Department of Endodontics, Case Western Reserve University, School of Dental Medicine, Cleveland, Ohio.
Department of Endodontics, Case Western Reserve University, School of Dental Medicine, Cleveland, Ohio.
J Endod. 2017 Sep;43(9):1438-1441. doi: 10.1016/j.joen.2017.04.014. Epub 2017 Jul 13.
The present study aimed to evaluate the prevalence of apical periodontitis (AP) and endodontic treatment in patients with end-stage renal disease (ESRD) as compared with patients with no history of ESRD.
In this cross-sectional study, 40 patients diagnosed with nondiabetic ESRD were included. The control group consisted of 40 age-matched and sex-matched healthy individuals. Digital panoramic radiographs were exposed on patients in both the experimental and control groups. The number of remaining teeth and the prevalence of nonsurgical and/or surgical root canal treatment were evaluated. Also, the presence of AP in all teeth and endodontically treated teeth (ETT) was recorded using the periapical index. Logistic regression was used to determine the possible association between ESRD and AP.
AP in at least 1 tooth was found in 29 of the patients with ESRD (73%) and in 16 of the control patients (40%) (odds ratio [OR] = 3.9, P < .05). In 21 (52%) patients with ESRD in the experimental group, at least 1 ETT was diagnosed with AP. In the control group, 11 (28%) individuals had AP affecting at least 1 of the ETT (OR = 2.9, P < .05). Adjusted for the number of teeth and endodontic treatment, ESRD was significantly associated with the presence of AP (P < .05; OR = 2.6; 95% confidence interval, 1.43-4.8). Also, the number of teeth with AP was significantly associated with the urea serum level in the experimental group (P < .05, β coefficient = 4.35).
AP was significantly more prevalent in the experimental group. This may suggest that ESRD could possibly alter the pathogenesis of AP. However, these findings do not confirm the presence of any cause-and-effect relationship between these conditions. Also, considering the modifying effect of AP on urea serum level, the treatment of AP could be incorporated in the treatment planning of patients with ESRD.
本研究旨在评估与无终末期肾病(ESRD)病史的患者相比,ESRD 患者根尖周炎(AP)和根管治疗的患病率。
在这项横断面研究中,纳入了 40 名诊断为非糖尿病 ESRD 的患者。对照组由 40 名年龄和性别匹配的健康个体组成。对实验组和对照组的所有患者进行数字全景射线照相。评估剩余牙齿的数量以及非手术和/或手术根管治疗的患病率。此外,使用根尖指数记录所有牙齿和根管治疗牙(ETT)的 AP 存在情况。使用逻辑回归确定 ESRD 与 AP 之间可能存在的关联。
在 29 名 ESRD 患者(73%)中至少有 1 颗牙齿存在 AP,在 16 名对照组患者(40%)中至少有 1 颗牙齿存在 AP(比值比[OR] = 3.9,P < 0.05)。在实验组的 21 名(52%)ESRD 患者中,至少有 1 颗 ETT 被诊断为 AP。在对照组中,有 11 名(28%)个体的至少 1 颗 ETT 患有影响 AP(OR = 2.9,P < 0.05)。调整牙齿数量和根管治疗后,ESRD 与 AP 的存在显著相关(P < 0.05;OR = 2.6;95%置信区间,1.43-4.8)。此外,实验组中 AP 牙齿数量与尿素血清水平显著相关(P < 0.05,β系数= 4.35)。
实验组中 AP 的患病率明显更高。这可能表明 ESRD 可能会改变 AP 的发病机制。然而,这些发现并不能证实这些疾病之间存在任何因果关系。此外,考虑到 AP 对尿素血清水平的修饰作用,AP 的治疗可以纳入 ESRD 患者的治疗计划中。