Abdinian Mehrdad, Mortazavi Mojgan, Jandaghian Zahra
Department of Maxillofacial Radiology, School of Dentistry, Dental Implant Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
Isfahan Kidney Diseases Research Center, Isfahan University of Medical Science, Isfahan, Iran.
Indian J Dent Res. 2019 May-Jun;30(3):358-362. doi: 10.4103/ijdr.IJDR_175_18.
Chronic kidney disease (CKD) is a prevalent condition affecting bone metabolism. Bone changes in CKD patients also known as renal osteodystrophy happen due to disorders in the regulation of water and electrolytes caused by the disease. The aim of this study is to investigate the bone changes of CKD stages 3-5 patients without dialysis using digital panoramic radiography.
In this cross-sectional study, panoramic radiographs were obtained from 30 patients with CKD stages 3-5 and 30 age and gender matched healthy individuals. The mean values of quantitative parameters such as mental index (MI), panoramic mandibular index (PMI), and antegonial index (AI) were measured and qualitative parameters such as mandibular cortical index (MCI) and trabecular bone pattern (TP) were recorded based on Kelemetti and Lindh calcifications, respectively. Statistical analysis was performed using t-test, Chi-square, and Mann-Whitney test (α = 0.05).
The mean values of MI, PMI, and AI in the two groups were not statistically significant (P > 0.05). MCI and TP were significantly different between the two groups. MCI showed more defects in mandibular cortex of CKD patients (6.7% of patients vs. 0% of control group were C, P = 0.038), and TP showed more porosity in mandibular bone of CKD patients (10% of patients vs. 0% of control group were sparse, P = 0.001).
The amount of MI, PMI, and AI were not related to CKD. While MCI and TP were significant parameters that showed mandibular cortical situation and trabecular bone pattern, they assess osteoporosis level in a more reliable manner in CKD stages 3-5 patients without dialysis.
慢性肾脏病(CKD)是一种影响骨代谢的常见病症。CKD患者的骨变化,也称为肾性骨营养不良,是由该疾病引起的水和电解质调节紊乱所致。本研究的目的是使用数字化全景X线摄影术调查3 - 5期未透析CKD患者的骨变化情况。
在这项横断面研究中,获取了30例3 - 5期CKD患者以及30例年龄和性别相匹配的健康个体的全景X线片。测量了诸如颏部指数(MI)、全景下颌骨指数(PMI)和下颌角点指数(AI)等定量参数的平均值,并分别基于Kelemetti和Lindh钙化记录了诸如下颌骨皮质指数(MCI)和骨小梁模式(TP)等定性参数。使用t检验、卡方检验和曼 - 惠特尼检验进行统计分析(α = 0.05)。
两组的MI、PMI和AI平均值无统计学差异(P > 0.05)。两组之间MCI和TP存在显著差异。MCI显示CKD患者下颌骨皮质的缺损更多(患者中6.7%为C级,对照组为0%,P = 0.038),并且TP显示CKD患者下颌骨的孔隙率更高(患者中10%为稀疏型,对照组为0%,P = 0.001)。
MI、PMI和AI的数值与CKD无关。虽然MCI和TP是显示下颌骨皮质情况和骨小梁模式的重要参数,但它们能更可靠地评估3 - 5期未透析CKD患者的骨质疏松程度。