Karita M Nylund1, Jukka H Meurman2, Anna Maria Heikkinen2, Jussi O Furuholm2, Fernanda Ortiz3,4, Hellevi M Ruokonen2. 1. Department of Oral and Maxillofacial Diseases, Head and Neck Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland. karita.nylund@helsinki.fi. 2. Department of Oral and Maxillofacial Diseases, Head and Neck Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland. 3. Abdominal Center, Nephrology, Helsinki University Hospital, Helsinki, Finland. 4. Folkhälsan Institute of Genetics, Folkhälsan Research Center, Helsinki, Finland.
Abstract
OBJECTIVES: The aim of this longitudinal study was to compare the oral health of chronic kidney disease patients at the predialysis (baseline) and post-transplantation (follow-up) stages and to investigate differences in oral health between diabetic nephropathy and other kidney disease patients at follow-up. MATERIALS AND METHODS: Fifty-three kidney disease patients (34 men) aged 31-86 years were followed up to 157 months. Clinical and radiological oral examinations, salivary and laboratory analyses, and oral health behavior questionnaires were conducted at the predialysis and follow-up stages at Helsinki University Hospital, Finland. Oral inflammatory burden was estimated by calculating deep periodontal pockets, periodontal inflammatory burden (PIBI), decayed, missing, and filled teeth (DMFT), and total dental indices (TDI). Results were analyzed using cross-tabulation Pearson chi-square or Fisher's exact test and the Mann-Whitney U test, and the McNemar and Wilcoxon signed-rank test. RESULTS: At the predialysis stage, patients more often had calculus and deep periodontal pockets; TDI, PIBI, number of teeth, and salivary flow rates were also statistically significantly higher compared to follow-up. At follow-up, diabetic nephropathy patients more often had Candida growth, more plaque, and used more drugs and had lower stimulated salivary flow than patients with other kidney diseases. CONCLUSION: Oral health was better at follow-up than at the predialysis stage; however, attention should be given to the lower salivary flow rate and higher number of drugs used at that stage. CLINICAL RELEVANCE: This study confirms the importance of treating oral infectious foci at the predialysis stage in order to prevent adverse outcomes after kidney transplantation.
OBJECTIVES: The aim of this longitudinal study was to compare the oral health of chronic kidney diseasepatients at the predialysis (baseline) and post-transplantation (follow-up) stages and to investigate differences in oral health between diabetic nephropathy and other kidney diseasepatients at follow-up. MATERIALS AND METHODS: Fifty-three kidney diseasepatients (34 men) aged 31-86 years were followed up to 157 months. Clinical and radiological oral examinations, salivary and laboratory analyses, and oral health behavior questionnaires were conducted at the predialysis and follow-up stages at Helsinki University Hospital, Finland. Oral inflammatory burden was estimated by calculating deep periodontal pockets, periodontal inflammatory burden (PIBI), decayed, missing, and filled teeth (DMFT), and total dental indices (TDI). Results were analyzed using cross-tabulation Pearson chi-square or Fisher's exact test and the Mann-Whitney U test, and the McNemar and Wilcoxon signed-rank test. RESULTS: At the predialysis stage, patients more often had calculus and deep periodontal pockets; TDI, PIBI, number of teeth, and salivary flow rates were also statistically significantly higher compared to follow-up. At follow-up, diabetic nephropathypatients more often had Candida growth, more plaque, and used more drugs and had lower stimulated salivary flow than patients with other kidney diseases. CONCLUSION: Oral health was better at follow-up than at the predialysis stage; however, attention should be given to the lower salivary flow rate and higher number of drugs used at that stage. CLINICAL RELEVANCE: This study confirms the importance of treating oral infectious foci at the predialysis stage in order to prevent adverse outcomes after kidney transplantation.
Authors: A Sánchez-Escuredo; A Alsina; F Diekmann; I Revuelta; N Esforzado; M J Ricart; F Cofán; J V Torregrosa; J M Campistol; F Oppenheimer; E Fernandez Journal: Transplant Proc Date: 2015 Jan-Feb Impact factor: 1.066
Authors: Maarit Vesterinen; Hellevi Ruokonen; Tomi Leivo; Anne-Marie Honkanen; Eero Honkanen; Kirsti Kari; Christian Lindqvist; Jukka H Meurman Journal: Quintessence Int Date: 2007-03 Impact factor: 1.677
Authors: K J Mattila; M S Nieminen; V V Valtonen; V P Rasi; Y A Kesäniemi; S L Syrjälä; P S Jungell; M Isoluoma; K Hietaniemi; M J Jokinen Journal: BMJ Date: 1989-03-25
Authors: Karita Nylund; Jukka H Meurman; Anna Maria Heikkinen; Eero Honkanen; Maarit Vesterinen; Hellevi Ruokonen Journal: Quintessence Int Date: 2015 Nov-Dec Impact factor: 1.677
Authors: Maria Pippias; Vianda S Stel; José Maria Abad Diez; Nikolaos Afentakis; Jose Antonio Herrero-Calvo; Manuel Arias; Natalia Tomilina; Encarnación Bouzas Caamaño; Jadranka Buturovic-Ponikvar; Svjetlana Čala; Fergus J Caskey; Pablo Castro de la Nuez; Harijs Cernevskis; Frederic Collart; Ramón Alonso de la Torre; Maria de Los Ángeles García Bazaga; Johan De Meester; Joan Manuel Díaz; Ljubica Djukanovic; Manuel Ferrer Alamar; Patrik Finne; Liliana Garneata; Eliezer Golan; Raquel González Fernández; Gonzalo Gutiérrez Avila; James Heaf; Andries Hoitsma; Nino Kantaria; Mykola Kolesnyk; Reinhard Kramar; Anneke Kramer; Mathilde Lassalle; Torbjørn Leivestad; Frantisek Lopot; Fernando Macário; Angela Magaz; Eduardo Martín-Escobar; Wendy Metcalfe; Marlies Noordzij; Runolfur Palsson; Ülle Pechter; Karl G Prütz; Marina Ratkovic; Halima Resić; Boleslaw Rutkowski; Carmen Santiuste de Pablos; Viera Spustová; Gültekin Süleymanlar; Karlijn Van Stralen; Nestor Thereska; Christoph Wanner; Kitty J Jager Journal: Clin Kidney J Date: 2015-03-23