Oral health and inflammation in patients with end-stage renal failure.

BACKGROUND/AIMS: End-stage renal disease (ESRD) patients have an increased risk of atherosclerotic complications. In both hemodialysis (HD) patients and the general population, it has become evident that inflammation plays an important role in the pathogenesis of atherosclerotic complications. Oral and dental problems in ESRD patients could be an important source of inflammation, thus treatment of these problems is important to protect these patients from potential infections. The decayed, missing, and filled teeth (DMFT) index is an indicator of oral and dental health status. Our aim was to analyze and compare salivary flow rate (SFR), salivary pH (SpH), salivary buffering capacity (SBC), and DMFT index and plaque index (PI) values in PD patients to HD patients and healthy controls (C) and establish the relationship between these parameters and C-reactive protein (CRP). METHODS: 76 PD patients, 100 HD patients, and 111 Cs were included in the study. SFR (milliliters/minute) was measured in stimulated whole saliva, SpH was measured using the Merck indicator, and SBC was measured according to the method of Ericsson: 1 mL whole saliva was added to 3 mL 0.005 N HCl and a stream of air was passed through this mixture for 20 minutes. Finally, DMFT index and PI values were calculated. RESULTS: No statistically significant differences were found in age or gender distribution among PD, HD, and C groups. There was also no significant difference in time on dialysis between PD and HD groups. SFR was significantly lower in the PD and HD groups than in the C group (1.30 +/- 0.83 and 0.70 +/- 0.32 vs 1.64 +/- 0.45 mL/min) and lower in the HD than in the PD group (p < 0.001). SpH (8.35 +/- 0.43 and 8.12 +/- 0.74 vs 7.16 +/- 0.76) and SBC (7.39 +/- 0.47 and 6.82 +/- 0.70 vs 5.08 +/- 0.73) were significantly higher in the PD and HD groups than in the C group and higher in the PD than in the HD group (p < 0.05 and p < 0.001 respectively). The numbers of filled teeth were significantly higher in the PD than in the HD and C groups (p < 0.001). DMFT index was significantly higher in the PD than in the HD group (p < 0.001). Finally, PI values were significantly higher in the PD and HD groups than in the C group (p < 0.001) and higher in the HD than in the PD group, although this was not statistically significant. In the present study, we also found higher CRP values in HD than in PD patients and a positive correlation between CRP and PI values in PD patients. CONCLUSIONS: PD patients have higher SFR, SpH, and SBC values than HD patients; however, higher DMFT index and higher numbers of filled teeth were observed in PD patients. Compared to healthy controls, patients on dialysis had worse dental and periodontal findings, which might have a role in microinflammation in this group of patients.

Effect of educational level on oral health in peritoneal and hemodialysis patients.

Background. In previous studies, the oral and dental health statuses were compared in hemodialysis (HD) and peritoneal dialysis (PD) patients without taking into account the effect of educational levels on oral health. Hence we aimed to make a comparison of these parameters based upon the subjects educational levels. Patients and Methods. 76 PD (33 males, 43 females-mean age: 44 +/- 12 years) and 100 HD (56 males, 44 females-mean age: 46 +/- 14 years) patients were included. The number of decayed, missing and filled teeth were detected, DMFT index was calculated and plaque index (PI) values were assessed. Results. Significantly higher numbers of filled teeth (P < .001) and lower PI values (P < .01) in the PD group were detected with higher educational levels, whereas no significance was detected in the HD group. Higher DMFT index values were assessed in the lower educated and high school levels in PD than HD patients (P < .05). Higher numbers of filled teeth (P < .05) were detected in the secondary school level in PD patients. This difference was even more significant in the high school level (P < .001). Conclusion. We assume that PD patients, who were found to be in a higher educational level, are more caring for their oral health as compared to HD patients.

Interim removable partial dentures: two case reports.

For the partially edentulous patient, an interim denture can provide acceptable short-term function and esthetics by replacing missing teeth and tissues until a definitive restoration can be performed. This article presents two cases that required interim removable partial dentures to maintain function, phonation, and esthetics until clinical conditions allowed for the fabrication of definitive dentures.