Oral health and dental treatment of patients with renal disease.

OBJECTIVES: To outline aspects that need consideration in the dental office when treating patients with renal disease and to present data on the oral health parameters of patients during the different phases of their renal disease during a 10-year follow-up period. Differences in clinical and salivary study parameters during the course of treatment of the renal disease were expected to occur. METHOD AND MATERIALS: Altogether, 39 patients with chronic renal failure were examined for dental health. Nine patients (mean age 50.8 years) were followed for 10 years through predialysis, dialysis, and posttransplant stages. The patients were examined clinically and radiographically and by analyzing the biochemical constituents of saliva. Patients' perceptions of oral health were recorded using structured questionnaires. RESULTS: No statistically significant differences were observed in the clinical parameters studied during the follow-up period. However, analyses of saliva components after renal transplantation showed significant improvement compared with components found during the predialysis stage. For example, median salivary albumin concentration, which describes the leakage of serum components to saliva, was 399 microg/mL at the predialysis stage, 353 microg/mL at the dialysis stage, and 181 .g/mL at the posttransplant stage. CONCLUSIONS: From the oral health point of view, the outcome was better than anticipated. The lower salivary albumin values after kidney transplantation may reflect the improvement of patients' health during the course of the treatment.

Bioportfolio: lifelong persistence of variant and prototypic erythrovirus DNA genomes in human tissue.

Human erythrovirus is a minute, single-stranded DNA virus causing many diseases, including erythema infectiosum, arthropathy, and fetal death. After primary infection, the viral genomes persist in solid tissues. Besides the prototype, virus type 1, two major variants (virus types 2 and 3) have been identified recently, the clinical significance and epidemiology of which are mostly unknown. We examined 523 samples of skin, synovium, tonsil, or liver (birth year range, 1913-2000), and 1,640 sera, by qualitative and quantitative molecular assays for the DNA of human erythroviruses. Virus types 1 and 2 were found in 132 (25%) and 58 (11%) tissues, respectively. DNA of virus type 1 was found in all age groups, whereas that of type 2 was strictly confined to those subjects born before 1973 (P < 0.001). Correspondingly, the sera from the past two decades contained DNA of type 1 but not type 2 or 3. Our data suggest strongly that the newly identified human erythrovirus type 2 as well as the prototype 1 circulated in Northern and Central Europe in equal frequency, more than half a century ago, whereafter type 2 disappeared from circulation. Type 3 never attained wide occurrence in this area during the past > or =70 years. The erythrovirus DNA persistence in human tissues is lifelong and represents a source of information about our past, the Bioportfolio, which, at the individual level, provides a registry of one's infectious encounters, and at the population level, a database for epidemiological and phylogenetic analyses.