condition and risk in patients with chronic kidney disease on hemodialysis. EINSTEIN-SAO PAULO 2017; 15:173-177. [PMID: 28767915 PMCID: PMC5609613 DOI: 10.1590/s1679-45082017ao3867] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2016] [Accepted: 02/17/2017] [Indexed: 01/02/2023] Open
Abstract
Objective To establish a profile of periodontal conditions in chronic kidney disease patients on hemodialysis and their periodontal risk. Methods We included 115 patients on hemodialysis. Clinical periodontal parameters assessed were: plaque index, gingival index, probing depth and clinical attachment level. Patients were classified according to presence/absence and severity of periodontal disease and periodontal risk. Results In 107 dentate patients (93%) the plaque index was 1.53±0.78, the gingival index was 0.95±0.85, the probing depth was 2.2±0.6mm and the clinical attachment level was 3.18±1.75mm. We observed that 1 patient (0.94%) did not have periodontal disease, 55 patients (51.40%) had slight, 28 (26.17%) moderate and 23 (21.49%) severe periodontal disease. Among 107 patients, 37 (34.58%) had low risk, 35 (32.71%) moderate risk and 35 (32.71%) high risk. Patients with severe periodontal disease showed 104.5 more chance of high risk compared with low risk individuals (odds ratio: 104.5; 95%CI: 10.7-1017.2; p<0.0001). Conclusion Most of patients with chronic renal disease presented periodontal disease, indicating the presence of chronic inflammatory and infection process that may influence in systemic conditions. A prevention and interventionist approach in this population is needed, especially to emphasize the importance of oral health. The periodontal risk assessment is a useful tool to create individualized periodontal therapies and to improve general health condition.
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Zhang J, Jiang H, Sun M, Chen J. Association between periodontal disease and mortality in people with CKD: a meta-analysis of cohort studies. BMC Nephrol 2017; 18:269. [PMID: 28814274 PMCID: PMC5558661 DOI: 10.1186/s12882-017-0680-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2017] [Accepted: 07/28/2017] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Periodontal disease occurs relatively prevalently in people with chronic kidney disease (CKD), but it remains indeterminate whether periodontal disease is an independent risk factor for premature death in this population. Interventions to reduce mortality in CKD population consistently yield to unsatisfactory results and new targets are necessitated. So this meta-analysis aimed to evaluate the association between periodontal disease and mortality in the CKD population. METHODS Pubmed, Embase, Web of Science, Scopus and abstracts from recent relevant meeting were searched by two authors independently. Relative risks (RRs) with 95% confidence intervals (CIs) were calculated for overall and subgroup meta-analyses. Statistical heterogeneity was explored by chi-square test and quantified by the I2 statistic. RESULTS Eight cohort studies comprising 5477 individuals with CKD were incorporated. The overall pooled data demonstrated that periodontal disease was associated with all-cause death in CKD population (RR, 1.254; 95% CI 1.046-1.503; P = 0.005), with a moderate heterogeneity, I2 = 52.2%. However, no evident association was observed between periodontal disease and cardiovascular mortality (RR, 1.30, 95% CI, 0.82-2.06; P = 0.259). Besides, statistical heterogeneity was substantial (I2 = 72.5%; P = 0.012). Associations for mortality were similar between subgroups, such as the different stages of CKD, adjustment for confounding factors. Specific to all-cause death, sensitivity and cumulative analyses both suggested that our results were robust. As for cardiovascular mortality, the association with periodontal disease needs to be further strengthened. CONCLUSIONS We demonstrated that periodontal disease was associated with an increased risk of all-cause death in CKD people. Yet no adequate evidence suggested periodontal disease was also at elevated risk for cardiovascular death.
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Affiliation(s)
- Jian Zhang
- Kidney Disease Center, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, 310003, People's Republic of China
- Kidney Disease Immunology Laboratory, The Third Grade Laboratory, State Administration of Traditional Chinese Medicine of PR China, Hangzhou, People's Republic of China
- Key Laboratory of Multiple Organ Transplantation, Ministry of Health, Key Laboratory of Nephropathy, Hangzhou, Zhejiang Province, People's Republic of China
| | - Hong Jiang
- Kidney Disease Center, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, 310003, People's Republic of China.
- Kidney Disease Immunology Laboratory, The Third Grade Laboratory, State Administration of Traditional Chinese Medicine of PR China, Hangzhou, People's Republic of China.
- Key Laboratory of Multiple Organ Transplantation, Ministry of Health, Key Laboratory of Nephropathy, Hangzhou, Zhejiang Province, People's Republic of China.
| | - Min Sun
- Department of General Surgery, Taihe Hospital, Hubei University of Medicine, Shiyan, 442000, People's Republic of China
| | - Jianghua Chen
- Kidney Disease Center, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, 310003, People's Republic of China.
- Kidney Disease Immunology Laboratory, The Third Grade Laboratory, State Administration of Traditional Chinese Medicine of PR China, Hangzhou, People's Republic of China.
- Key Laboratory of Multiple Organ Transplantation, Ministry of Health, Key Laboratory of Nephropathy, Hangzhou, Zhejiang Province, People's Republic of China.
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Medical and Periodontal Clinical Parameters in Patients at Different Levels of Chronic Renal Failure. Int J Dent 2017; 2017:9858073. [PMID: 28473854 PMCID: PMC5394392 DOI: 10.1155/2017/9858073] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2016] [Revised: 02/13/2017] [Accepted: 02/27/2017] [Indexed: 02/02/2023] Open
Abstract
Aim. To assess the clinical periodontal and medical parameters in patients with chronic renal failure (CRF) at different levels of renal disease. Background. CRF is a progressive and irreversible loss of renal function associated with a decline in the glomerular filtration rate. Periodontal disease is a destructive inflammatory disease affecting periodontal tissues that shows high prevalence in patients with CRF. Materials and Methods. 102 CRF patients were included and divided into an early stage group (EG), predialysis group (PDG), and hemodialysis group (HDG). The medical parameters were taken from the patients' records. Results. Periodontal clinical condition differed among the CRF groups. Clinical attachment loss was greater in the HDG and PDG group compared to the EG (p = 0.0364); the same was observed in the Plaque Index (p = 0.0296); the others periodontal parameters did not show any differences. Ferritin levels were significantly higher in the HDG when compared to the EG and PGD (p < 0.0001), and fibrinogen was higher in PDG compared with the others (p < 0.0001); the triglycerides also showed higher values in the HDG compared with the other groups (p < 0.0001). Conclusion. The patients with renal involvement should have a multidisciplinary approach to an improvement in their oral and systemic health.
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Xi W, Bo H, Haiyang P, Chang L, Jinlin S, Ming T. [Oral health status of patients undergoing hemodialysis: a Meta-analysis]. HUA XI KOU QIANG YI XUE ZA ZHI = HUAXI KOUQIANG YIXUE ZAZHI = WEST CHINA JOURNAL OF STOMATOLOGY 2017; 35:155-161. [PMID: 28682545 DOI: 10.7518/hxkq.2017.02.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
OBJECTIVE This study aimed to systematically evaluate the oral health status of patients suffering from chronic renal failure and undergoing hemodialysis (HD). METHODS Electronic databases, namely, China National Knowledge Infrastructure, Wanfang Data base, PubMed, Web of Science, and Cochrane Library, were searched until May 2016 for cross-sectional and case-control studies that investigated the oral health status of patients suffering from chronic renal failure and undergoing HD. Two reviewers independently screened the trials, extracted the data, assessed the quality, and conducted a Meta-analysis with RevMan 5.3 in accordance with the inclusion and exclusion criteria. RESULTS Sixteen studies satisfied the eligibility criteria. Meta-analysis revealed that plaque index (MD=0.62, 95%CI: 0.51-0.72), calculus index (MD=1.09, 95%CI: 0.56-1.63), probing depth (MD=0.63, 95%CI: 0.29-0.98), and attachment loss (MD=0.63, 95%CI: 0.56-0.69) were significantly higher in the patients undergoing HD than in the healthy control group (P<0.01). No significant differences in decayed missing filled teeth (MD=1.12, 95%CI: -1.08-3.32) were observed between the patients undergoing HD and the healthy control group (P=0.32). CONCLUSIONS The prevalence of caries in patients undergoing HD is similar to that in the healthy control group. However, these patients are at a higher risk of acquiring periodontal diseases than the healthy control group. Thus, the oral health status of these patients should be further evaluated in clinical treatments.
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Affiliation(s)
- Wei Xi
- Dept. of Stomatology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
| | - Hu Bo
- College of Stomatology, Chongqing Medical University, Chongqing 401147, China
| | - Peng Haiyang
- Dept. of Stomatology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
| | - Liu Chang
- Dept. of Stomatology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
| | - Song Jinlin
- College of Stomatology, Chongqing Medical University, Chongqing 401147, China
| | - Tang Ming
- Dept. of Stomatology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
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Schmalz G, Schiffers N, Schwabe S, Vasko R, Müller GA, Haak R, Mausberg RF, Ziebolz D. Dental and periodontal health, and microbiological and salivary conditions in patients with or without diabetes undergoing haemodialysis. Int Dent J 2017; 67:186-193. [PMID: 28547773 DOI: 10.1111/idj.12282] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVE The aim of this cross-sectional study was to evaluate the dental and periodontal health, as well as the microbiological and salivary conditions, of patients with and without diabetes mellitus (DM) who are receiving haemodialysis. METHODS One-hundred and fifty-nine haemodialysis patients were included and divided into groups according to the pre-existing diabetes status: DM or no DM. The oral examination included dental findings and assessment of the periodontal situation. The periodontal condition was classified as healthy/mild, moderate or severe periodontitis. Subgingival biofilm samples were analysed using the polymerase chain reaction. The salivary diagnostics included measurement of unstimulated and stimulated salivary flow, pH and buffer capacity. Statistical analyses used Fisher's test, the t-test and the Mann-Whitney U-test (α = 5%). RESULTS The dental findings showed no significant difference between patients with and without DM (P = 0.44). The prevalence of periodontitis was high (96% in patients with DM and 97% in patients who did not have DM) and there was no significant difference between the groups (P = 0.71). There was a higher prevalence of Porphyromonas gingivalis, Parvimonas micros, Eubacterium nucleatum and Capnocytophaga spp. in patients without DM (P < 0.05). The salivary pH was significantly higher in patients without DM (P < 0.01). CONCLUSION While differences in the prevalence of periodontal pathogenic bacteria and in the salivary pH were detected between the groups, the dental and periodontal status was comparable between patients with and without DM. Accordingly, DM appears to have no decisive influence on the oral health in patients treated with haemodialysis who have well-controlled diabetes.
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Affiliation(s)
- Gerhard Schmalz
- Department of Cariology, Endodontology, and Periodontology, University of Leipzig, Leipzig, Germany
| | - Nora Schiffers
- Department of Cariology, Endodontology, and Periodontology, University of Leipzig, Leipzig, Germany.,Department of Preventive Dentistry, Periodontology, and Cariology, University Medical Center Goettingen, Goettingen, Germany
| | - Sandra Schwabe
- Department of Preventive Dentistry, Periodontology, and Cariology, University Medical Center Goettingen, Goettingen, Germany
| | - Radovan Vasko
- Department of Nephrology and Rheumatology, University Medical Center Goettingen, Goettingen, Germany
| | - Gerhard A Müller
- Department of Nephrology and Rheumatology, University Medical Center Goettingen, Goettingen, Germany
| | - Rainer Haak
- Department of Cariology, Endodontology, and Periodontology, University of Leipzig, Leipzig, Germany
| | - Rainer F Mausberg
- Department of Preventive Dentistry, Periodontology, and Cariology, University Medical Center Goettingen, Goettingen, Germany
| | - Dirk Ziebolz
- Department of Cariology, Endodontology, and Periodontology, University of Leipzig, Leipzig, Germany
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Rezazadeh F, Bazargani A, Roozbeh-Shahroodi J, Pooladi A, Arasteh P, Zamani K. Comparison of oral Lactobacillus and Streptococcus mutans between diabetic dialysis patients with non-diabetic dialysis patients and healthy people. J Renal Inj Prev 2016; 5:148-52. [PMID: 27689112 PMCID: PMC5040002 DOI: 10.15171/jrip.2016.31] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2016] [Accepted: 07/01/2016] [Indexed: 11/09/2022] Open
Abstract
INTRODUCTION Diabetes is associated with higher rates of caries, on the other hand some studies have shown that renal failure can be protective against dental caries. OBJECTIVES In this study we compared oral Lactobacillus and Streptococcus mutans between diabetic dialysis and non-diabetic dialysis patients and the normal population. PATIENTS AND METHODS During November 2014 to January 2014, 85 people that referred to our medical care center entered the study. The sample included 30 diabetic dialysis, 28 non-diabetic dialysis patients and 27 healthy people. Oral saliva samples were obtained from their tongue and oral floor for microbiological examination. Patients' data were compared before and after dialysis. RESULTS The amount of Lactobacillus and S. mutans did not show a significant difference between the three groups (P=0.092 and P=0.966 for S. mutans and lactobacillus, respectively). A positive and meaningful correlation was seen between fasting blood sugar (FBS) levels and the amount of S. mutans in the diabetic dialysis group (P=0.023; r=0.413). A meaningful and positive correlation was also seen between the amount of blood urea nitrogen (BUN) after dialysis and the amount of oral S. mutans in the non-diabetic dialysis group (P=0.03; r=0.403). CONCLUSION Despite the differences in the prevalence of caries that have been reported between renal failure patients and diabetic patients, we did not find any significant difference between diabetic dialysis, non-diabetic dialysis patients and the healthy population, regarding their amount of oral cariogenic bacteria.
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Affiliation(s)
- Fahimeh Rezazadeh
- Department of Oral and Maxillofacial Medicine, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Abdollah Bazargani
- Department of Bacteriology and Virology, Shiraz Medical School, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Ali Pooladi
- Student Research Committee, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Peyman Arasteh
- Non communicable Disease Research Center, Fasa University of Medical Sciences, Fasa, Iran ; Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Khosro Zamani
- Department of Bacteriology and Virology, Shiraz Medical School, Shiraz University of Medical Sciences, Shiraz, Iran
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Schmalz G, Kollmar O, Vasko R, Müller GA, Haak R, Ziebolz D. Oral health-related quality of life in patients on chronic haemodialysis and after kidney transplantation. Oral Dis 2016; 22:665-72. [PMID: 27265431 DOI: 10.1111/odi.12519] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2016] [Revised: 04/07/2016] [Accepted: 06/01/2016] [Indexed: 01/28/2023]
Abstract
OBJECTIVES The objective of the study was to evaluate oral health-related quality of life (OHRQoL) depending on dental and periodontal situation in patients on haemodialysis (HD) and after kidney transplantation (KTx) compared to healthy controls (HC). SUBJECTS AND METHODS OHRQoL was assessed using the German short form of Oral Health Impact Profile (OHIP G14). Dental health was estimated using the decayed, missing and filled teeth index (DMF-T). Periodontal health was classified as healthy/mild or moderate/severe periodontitis. STATISTICAL ANALYSIS Mann-Whitney U-test, Kruskal-Wallis test, chi-square test and Fisher's test. RESULTS Eighty-seven HD patients, 39 KTx patients and 91 HC were included. Significant differences in DMF-T, D-T, M-T and F-T scores were identified between groups (P < 0.001). The prevalence of moderate/severe periodontitis was significantly higher in the HD and KTx group compared to HC (P = 0.002). Differences in OHIP G14 between groups were neither clinical relevant nor statistically significant (P = 0.199). A significant effect of DMF-T (P = 0.012), M-T (P < 0.001) and periodontitis (P = 0.023) on the OHIP G14 scores was identified only in HC. CONCLUSIONS Improvement in dental care of HD and KTx patients is required. OHIP G14 values provide a subjectively considered low importance of oral health in HD and KTx patients, leading to need of motivation and sensitisation of these patients.
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Affiliation(s)
- G Schmalz
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, Leipzig, Germany
| | - O Kollmar
- Department of General, Visceral and Pediatric Surgery, University Medical Center, Goettingen, Germany
| | - R Vasko
- Department of Nephrology and Rheumatology, University Medical Center, Goettingen, Germany
| | - G A Müller
- Department of Nephrology and Rheumatology, University Medical Center, Goettingen, Germany
| | - R Haak
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, Leipzig, Germany
| | - D Ziebolz
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, Leipzig, Germany.
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20
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Alves LAC, Souza RC, da Silva TMC, Watanabe A, Dias M, Mendes MA, Ciamponi AL. Identification of microorganisms in biofluids of individuals with periodontitis and chronic kidney disease using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry. RAPID COMMUNICATIONS IN MASS SPECTROMETRY : RCM 2016; 30:1228-1232. [PMID: 28328023 DOI: 10.1002/rcm.7555] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2015] [Revised: 03/01/2016] [Accepted: 03/06/2016] [Indexed: 06/06/2023]
Abstract
RATIONALE Chronic kidney disease (CKD) and periodontitis (PD) are important health issues. There is a large variety of microorganisms related to the pathogenesis of periodontitis, and optimising the time and the cost of laboratory assays to detect these organisms is highly valuable in the medical field. METHODS Bacteria were isolated from saliva and oral biofilm of 30 adolescents and young adults with definite medical and dental diagnosis of CKD and PD, respectively, and proteins were extracted for microorganism identification by means of the matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOFMS) technique. RESULTS The results showed that the most incident microorganisms were Actinomyces dentalis (43%), Acinetobacter ursingi (60%), Aggregatibacter actinomycetencomitans (60%), Corynebacterium argentoctens (63%), Staphylococcus aureus (93%), Streptococcus salivarius (97%) and Tannerella forsythensis (43%). The analysis of oral biofilm showed higher incidences for Actinomyces dentalis (33%), Acinetobacter ursingi (50%), Aggregatibacter actinomycetencomitans (50%), Corynebacterium argentoctens (70%), Pseudomonas aeruginosa (40%), Staphylococcus aureus (73%) and Streptococcus salivarius (87%). CONCLUSIONS Based on these results, we concluded that the MALDI Biotyper protocol proves useful as a rapid and reliable assay for distinguishing different microorganisms possibly related to CKD and PD. Copyright © 2016 John Wiley & Sons, Ltd.
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Affiliation(s)
| | - Rafael Celestino Souza
- Orthodontics and Paediatric Department, Dental School, University of São Paulo (USP), Brazil
| | | | - Andreia Watanabe
- Paediatric Nephrology Department, University of São Paulo (USP), Brazil
| | - Meriellen Dias
- LSCP - Chemical Engineering Department, University of São Paulo (USP), Brazil
| | - Maria Anita Mendes
- LSCP - Chemical Engineering Department, University of São Paulo (USP), Brazil
| | - Ana Lídia Ciamponi
- Orthodontics and Paediatric Department, Dental School, University of São Paulo (USP), Brazil
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21
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Chen YT, Shih CJ, Ou SM, Hung SC, Lin CH, Tarng DC. Periodontal Disease and Risks of Kidney Function Decline and Mortality in Older People: A Community-Based Cohort Study. Am J Kidney Dis 2015; 66:223-30. [DOI: 10.1053/j.ajkd.2015.01.010] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2014] [Accepted: 01/04/2015] [Indexed: 11/11/2022]
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Araújo MVF, Hong BY, Fava PL, Khan S, Burleson JA, Fares G, Samson W, Strausbaugh LD, Diaz PI, Ioannidou E. End stage renal disease as a modifier of the periodontal microbiome. BMC Nephrol 2015; 16:80. [PMID: 26055269 PMCID: PMC4460699 DOI: 10.1186/s12882-015-0081-x] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2014] [Accepted: 06/01/2015] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Evidence supports high prevalence of periodontitis in patients with chronic kidney disease. Several renal factors have been proposed as possible modifiers of periodontitis pathogenesis in this population. In this cross sectional study, we investigated whether distinct microbial profiles in renal patients could explain high periodontitis prevalence. METHODS We characterized the subgingival microbiome in 14 End Stage Renal Disease (ESRD) and 13 control individuals with chronic periodontitis with similar demographic and clinical parameters. Medical, demographic and periodontal parameters were recorded. Subgingival biofilm samples were collected from the deepest pocket in two different quadrants and characterized via 454-pyrosequencing of the 16S rRNA gene. RESULTS We found 874 species-level operational taxonomic units (OTU) across samples. Renal and control groups did not differ in the individual proportions of periodontitis-associated taxa. However, in principal coordinate plots of distance among samples based on OTU prevalence, some renal patients clustered apart from controls, with the microbial communities of these outlier subjects showing less diversity. Univariate correlation analysis showed a significant negative correlation between dialysis vintage and community diversity. CONCLUSIONS Within the study limitations, dialysis vintage was associated with a less diverse periodontal microbial community in ESRD suggesting the need for further research.
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Affiliation(s)
- Michel V Furtado Araújo
- Division of Periodontology, Department of Oral Health and Diagnostic Sciences, School of Dental Medicine, University of Connecticut Health Center, 263 Farmington Ave, Farmington, CT, 06030-1710, USA.
| | - Bo-Young Hong
- Division of Periodontology, Department of Oral Health and Diagnostic Sciences, School of Dental Medicine, University of Connecticut Health Center, 263 Farmington Ave, Farmington, CT, 06030-1710, USA.
| | - Philip L Fava
- Division of Periodontology, Department of Oral Health and Diagnostic Sciences, School of Dental Medicine, University of Connecticut Health Center, 263 Farmington Ave, Farmington, CT, 06030-1710, USA.
| | - Shiza Khan
- Division of Periodontology, Department of Oral Health and Diagnostic Sciences, School of Dental Medicine, University of Connecticut Health Center, 263 Farmington Ave, Farmington, CT, 06030-1710, USA.
| | - Joseph A Burleson
- Department of Community Medicine and Health Care, University of Connecticut Health Center, Farmington, CT, USA.
| | | | - Wilner Samson
- Division of Nephrology, Department of Medicine, School of Medicine, University of Connecticut Health Center, Farmington, CT, USA.
| | - Linda D Strausbaugh
- Center for Applied Genetics and Technologies, University of Connecticut, Storrs, CT, USA.
| | - Patricia I Diaz
- Division of Periodontology, Department of Oral Health and Diagnostic Sciences, School of Dental Medicine, University of Connecticut Health Center, 263 Farmington Ave, Farmington, CT, 06030-1710, USA.
| | - Effie Ioannidou
- Division of Periodontology, Department of Oral Health and Diagnostic Sciences, School of Dental Medicine, University of Connecticut Health Center, 263 Farmington Ave, Farmington, CT, 06030-1710, USA.
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Identification of subgingival periodontal pathogens and association with the severity of periodontitis in patients with chronic kidney diseases: a cross-sectional study. BIOMED RESEARCH INTERNATIONAL 2015; 2015:370314. [PMID: 25922833 PMCID: PMC4398940 DOI: 10.1155/2015/370314] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/08/2015] [Revised: 03/22/2015] [Accepted: 03/24/2015] [Indexed: 11/17/2022]
Abstract
BACKGROUND The aim of our study was to assess the subgingival profile of 9 periodontal pathogens, by means of real-time PCR, in a group of predialysis chronic kidney disease patients with and without periodontal disease and to identify the risk factors associated with periodontal disease in these patients. MATERIAL AND METHODS This is a single centre cross-sectional cohort study performed on 70 CKD patients. Patients received a full-mouth periodontal examination and the following parameters were assessed: periodontal pocket depth (PPD), clinical attachment level, bleeding on probing, and plaque index; subgingival biofilm samples were collected from the deepest periodontal pocket of each quadrant and were pooled in one transporting unit. Clinical data were drawn from the medical file of the patients. RESULTS T. denticola (P = 0.001), T. forsythia (P < 0.001), and P. micros (P = 0.003) are significantly associated with periodontal disease in CKD subjects but in a multivariate model only age and T. forsythia remain independent risk factors for periodontal disease in patients with CKD. CONCLUSIONS In our cohort, age and T. forsythia are independently associated with periodontitis in CKD patients. Within the limits of this study, CKD was not significantly associated with a particular subgingival periodontal pathogens profile in periodontitis patients.
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24
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Role of saliva in the caries experience and calculus formation of young patients undergoing hemodialysis. Clin Oral Investig 2015; 19:1973-80. [DOI: 10.1007/s00784-015-1441-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2014] [Accepted: 02/25/2015] [Indexed: 11/30/2022]
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25
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Zhao D, Zhang S, Chen X, Liu W, Sun N, Guo Y, Dong Y, Mo A, Yuan Q. Evaluation of Periodontitis and Bone Loss in Patients Undergoing Hemodialysis. J Periodontol 2014; 85:1515-20. [DOI: 10.1902/jop.2014.140119] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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Pieralisi N, Godoy J, Yamada S, Santana R, Svidzinski T. Oral lesions and colonization by yeasts in hemodialysis patients. J Oral Pathol Med 2014; 44:585-90. [DOI: 10.1111/jop.12277] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/16/2014] [Indexed: 11/29/2022]
Affiliation(s)
- Neli Pieralisi
- Department of Dentistry; State University of Maringá; Paraná Brazil
| | - Janine Godoy
- Section of Medical Mycology; Department of Clinical Analysis; State University of Maringá; Paraná Brazil
| | - Sergio Yamada
- University Hospital of Maringá; State University of Maringá; Paraná Brazil
| | - Rosangela Santana
- Department of Statistics; State University of Maringá; Paraná Brazil
| | - Terezinha Svidzinski
- Section of Medical Mycology; Department of Clinical Analysis; State University of Maringá; Paraná Brazil
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Rodrigues VP, Libério SA, Lopes FF, Thomaz EBFA, Guerra RNM, Gomes-Filho IS, Pereira ALA. Periodontal status and serum biomarkers levels in haemodialysis patients. J Clin Periodontol 2014; 41:862-8. [DOI: 10.1111/jcpe.12283] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/09/2014] [Indexed: 11/29/2022]
Affiliation(s)
| | - Silvana A. Libério
- Postgraduate Dentistry Program; Federal University of Maranhão; São Luís Brazil
| | - Fernanda F. Lopes
- Postgraduate Dentistry Program; Federal University of Maranhão; São Luís Brazil
| | | | - Rosane N. M. Guerra
- Laboratory of Immunophysiology; Federal University of Maranhão; São Luís Brazil
| | - Isaac S. Gomes-Filho
- Department of Periodontics; Feira de Santana State University; Feira de Santana Brazil
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Wahid A, Chaudhry S, Ehsan A, Butt S, Ali Khan A. Bidirectional Relationship between Chronic Kidney Disease & Periodontal Disease. Pak J Med Sci 2014; 29:211-5. [PMID: 24353542 PMCID: PMC3809193 DOI: 10.12669/pjms.291.2926] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2012] [Revised: 09/24/2012] [Accepted: 11/20/2012] [Indexed: 02/06/2023] Open
Abstract
Non communicable diseases (NCDs) affect the life of an individual in terms of mortality, morbidity and financial crises. Main NCDs are diabetes mellitus (DM), cardiovascular diseases (CVD), pulmonary diseases, osteoporosis and chronic kidney diseases (CKD). About 40% of the total deaths can be controlled by eliminating the risk factors for NCDs. Periodontitis have recently been labeled as an important potential risk factor for NCDs. CKD affect the oral health status of patients by inducing gingival hyperplasia, xerostomia, calcification of root canals and delayed eruption of teeth. Periodontitis increases systemic inflammatory burden leading to worsening of CKD which in turn has been has been found to negatively affect CKD of patients on hemodialysis therapy by altering their serum albumin and C-reactive protein levels. As hypoalbuminemia leads to increased mortality in CKD patients, it needs to be avoided by reducing systemic inflammatory burden in patients receiving HD therapy. Treating periodontal disease could be one factor that might decrease the systemic inflammatory burden and thereby improve quality of life of these patients. Sources of Data: Data from descriptive, cross sectional and longitudinal studies published between 2000 and 2012 were included. Data searches based on human studies only. Data Extraction: The key words, periodontitis, chronic kidney disease and hemodialysis, on MEDLINE, approximately 120 studies were identified. 35 of them were relevant to all three keywords. Most of them were cross sectional studies and total 7 clinical trials were identified regarding checking of serum levels after periodontal therapy with variable results. Conclusion: Patients with CKD have higher prevalence of periodontal disease while non-surgical periodontal therapy has been indicated to decrease the systemic inflammatory burden in patients with CKD specially those undergoing HD therapy.
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Affiliation(s)
- Arsalan Wahid
- Arsalan Wahid, M. Phil Scholar, Department of Oral Health Sciences, Shaikh Zayed Medical Complex, Lahore, Pakistan
| | - Saima Chaudhry
- Saima Chaudhry, PhD, Lecturer (Oral Pathology),Department of Oral Health Sciences, Shaikh Zayed Medical Complex, Lahore, Pakistan
| | - Afifa Ehsan
- Afifa Ehsan, M. Phil Scholar, Department of Oral Health Sciences, Shaikh Zayed Medical Complex, Lahore, Pakistan
| | - Sidra Butt
- Sidra Butt, M. Phil Scholar, Department of Oral Health Sciences, Shaikh Zayed Medical Complex, Lahore, Pakistan
| | - Ayyaz Ali Khan
- Ayyaz Ali Khan, PhD, Head (Community Dentistry), Department of Oral Health Sciences, Shaikh Zayed Medical Complex, Lahore, Pakistan
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Chhokra M, Manocha S, Dodwad V, Gupta U, Vaish S. Establishing an Association between Renal Failure and Periodontal Health: A Cross Sectional Study. JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH : JCDR 2013; 7:2348-50. [PMID: 24298526 DOI: 10.7860/jcdr/2013/5937.3521] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 02/22/2013] [Accepted: 08/08/2013] [Indexed: 11/24/2022]
Abstract
UNLABELLED Periodontal infections can act as focus of infection, aggravating the immunocompromised state of End Stage Renal Disease patients (ESRD). AIM Evaluation of the periodontal health status of ESRD patients undergoing haemodialysis and establishing the underlying association between renal failure and periodontal disease. MATERIAL AND METHODS Eighty control and test subjects were included in the study, after matching age and sex. Creatinine and GFR were measured in each patient. Oral hygiene index- Simplified (OHI-S), Gingival Index (GI), Pocket Depth (PD) and Clinical Attachment Level (CAL) were recorded as periodontal parameters to assess the correlation between the subjects of the two groups. Further, the test group was divided into three sub-groups, on basis of duration, as less than 6 months, from 6 months to one year and more than one year. STATISTICAL ANALYSIS Student's t - test and ANOVA were used to analyze the inter-group and intragroup comparisons. RESULTS Statistical significant difference was observed for all periodontal parameters between the test and control group. However, difference amongst periodontal parameters on basis of duration of haemodialysis was seen between the subgroups of test subjects, it was not found to be statistically significant. CONCLUSION Severity of periodontal diseases in ESRD patients undergoing haemodialysis majorly affected due to debilitating condition of the subjects. Dialysis vintage has only a small role to play in worsening of the condition. Further research is needed to potentiate the establishment of two-way relationship between renal disease and periodontal condition.
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Tiwari V, Saxena V, Bhambhal A, Tiwari U, Singh A, Goud S. THE ORAL HEALTH STATUS OF PATIENTS WITH RENAL DISEASE IN CENTRAL INDIA: A PRELIMINARY STUDY. J Ren Care 2013; 39:208-13. [DOI: 10.1111/j.1755-6686.2013.12040.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Vidhatri Tiwari
- Department of Public Health Dentistry; R.K.D.F. Dental College and Research Centre; Bhopal Madhya Pradesh India
| | - Vrinda Saxena
- Department of Public Health Dentistry; People's College of Dental Sciences and Research Centre; Bhopal Madhya Pradesh India
| | - Ajay Bhambhal
- Department of Public Health Dentistry; People's College of Dental Sciences and Research Centre; Bhopal Madhya Pradesh India
| | - Utkarsh Tiwari
- Department of Pedodontics; People's College of Dental Sciences and Research Centre; Bhopal Madhya Pradesh India
| | - Aishwarya Singh
- Department of Public Health Dentistry; People's College of Dental Sciences and Research Centre; Bhopal Madhya Pradesh India
| | - Siddana Goud
- Department of Public Health Dentistry; R.K.D.F. Dental College and Research Centre; Bhopal Madhya Pradesh India
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Ruospo M, Palmer SC, Craig JC, Gentile G, Johnson DW, Ford PJ, Tonelli M, Petruzzi M, De Benedittis M, Strippoli GFM. Prevalence and severity of oral disease in adults with chronic kidney disease: a systematic review of observational studies. Nephrol Dial Transplant 2013; 29:364-75. [PMID: 24081863 DOI: 10.1093/ndt/gft401] [Citation(s) in RCA: 86] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Oral disease may be increased in people with chronic kidney disease (CKD) and, due to associations with inflammation and malnutrition, represents a potential modifiable risk factor for cardiovascular disease and mortality. We summarized the prevalence of oral disease in adults with CKD and explored any association between oral disease and mortality. METHODS We used systematic review of observational studies evaluating oral health in adults with CKD identified in MEDLINE (through September 2012) without language restriction. We summarized prevalence and associations with all-cause and cardiovascular mortality using random-effects meta-analysis. We explored for sources of heterogeneity between studies using meta-regression. RESULTS Eighty-eight studies in 125 populations comprising 11 340 adults were eligible. Edentulism affected one in five adults with CKD Stage 5D (dialysis) {20.6% [95% confidence interval (CI), 16.4-25.6]}. Periodontitis was more common in CKD Stage 5D [56.8% (CI, 39.3-72.8)] than less severe CKD [31.6% (CI, 19.0-47.6)], although data linking periodontitis with premature death were scant. One-quarter of patients with CKD Stage 5D reported never brushing their teeth [25.6% (CI, 10.2-51.1)] and a minority used dental floss [11.4% (CI, 6.2-19.8)]; oral pain was reported by one-sixth [18.7% (CI, 8.8-35.4)], while half of patients experienced a dry mouth [48.4% (CI, 37.5-59.5)]. Data for kidney transplant recipients and CKD Stages 1-5 were limited. CONCLUSIONS Oral disease is common in adults with CKD, potentially reflects low use of preventative dental services, and may be an important determinant of health in this clinical setting.
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Periodontal disease: a covert source of inflammation in chronic kidney disease patients. Int J Nephrol 2013; 2013:515796. [PMID: 23840952 PMCID: PMC3690231 DOI: 10.1155/2013/515796] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2013] [Accepted: 05/24/2013] [Indexed: 12/14/2022] Open
Abstract
The prevalence of atherosclerotic complications (myocardial infarction, stroke, and sudden death) is increased in end-stage renal disease (ESRD) patients, especially in haemodialysis patients. Increasing evidence suggests that both in general population and in dialysis patients, systemic inflammation plays a dominant role in the pathogenesis of atherosclerotic complications. In general population, also, evidence shows that moderate to severe periodontitis can contribute to inflammatory burden by increasing serum CRP levels and may increase the prevalence of atherosclerotic events. Moreover, the results of some new interventional studies reveal that effective phase I periodontal therapy may decrease serum CRP levels, the most important acute phase protein, monitored as a systemic marker of inflammation and endothelial dysfunction as well, used as an initial predictor of atherosclerotic events. Considering that moderate to severe periodontal diseases have a higher prevalence in CKD and in dialysis population and that periodontal examination is not part of the standard medical assessment, destructive periodontitis might be an ignored source of systemic inflammation in end-stage renal disease patients and may add to the chronic inflammatory status in CKD.
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Pereira-Lopes O, Sampaio-Maia B, Sampaio S, Vieira-Marques P, Monteiro-da-Silva F, Braga AC, Felino A, Pestana M. Periodontal inflammation in renal transplant recipients receiving Everolimus or Tacrolimus - preliminary results. Oral Dis 2012; 19:666-72. [DOI: 10.1111/odi.12051] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2012] [Revised: 10/29/2012] [Accepted: 11/18/2012] [Indexed: 12/12/2022]
Affiliation(s)
| | | | - S Sampaio
- Nephrology Research and Development Unit (FCT-725); Faculty of Medicine; São João Hospital Center; University of Porto; Porto; Portugal
| | - P Vieira-Marques
- Center for Research in Health Technologies and Information Systems; Faculty of Medicine; University of Porto; Porto; Portugal
| | - F Monteiro-da-Silva
- Department of Basic Medical and Dental Sciences; Faculty of Dental Medicine; University of Porto; Porto; Portugal
| | - AC Braga
- Department of Production and Systems; University of Minho; Porto; Portugal
| | - A Felino
- Department of Oral Medicine and Oral Surgery; Faculty of Dental Medicine; University of Porto; Porto; Portugal
| | - M Pestana
- Nephrology Research and Development Unit (FCT-725); Faculty of Medicine; São João Hospital Center; University of Porto; Porto; Portugal
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Lam OL, McGrath C, Li LS, Samaranayake LP. Effectiveness of oral hygiene interventions against oral and oropharyngeal reservoirs of aerobic and facultatively anaerobic gram-negative bacilli. Am J Infect Control 2012; 40:175-82. [PMID: 21719150 DOI: 10.1016/j.ajic.2011.03.004] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2010] [Revised: 03/04/2011] [Accepted: 03/04/2011] [Indexed: 10/18/2022]
Abstract
BACKGROUND Aerobic and facultatively anaerobic gram-negative bacilli (AGNB) are opportunistic pathogens and continue to cause a large number of hospital-acquired infections. AGNB residing in the oral cavity and oropharynx have been linked to nosocomial pneumonia and septicemia. Although AGNB are not considered members of the normal oral and oropharyngeal flora, medically compromised patients have been demonstrated to be susceptible to AGNB colonization. METHODS A literature search was conducted to retrieve articles that evaluated the effectiveness of oral hygiene interventions in reducing the oral and oropharyngeal carriage of AGNB in medically compromised patients. RESULTS Few studies have documented the use of mechanical oral hygiene interventions alone against AGNB. Although a number of studies have employed oral hygiene interventions complemented by antiseptic agents such as chlorhexidine and povidone iodine, there appears to be a discrepancy between their in vitro and in vivo effectiveness. CONCLUSION With the recognition of the oral cavity and oropharynx as a reservoir of AGNB and the recent emergence of multidrug and pandrug resistance in hospital settings, there is a pressing need for additional high-quality randomized controlled trials to determine which oral hygiene interventions or combination of interventions are most effective in eliminating or reducing AGNB carriage.
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Iwasaki M, Taylor GW, Nesse W, Vissink A, Yoshihara A, Miyazaki H. Periodontal Disease and Decreased Kidney Function in Japanese Elderly. Am J Kidney Dis 2012; 59:202-9. [DOI: 10.1053/j.ajkd.2011.08.027] [Citation(s) in RCA: 71] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2011] [Accepted: 08/09/2011] [Indexed: 01/22/2023]
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Querido SMR, Back-Brito GN, Dos Santos SSF, Leão MVP, Koga-Ito CY, Jorge AOC. Opportunistic microorganisms in patients undergoing antibiotic therapy for pulmonary tuberculosis. Braz J Microbiol 2011; 42:1321-8. [PMID: 24031759 PMCID: PMC3768714 DOI: 10.1590/s1517-838220110004000012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2010] [Revised: 02/25/2011] [Accepted: 05/30/2011] [Indexed: 11/25/2022] Open
Abstract
Antimicrobial therapy may cause changes in the resident oral microbiota, with the increase of opportunistic pathogens. The aim of this study was to compare the prevalence of Candida, Staphylococcus, Pseudomonas and Enterobacteriaceae in the oral cavity of fifty patients undergoing antibiotic therapy for pulmonary tuberculosis and systemically healthy controls. Oral rinsing and subgingival samples were obtained, plated in Sabouraud dextrose agar with chloramphenicol, mannitol agar and MacConkey agar, and incubated for 48 h at 37°C. Candida spp. and coagulase-positive staphylococci were identified by phenotypic tests, C. dubliniensis, by multiplex PCR, and coagulase-negative staphylococci, Enterobacteriaceae and Pseudomonas spp., by the API systems. The number of Candida spp. was significantly higher in tuberculosis patients, and C. albicans was the most prevalent specie. No significant differences in the prevalence of other microorganisms were observed. In conclusion, the antimicrobial therapy for pulmonary tuberculosis induced significant increase only in the amounts of Candida spp.
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Affiliation(s)
- Silvia Maria Rodrigues Querido
- Laboratório de Microbiologia, Departamento de Biociências e Diagnóstico Bucal, Faculdade de Odontologia, São José dos Campos, Universidade Estadual Paulista , São José dos Campos, SP , Brasil
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Messier MD, Emde K, Stern L, Radhakrishnan J, Vernocchi L, Cheng B, Angelopoulos C, Papapanou PN. Radiographic periodontal bone loss in chronic kidney disease. J Periodontol 2011; 83:602-11. [PMID: 22060047 DOI: 10.1902/jop.2011.110306] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND We examined the extent and severity of radiographic periodontal bone loss in patients with different stages of chronic kidney disease (CKD) and explored a potential dose-response relationship between bone loss and CKD-related biomarkers. METHODS Panoramic radiographs were obtained from 129 CKD patients (78 males and 51 females; mean age: 63.5 years, range: 24 to 91 years), including 63 patients undergoing dialysis for an average of 3.3 years (range: 0.5 to 14 years). Glomerular filtration rate (GFR), dialysis dose, and levels of serum biomarkers were obtained through a hospital database. Interproximal bone loss was assessed as a percentage of root length. RESULTS Twenty-nine participants were edentulous (23.8% of those on dialysis versus 21.2% of those with residual kidney function; χ(2) test, P = 0.724). The extent of bone loss was higher among dialysis patients (analysis of variance [ANOVA], P = 0.007), but no clear dose-response association between CKD stage and extent was evident. GFR, dialysis dose, and levels of serum biomarkers did not differ between edentulous and dentate individuals, and only serum albumin was lower in patients with extensive bone loss (ANOVA, P = 0.030). After adjusting for dialysis status, the severity of bone loss was positively associated with glucose levels (multiple regression, P = 0.019) and white blood cell count (P = 0.032), whereas the number of teeth present was positively associated with plasma phosphorus (P = 0.008) and negatively with glucose levels (P = 0.011). CONCLUSION Despite a higher extent of bone loss in dialysis patients, the lack of a dose-response association between bone loss and CKD stage or the levels of CKD-related serum biomarkers underscores the complex relationship between the two conditions.
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Malekmakan L, Haghpanah S, Pakfetrat M, Ebrahimic Z, Hasanlic E. Oral health status in Iranian hemodialysis patients. Indian J Nephrol 2011; 21:235-8. [PMID: 22022082 PMCID: PMC3193665 DOI: 10.4103/0971-4065.82634] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Due to increased survival among hemodialysis (HD) patients, new problems including concerns of oral health have appeared. In this study, we aimed to evaluate the oral health status and related risk factors in Iranian HD patients. Demographic information, medical history, laboratory findings, and dental health status were gathered. The decayed, missing and filled teeth (DMFT) index in accordance with the World Health Organization (WHO) criteria was obtained. Kt/V was calculated for patients. A P-value of <0.05 was considered statistically significant. Seventy-two patients were evaluated, with a mean age and HD time of 53.4±15.3 years and 36.9±33.8 months, respectively. Thirty-five (48.6%) complained of dry mouth, 33 (49.3%) of taste change, 22 (31%) of malodor mouth, and 30 (46.9%) had dental calculus. The overall mean DMFT score was 18.6±9.9. DMFT score had a negative significant correlation with Kt/V (r=–0.4, P=0.004). Women and singles as well as patients with a low educational level and/or lesser dialysis time had a significantly higher DMFT score (P<0.05). Kt/V was significantly lower in patients suffering from dry mouth and dental calculus (P<0.05). Interestingly DMFT score was significantly lower in patients with dental calculus compared to patients without it (P=0.001). It seems that our patients have a poor dental hygiene level and high DMFT score especially women, singles, patients with low Kt/V and a low education level. The oral health maintenance program for a patient receiving dialysis should be reinforced in our centers.
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Affiliation(s)
- L Malekmakan
- Nephro-Urology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
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Bastos JA, Diniz CG, Bastos MG, Vilela EM, Silva VL, Chaoubah A, Souza-Costa DC, Andrade LCF. Identification of periodontal pathogens and severity of periodontitis in patients with and without chronic kidney disease. Arch Oral Biol 2011; 56:804-11. [PMID: 21211789 DOI: 10.1016/j.archoralbio.2010.12.006] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2010] [Revised: 12/07/2010] [Accepted: 12/07/2010] [Indexed: 01/12/2023]
Abstract
OBJECTIVE In this study of patients with chronic periodontitis (CP), the severity of the disease and the main periodontal pathogens identified in patients with chronic kidney disease (CKD) were compared with those detected in individuals without systemic disease. DESIGN Nineteen patients with CP without evidence of systemic disease (control group), 25 patients with CP and CKD who were in the pre-dialysis stages (pre-dialysis group), and 22 patients with CP and CKD who were on renal replacement therapy (RRT group) were examined. The severity of CP was based on the investigation of probing depth (PD) and clinical attachment level (CAL). The definition and stage of CKD were based on the criteria proposed by the Kidney Disease Outcomes Quality Initiative of the National Kidney Foundation. Glomerular filtration rate (GFR) was estimated using the equation of Modification of Diet in Renal Disease and the identification of microorganisms in subgingival plaque was performed using polymerase chain reaction (PCR). RESULTS Candida albicans, Porphyromonas gingivalis, Tannerella forsythia, and Treponema denticola were more common in patients who were on RRT and pre-dialysis than in control subjects. CP was more severe in patients with CKD. A strong association was observed between the frequency of C. albicans (P = 0.056), P.gingivalis (P = 0.008), T. denticola (P = 0.013) and CAL, when CKD patients were compared with the control group. CONCLUSION CP is more severe and is associated with increased frequency of C. albicans, P. gingivalis, T. forsythia, and T. denticola in patients with CKD.
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Affiliation(s)
- Jessica A Bastos
- Postgraduate Program in Health - Concentration Area, Brazilian Health, Federal University of Juiz de Fora, MG, Brazil.
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Torres SA, Rosa OPDS, Hayacibara MF, Guimarães MDCM, Hayacibara RM, Bretz WA. Periodontal parameters and BANA test in patients with chronic renal failure undergoing hemodialysis. J Appl Oral Sci 2010; 18:297-302. [PMID: 20857011 PMCID: PMC5349042 DOI: 10.1590/s1678-77572010000300018] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2009] [Accepted: 02/16/2010] [Indexed: 11/22/2022] Open
Abstract
Objectives The aim of this study was to analyze the periodontal parameters of patients with
chronic renal failure. Material and Methods The periodontal status of 16 Brazilian patients aged 29 to 53 (41.7±7.2)
years with chronic renal failure (CRF) and another matched group of 14 healthy
controls with periodontitis was assessed clinically and microbiologically. Probing
pocket depth (PPD), gingival recession (GR), dental plaque index (PLI), gingival
index (GI), and dental calculus index (CI) were the clinical parameters recorded
for the entire dentition (at least 19 teeth), while the anaerobic
periodontopathogen colonization in four sites with the highest PPD was evaluated
using the BANA test (“PerioScan”; Oral B). Results The results for the CRF group and control group, respectively were: PPD:
1.77±0.32 and 2.65±0.53; GR: 0.58±0.56 and 0.51±0.36;
PLI: 1.64±0.56 and 1.24±0.67; GI: 0.64±0.42 and
0.93±0.50; CI: 1.17±0.54 and 0.87±0.52. Comparison between
groups using the "t" test revealed a significantly increased PPD (p<0.001) in
the control group. Comparison of the other clincial parameters by the Mann-Whitney
test showed differences only for PLI, which was significantly higher (p<0.05)
in the CRF group. Spearman's test applied to each group showed a positive
correlation among all clinical parameters, except for GR (p<0.05). None of the
groups showed any correlation between GR and GI, while a significant negative
correlation between GR and PPD was observed for the CRF group. The percentage of
BANA-positive sites was 35.9% for the CRF group and 35.7% for the control group.
The BANA test correlated positively with PPD only in the control group and with GR
only in the CRF group. Conclusions In spite of a higher PLI and dense anaerobic microbial population even in shallow
PPD, patients with CRF exhibited better periodontal conditions than periodontitis
patients, which is an evidence of altered response to local irritants.
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Affiliation(s)
- Sérgio Aparecido Torres
- Department of Biological Science, Bauru School of Dentistry, University of São Paulo, Bauru, SP, Brazil
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Cengiz MI, Sümer P, Cengiz S, Yavuz U. The effect of the duration of the dialysis in hemodialysis patients on dental and periodontal findings. Oral Dis 2009; 15:336-41. [DOI: 10.1111/j.1601-0825.2009.01530.x] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Abstract
The incidence of end-stage renal disease (ESRD) is increasing and patients receiving renal replacement therapy including hemodialysis, peritoneal dialysis or renal transplantation will comprise an enlarging segment of the dental patient population. Renal replacement therapy can affect periodontal tissues including gingival hyperplasia in immune suppressed renal transplantation patients and increased levels of plaque, calculus and gingival inflammation and possible increased prevalence and severity of destructive periodontal diseases in ESRD patients on dialysis maintenance therapy. Also, the presence of undiagnosed periodontitis may have significant effects on the medical management of the ESRD patient. Periodontitis has been found to contribute to systemic inflammatory burden including the elevation of C-reactive protein (CRP) in the general population. Atherosclerotic complications including myocardial infarction and stroke are the primary causes of mortality in the ESRD population and, in contrast to that of the general population, the best predictor of all cause and cardiac death in this population is CRP. Consequently, periodontitis may be a covert but treatable source of systemic inflammation in the ESRD population. The objective of this review was to explore the interaction between chronic renal disease, renal replacement therapy and periodontal diseases based upon the results of studies published within the last decade.
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Affiliation(s)
- R G Craig
- Department of Basic Sciences and Craniofacial Biology, New York University College of Dentistry, New York, NY 10010, USA.
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