["Renal dwarfism". Its impact on dental development and on maxillary growth]

Children with terminal renal failure require iterative dialysis while awaiting kidney graft, and these have to be repeated over a period of years until a suitable graft presenting histocompatibility with the receiver is found. This has a considerable growth retardation effect (-3 to -6 SD, according to the age at onset of terminal failure). Two features appear to be paradoxical in these children. 1) In spite of a high carbohydrate diet and generally poor oral hygiene, they present a low prevalence of caries, probably related to modified salivary components. The only objective finding is an increase in salivary urea levels. 2) In spite of harmonious hypotrophy, no particular encumbrance of the dental arch is observed. Alveolar growth, contemporary with dental eruption, is sufficient to compensate possible hypotrophy of maxillary bone bases.