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慢性肾病患儿的龋齿、口腔卫生及唾液特征:一项病例对照研究。

Dental caries, oral hygiene and salivary characteristics in children with chronic kidney disease: a case-control study.

作者信息

Kodaman Dokumacıgil Nur, Sezer Berkant, Oktay Şehkar, Alpay Harika, Kargül Betül

机构信息

Department of Pediatric Dentistry, Faculty of Dentistry, Institute of Health Science, Marmara University, Istanbul, Türkiye.

Department of Pediatric Dentistry, School of Dentistry, Marmara University, Istanbul, Türkiye.

出版信息

Pediatr Nephrol. 2025 Mar 19. doi: 10.1007/s00467-025-06730-4.

Abstract

BACKGROUND

The aim of this study was to compare the oral health findings and salivary parameters of children with different stages of chronic kidney disease (CKD) with those of healthy peers.

METHODS

Intraoral examinations were performed on 43 children aged 8-17 years with CKD and 40 healthy controls from the same pediatric nephrology clinic. Oral health was assessed using the DMFT/dft indices (decayed-missing-filled-teeth), debris index (DI), calculus index (CI), and simplified oral hygiene index (OHI-S). Saliva samples from the children were analyzed for salivary flow rate (SFR), pH, buffering capacity (BC), total oxidant status (TOS), total antioxidant capacity (TAOC), urea, creatinine (Cr), calcium (Ca), potassium (K), phosphorus (P), and salivary α-amylase (SAA). Spearman's rho coefficient was used to examine the relationship between salivary and serum biomarkers levels and oral health findings.

RESULTS

While the DMFT/dft scores were lower in children with CKD (p = 0.001), DI, CI, and OHI-S scores were higher in healthy peers (p < 0.001). Children with CKD had lower SFR, Ca, and TAOC levels, and higher BC, pH, urea, Cr, K, P, TOS, and SAA levels (p < 0.001) compared to healthy controls. Later stages of CKD was associated with the lower dft ( = - 0.35; p = 0.022).

CONCLUSIONS

Children with CKD exhibit fewer caries and poorer oral hygiene compared to their healthy peers, and their saliva characteristics differ significantly from those of the healthy group. Disease-related changes in serum and salivary characteristics affect the oral health of children with CKD, necessitating collaboration between pediatric nephrologists and dentists.

TRIAL REGISTRATION

ClinicalTrials.gov (NCT06578832).

摘要

背景

本研究旨在比较不同阶段慢性肾脏病(CKD)儿童与健康同龄人的口腔健康状况及唾液参数。

方法

对来自同一儿科肾脏病诊所的43名8至17岁的CKD儿童和40名健康对照者进行口腔内检查。使用DMFT/dft指数(龋失补牙数)、软垢指数(DI)、牙石指数(CI)和简化口腔卫生指数(OHI-S)评估口腔健康状况。分析儿童的唾液样本,检测唾液流速(SFR)、pH值、缓冲能力(BC)、总氧化状态(TOS)、总抗氧化能力(TAOC)、尿素、肌酐(Cr)、钙(Ca)、钾(K)、磷(P)和唾液α淀粉酶(SAA)。采用Spearman等级相关系数检验唾液和血清生物标志物水平与口腔健康状况之间的关系。

结果

CKD儿童的DMFT/dft评分较低(p = 0.001),而健康同龄人的DI、CI和OHI-S评分较高(p < 0.001)。与健康对照者相比,CKD儿童的SFR、Ca和TAOC水平较低,而BC、pH值、尿素、Cr、K、P、TOS和SAA水平较高(p < 0.001)。CKD后期阶段与较低的dft相关(ρ = - 0.35;p = 0.022)。

结论

与健康同龄人相比,CKD儿童龋齿较少但口腔卫生较差,且其唾液特征与健康组有显著差异。血清和唾液特征的疾病相关变化影响CKD儿童的口腔健康,因此儿科肾脏病医生和牙医之间需要合作。

试验注册

ClinicalTrials.gov(NCT06578832)。

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