Pereira-Lopes Otília, Simões-Silva Liliana, Araujo Ricardo, Correia-Sousa Joana, Braga Ana C, Soares-Silva Isabel, Sampaio-Maia Benedita
Quintessence Int. 2019;50(3):216-223. doi: 10.3290/j.qi.a41920.
Chronic kidney disease (CKD) is a public health problem worldwide. Currently, the link between oral health status, dialysis modality, and dialysis vintage is still not clear. The aim of this study was to evaluate periodontal disease, dental caries, and Candida colonization among patients under hemodialysis (HD) therapy, peritoneal dialysis (PD) therapy, and PD with previous history of HD (HD/PD).
The clinical history, smoking, and oral hygiene habits were recorded. Decayed, missing, or filled teeth (DMFT) index, Visible Plaque Index (VPI), clinical attachment level (CAL), bleeding on probing, saliva flow rate, saliva pH, and oral yeast colonization were assessed.
HD/PD patients were generally submitted to longer periods of dialysis therapy than the other groups. The number of decayed and filled teeth did not differ between groups; HD patients presented a higher number of teeth, but poor periodontal status. Among the three groups, HD patients presented higher VPI, CAL, and oral Candida colonization, independently of the time under dialysis therapy. Candida albicans (HD and PD), Candida krusei (HD), and Candida carpophila (PD) were isolated in these patients.
HD presented a more adverse impact on oral health than PD, particularly periodontal disease and oral Candida colonization; however, this impact on oral health appears to be reduced or ameliorated when patients change from HD to PD therapy.
慢性肾脏病（CKD）是一个全球性的公共卫生问题。目前，口腔健康状况、透析方式和透析龄之间的联系仍不明确。本研究的目的是评估接受血液透析（HD）治疗、腹膜透析（PD）治疗以及有HD病史的PD（HD/PD）患者的牙周疾病、龋齿和念珠菌定植情况。
记录临床病史、吸烟情况和口腔卫生习惯。评估龋失补牙（DMFT）指数、可见菌斑指数（VPI）、临床附着水平（CAL）、探诊出血、唾液流速、唾液pH值和口腔酵母菌定植情况。
HD/PD患者接受透析治疗的时间通常比其他组更长。各组之间龋牙和补牙的数量没有差异；HD患者的牙齿数量较多，但牙周状况较差。在三组中，HD患者的VPI、CAL和口腔念珠菌定植情况更高，且与透析治疗时间无关。在这些患者中分离出白色念珠菌（HD和PD）、克鲁斯念珠菌（HD）和嗜果念珠菌（PD）。
HD对口腔健康的不良影响比PD更大，尤其是牙周疾病和口腔念珠菌定植；然而，当患者从HD转为PD治疗时，这种对口腔健康的影响似乎会减轻或改善。
