Sezer Berkant, Kaya Remziye, Kodaman Dokumacıgil Nur, Sıddıkoğlu Duygu, Güven Serçin, Yıldız Nurdan, Alpay Harika, Kargül Betül
Department of Pediatric Dentistry, School of Dentistry, Çanakkale Onsekiz Mart University, Çanakkale, Turkey.
Department of Pediatric Dentistry, School of Dentistry, Marmara University, Istanbul, Turkey.
Pediatr Nephrol. 2023 Jan;38(1):269-277. doi: 10.1007/s00467-022-05590-6. Epub 2022 Apr 30.
There are various oral symptoms related to the disease and its management in individuals with chronic kidney disease (CKD). The aim of the study was to investigate the oral health status of children with different stages of CKD, kidney transplant recipients (KTR), and healthy children.
A total of seventy-one children diagnosed with CKD and fifty-two healthy children were included in the study. Each patient was examined for dental caries by the decayed-missing-filled-teeth (DMFT/dmft) index and the International Caries Detection and Assessment System (ICDAS-II), developmental defects of enamel (DDE) by the DDE index, and oral hygiene by the debris (DI), calculus (CI), and simplified oral hygiene (OHI-S) indices.
The median number of DMFT/dmft was 1.00 (interquartile range (IQR):1.00-4.00) in children with stage 1-3 CKD, 0.00 (IQR: 0.00-2.50) in stage 4-5 children, 0.00 (IQR: 1.00-3.00) in KTR, and 8.00 (IQR: 1.00-13.00) in healthy children. According to ICDAS-II categories, the percentage of children with severe caries was 53.8% in healthy children, while it was 44.4% in KTR, 25.9% in stage 1-3, and 11.4% in stage 4-5 children. While the percentage of children with DDE was 88.8% in KTR, 80% in stage 4-5, and 66.7% in stage 1-3 children, this rate was 44.2% in healthy children. The highest mean OHI-S score was observed in stage 4-5 children (2.10 ± 1.08), followed by KTR (1.46 ± 1.19), stage 1-3 (1.27 ± 0.61), and healthy children (0.45 ± 0.44), respectively.
Compared to healthy children, children with CKD had more debris accumulation, calculus formation, and more DDE but a lower severity of dental caries. A higher resolution version of the Graphical abstract is available as Supplementary information.
慢性肾脏病（CKD）患者存在与疾病及其治疗相关的各种口腔症状。本研究旨在调查不同阶段CKD患儿、肾移植受者（KTR）及健康儿童的口腔健康状况。
本研究共纳入71例诊断为CKD的患儿和52例健康儿童。采用龋失补牙数（DMFT/dmft）指数和国际龋病检测与评估系统（ICDAS-II）检查每位患者的龋齿情况，采用釉质发育缺陷（DDE）指数检查釉质发育缺陷情况，采用软垢指数（DI）、牙石指数（CI）和简化口腔卫生指数（OHI-S）检查口腔卫生情况。
1-3期CKD患儿的DMFT/dmft中位数为1.00（四分位数间距（IQR）：1.00-4.00），4-5期患儿为0.00（IQR：0.00-2.50），KTR为0.00（IQR：1.00-3.00），健康儿童为8.00（IQR：1.00-13.00）。根据ICDAS-II分类，重度龋齿患儿在健康儿童中的比例为53.8%，在KTR中为44.4%，在1-3期为25.9%，在4-5期为11.4%。DDE患儿在KTR中的比例为88.8%，在4-5期为80%，在1-3期为66.7%，而在健康儿童中这一比例为44.2%。4-5期患儿的平均OHI-S评分最高（2.10±1.08），其次是KTR（1.46±1.19）、1-3期（1.27±0.61）和健康儿童（0.45±0.44）。
与健康儿童相比，CKD患儿软垢堆积、牙石形成更多，釉质发育缺陷更多，但龋齿严重程度较低。更高分辨率的图形摘要可作为补充信息获取。
