RESUMEN
The periodontal condition of 45 uremic children and 35 prospective [on hemodialysis]; was compared with that of systemically healthy children, matched for age, teeth present and sex. The two renal groups had significantly [p < 0.05] higher plaque scores than the control group. The hemodialysis group showed significantly [p < 0.05] fewer gingival bleeding points than their respective controls. Progressive uremia; thus; entailed less clinical gingivitis. The mean attachment loss as judged from clinical measurements was similar among the paired groups. It is a must that a special program of periodontal disease prevention for such children is quite needed. Over the last two decades renal allotransplantation and treatment have saved many patients with chronic renal failure with immunosuppressive agents. There is no exaggeration to mention that, so many children are included to share the same aforementioned problem. The drug regimen creates a life-long susceptibility to infections, even by the commensal flora [1]. To minimize this risk the periodontist should reduce dental plaque as a source of noxious bacterial products. The progressive nature of chronic periodontal disease has been well documented in epidemiological studies [2]. It is suggested that the gingival inflammatory reaction to dental plaque released mediators that may initiate destructive activities in the periodontium [3]. Moreover, the gingival response to dental plaque can be modulated by the host's medical status and by drugs [4]. If chronic inflammatory periodontal disease, in part at least, reflects local immune-based inflammatory reactions, then patients with reduced immune capacity might show less severe periodontal disease than otherwise healthy subjects [5, 6]. However, others found about the same degree of periodontal destruction in patients on hemodialysis and in systemically healthy subjects [6]. They pointed out that substances released from dental plaque may also directly cause periodontal breakdown. Since local immune reactions provide an important barrier against invading toxins and antigens, lack of proper immune responses might well accentuate the loss of tooth support. Moreover, children with renal problems provide an opportunity to study the pathogenesis of periodontal diseases, because these individuals have an altered immune system [7]. The aim of the present study was to compare the relationship between plaque and gingival inflammation under uremia and immunosuppression; added to the assessment of periodontal disease progression in such patients