Sun Kristine, Shen Hui, Liu Yingli, Deng Hai, Chen Huiwen, Song Zhongchen
Department of Periodontology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai, China.
Department of Nephrology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Front Physiol. 2021 Dec 13;12:759056. doi: 10.3389/fphys.2021.759056. eCollection 2021.
Chronic kidney disease (CKD) affects 8-13% of the global population and has become one of the largest burdens on healthcare systems around the world. Peritoneal dialysis is one of the ultimate treatments for patients with severe CKD. Recently, increasing severe periodontal problems have been found in CKD patients. Periodontitis has been identified as a new variable risk factor for CKD. The aim of this study was to investigate the periodontal status and severity of alveolar bone loss in CKD patients with peritoneal dialysis (PD). One hundred and six patients undergoing PD (PD group) and 97 systemically healthy periodontitis patients (control group) were enrolled. The differences in the dimensions of the alveolar bone between two groups were compared, and the distribution of alveolar bone defects was analyzed by cone-beam computed tomography (CBCT). Gingival index (GI), plaque index (PLI), periodontal probing depth (PPD), and attachment loss (AL) were recorded. The levels of inflammatory factors in gingival crevicular fluid were assessed by ELISA. Compared to control group, there was a higher degree of alveolar bone loss in maxillary premolars, maxillary 2nd molar and mandibular 1st molar in patients with PD ( < 0.05). A comparison of bone loss in different sites revealed that the area with the highest degree of bone loss were on the mesial-buccal, mid-buccal, distal-buccal, and mesial-lingual site in PD patients. The expression levels of inflammatory factors were higher in PD group ( < 0.01). In conclusion, PD patients presented more severe periodontal and inflammatory status than systemically healthy periodontitis patients. The loss of the alveolar bone differed between the two groups. Different sites and teeth exhibited a diverse degree of bone loss. This study highlights that clinicians should pay close attention to periodontal status of peritoneal dialysis patients and provides a new thinking to improve healthcare for CKD.
慢性肾脏病(CKD)影响着全球8%-13%的人口,已成为全球医疗保健系统的最大负担之一。腹膜透析是重症CKD患者的最终治疗方法之一。最近,在CKD患者中发现严重牙周问题日益增多。牙周炎已被确定为CKD的一个新的可变风险因素。本研究的目的是调查接受腹膜透析(PD)的CKD患者的牙周状况和牙槽骨丧失的严重程度。招募了106例接受PD的患者(PD组)和97例全身健康的牙周炎患者(对照组)。比较两组之间牙槽骨尺寸的差异,并通过锥形束计算机断层扫描(CBCT)分析牙槽骨缺损的分布。记录牙龈指数(GI)、菌斑指数(PLI)、牙周探诊深度(PPD)和附着丧失(AL)。通过酶联免疫吸附测定(ELISA)评估龈沟液中炎症因子的水平。与对照组相比,PD患者上颌前磨牙、上颌第二磨牙和下颌第一磨牙的牙槽骨丧失程度更高(<0.05)。不同部位骨丧失的比较显示,PD患者中骨丧失程度最高的区域位于近中颊侧、颊侧中部、远中颊侧和近中舌侧部位。PD组炎症因子的表达水平更高(<0.01)。总之,与全身健康的牙周炎患者相比,PD患者的牙周和炎症状况更严重。两组之间牙槽骨丧失情况不同。不同部位和牙齿表现出不同程度的骨丧失。本研究强调临床医生应密切关注腹膜透析患者的牙周状况,并为改善CKD的医疗保健提供了新的思路。