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Chronic renal failure and periodontal disease
V K Kitsou1, A Konstantinidis, K C Siamopoulos
1Department of Internal Medicine, School of Medicine, University of Ioannina, Greece.
Insights
Chronic renal failure (CRF) does not affect the progression of gingival inflammation. Patients undergoing hemodialysis showed similar responses to experimental gingivitis as healthy individuals, indicating no impact on periodontal tissue defense against plaque.
Area of Science:
- Periodontology
- Nephrology
- Oral Health
Background:
- Chronic renal failure (CRF) impacts various bodily systems.
- The effect of CRF on periodontal health, specifically gingival inflammation, requires clarification.
- Understanding these effects is crucial for comprehensive patient care.
Purpose of the Study:
- To investigate the influence of chronic renal failure (CRF) on the development of experimental gingivitis.
- To compare the progression of gingival inflammation in patients on chronic hemodialysis versus healthy controls.
- To determine if uremia affects the periodontal tissue's defense mechanisms against microbial plaque.
Main Methods:
- A study involving 6 CRF patients on hemodialysis and 6 matched healthy controls.
- A 40-day preparation period with gingivitis therapy and plaque control.
- A 28-day experimental period involving cessation of oral hygiene, monitoring gingival index (GI), plaque index (PII), and gingival crevicular fluid (GCF), followed by professional cleaning and reassessment.
Main Results:
- Both CRF patients and controls exhibited increases in GI, PII, and GCF during the experimental period (days 7, 14, 21).
- No significant differences in the progression of gingival inflammation or plaque accumulation were observed between the CRF group and the control group.
- Gingival parameters returned to baseline levels by day 28 in both groups after oral hygiene was resumed.
Conclusions:
- Chronic renal failure, even in patients undergoing chronic hemodialysis, does not significantly alter the inflammatory response to experimental gingivitis.
- Periodontal tissues in CRF patients demonstrate a comparable defense against microbial plaque accumulation and subsequent inflammation as observed in healthy individuals.
- These findings suggest that chronic uremia does not impair the periodontal tissue's ability to respond to plaque-induced inflammation.
Abstract:
In order to define the effects of chronic renal failure (CRF) in the progress of gingival inflammation, we studied 6 patients (4 male, 2 female) with CRF who were on chronic hemodialysis for 4.25 (range 1-15) years. Six healthy individuals, age and sex matched were used as controls. The protocol which we used comprised of two periods (a) a 40-day duration period of preparation and (b) a 28-day duration experimental period. During the (a) period, all subjects went through: (1) therapy of the chronic gingivitis and (2) complete control of dental plaque by oral hygiene. During the experimental period, all subjects were advised to avoid, for at least 21 days, any mechanical or chemical media of oral hygiene and went through photographing, recording of gingival index (GI), recording of plaque index (PII), and the collection and quantification of gingival crevicular fluid (GCF). On the 21st day, root planning and polishing were performed and subjects were advised to carry out oral hygiene. On the 28th day, all previous examinations (GI, PII, GCF) were repeated. In both patients and controls, GI, PII and GCF were increased on 7th, 14th and 21st day, without significant differences between the groups and returned to normal (close to zero point) on the 28th day. There are no significant differences between patients with CRF and normal controls in the evolution of experimental gingivitis. Therefore, chronic uremia has no effect on the defense of periodontal tissue against microbial plaque.