Investigation of dental caries and periodontal conditions in maintenance hemodialysis patients

doi:10.12016/j.issn.2096-1456.2020.05.008

Abstract

Abstract:

Objective To compare the prevalence of dental caries and periodontal disease in patients with end-stage renal disease treated with maintenance hemodialysis with that in healthy controls and to investigate the relationship between end-stage renal disease, dental caries and periodontal disease.Methods A total of 82 maintenance hemodialysis patients who met the inclusion criteria were selected as the case group, and 86 healthy persons who underwent oral examination in the physical examination center were selected as the control group. Dental caries and periodontal conditions were examined in the two groups. The dental caries examination was conducted by determining the number of decayed-missing-filled teeth, which was recorded as recommended by the World Health Organization. The periodontal condition parameters included the plaque index, calculus index, bleeding on probing, periodontal pocket depth and clinical attachment loss.Results The prevalence of dental caries in the case group and healthy control group was 87.8% and 81.4%, respectively, and there was no statistically significant difference between the two groups (P > 0.05). The periodontal indexes, including the plaque index, calculus index, probe bleeding index, periodontal pocket depth and clinical attachment level, in the case group were significantly higher than those in the control group (P < 0.05), and the prevalence of periodontitis in the case group was significantly higher than that in the control group (97.6% vs 88.4%, P < 0.05).Conclusion The dental caries conditions were comparable between the case group and the control group, but the prevalence and severity of periodontitis were significantly higher in the case group than in the control group.

Key words: chronic kidney disease, end-stage renal disease, maintenance hemodialysis, dental caries, periodontitis, plaque index, calculus index, bleeding on probing, periodontal pocket depth, clinical attachment loss

摘要：

目的比较维持性血液透析治疗的终末期肾脏病患者组和健康人群组龋病和牙周病患病率的差异,初步探讨终末期肾脏病和龋病、牙周病之间的关系。方法选择符合纳入标准的进行维持性血液透析治疗的患者作为病例组（82例）,同时选择在体检中心进行口腔检查的正常人群作为健康对照组（86例）。两组采用统一的方法进行龋病和牙周状况的检查。龋病状况检查采用世界卫生组织推荐的龋失补牙数进行诊断和记录,牙周状况检查包括菌斑指数、牙石指数、探诊出血、牙周袋深度和临床附着水平。结果维持性血液透析组和健康对照组的患龋率分别为87.8%和81.4%,两组患龋率间差异无统计学意义（P > 0.05）;病例组的菌斑指数、牙石指数、探诊出血、牙周袋深度和临床附着水平均高于对照组（P < 0.05）,病例组的牙周炎患病率（97.6%）高于对照组（88.4%）,差异有统计学意义（P < 0.05）。结论维持性血液透析组患者的龋齿水平与健康对照人群无明显差异,但牙周炎的患病率和严重程度高于健康人群。

关键词: 慢性肾脏病, 终末期肾脏病, 维持性血液透析, 龋病, 牙周炎, 菌斑指数, 牙石指数, 探诊出血, 牙周袋深度, 临床附着水平

CLC Number:

WU Hongyu,MA Xiaoxin,LU Haixia,FENG Xiping,GU Qin,YE Wei,XIE Yingxin,XIE Danshu,WANG Wenji. Investigation of dental caries and periodontal conditions in maintenance hemodialysis patients[J]. Journal of Prevention and Treatment for Stomatological Diseases, 2020, 28(5): 313-317.

吴红雨,马晓欣,陆海霞,冯希平,顾钦,叶玮,解莹馨,谢丹庶,王文姬. 维持性血液透析患者的龋病和牙周病状况调查[J]. 口腔疾病防治, 2020, 28(5): 313-317.

Figures/Tables 3

References 23

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		MHD group	Control group	χ²	P
Toothbrushing frequency
	Once or less	44（53.7%）	22（25.6%）	13.873	<0.001
	Twice or more	38（46.3%）	64（74.4%）	13.873	<0.001
Use of mouth rinse
	Yes	8（9.8%）	16（18.6%）	2.684	0.101
	No	74（90.2%）	70（81.4%）	2.684	0.101
Use of dental floss
	Yes	6（7.3%）	18（21.2%）	6.515	0.011
	No	76（92.7%）	67（78.8%）	6.515	0.011
Use of toothpick
	Yes	35（42.7%）	49（57.6%）	3.738	0.053
	No	47（57.3%）	36（42.4%）	3.738	0.053
Smoking
	Yes	56（68.3%）	67（77.9%）	1.979	0.160
	No	26（31.7%）	19（22.1%）	1.979	0.160
Alcohol consumption
	Yes	71（86.6%）	52（60.5%）	14.604	<0.001
	No	11（13.4%）	34（39.5%）	14.604	<0.001
Diabetes
	Yes	24（29.3%）	4（4.7%）	18.043	<0.001
	No	58（70.7%）	81（95.3%）	18.043	<0.001
Hypertension
	Yes	68（82.9%）	26（30.6%）	46.467	<0.001
	No	14（17.1%）	59（69.4%）	46.467	<0.001
Total		82	86

		MHD group	Control group	χ²	P
Toothbrushing frequency
	Once or less	44（53.7%）	22（25.6%）	13.873	<0.001
	Twice or more	38（46.3%）	64（74.4%）	13.873	<0.001
Use of mouth rinse
	Yes	8（9.8%）	16（18.6%）	2.684	0.101
	No	74（90.2%）	70（81.4%）	2.684	0.101
Use of dental floss
	Yes	6（7.3%）	18（21.2%）	6.515	0.011
	No	76（92.7%）	67（78.8%）	6.515	0.011
Use of toothpick
	Yes	35（42.7%）	49（57.6%）	3.738	0.053
	No	47（57.3%）	36（42.4%）	3.738	0.053
Smoking
	Yes	56（68.3%）	67（77.9%）	1.979	0.160
	No	26（31.7%）	19（22.1%）	1.979	0.160
Alcohol consumption
	Yes	71（86.6%）	52（60.5%）	14.604	<0.001
	No	11（13.4%）	34（39.5%）	14.604	<0.001
Diabetes
	Yes	24（29.3%）	4（4.7%）	18.043	<0.001
	No	58（70.7%）	81（95.3%）	18.043	<0.001
Hypertension
	Yes	68（82.9%）	26（30.6%）	46.467	<0.001
	No	14（17.1%）	59（69.4%）	46.467	<0.001
Total		82	86

	MHD group		Control group		U^*	P^*	χ²	P^#
	Median（IQR ）	Prevalence	Median（IQR ）	Prevalence	U^*	P^*	χ²	P^#
DT	1.0（0,2.0）	74.40%	0（0,1.0）	46.50%	2290.5	< 0.001	13.607	< 0.001
MT	1.0（0,3.0）	56.10%	0（0,1.0）	41.90%	2826.0	0.016	3.405	0.065
FT	0（0,1.0）	39.00%	1.0（0,3.0）	54.70%	2733.0	0.006	4.115	0.043
DMFT	4.0（2.0,6.0）	87.80%	3.0（1.0,5.25）	81.40%	3154.0	0.235	1.318	0.251

	MHD group		Control group		U^*	P^*	χ²	P^#
	Median（IQR ）	Prevalence	Median（IQR ）	Prevalence	U^*	P^*	χ²	P^#
DT	1.0（0,2.0）	74.40%	0（0,1.0）	46.50%	2290.5	< 0.001	13.607	< 0.001
MT	1.0（0,3.0）	56.10%	0（0,1.0）	41.90%	2826.0	0.016	3.405	0.065
FT	0（0,1.0）	39.00%	1.0（0,3.0）	54.70%	2733.0	0.006	4.115	0.043
DMFT	4.0（2.0,6.0）	87.80%	3.0（1.0,5.25）	81.40%	3154.0	0.235	1.318	0.251

	n	MHD group	n	Control group	χ²/t	P
PLI%	82	35.4 ± 14.1	86	23.8 ± 10.8	6.013	< 0.001
BOP%	82	19.7 ± 9.2	86	14.1 ± 9.7	3.826	< 0.001
CI%	82	9.6 ± 8.1	86	5.8 ± 5.3	3.654	< 0.001
PD(mm)	82	3.4 ± 0.3	86	3.2 ± 0.3	2.902	0.004
CAL(mm)	82	1.5 ± 0.4	86	1.3 ± 0.3	2.408	0.017
Prevalence of periodontitis	82	80（97.6%）	86	76（88.4%）	5.344	0.021