End-stage renal failure is the reason for complications in many systems and organs, and the applied pharmacotherapy often causes the deepening of already existing pathologies within the oral cavity, such as: caries, periodontal diseases, mucosal lesions or reduced saliva secretion. Reduced saliva secretion results in an increased accumulation of dental plaque, its mineralization and prolonged retention, which leads to the development of gingival and periodontal inflammation. There is some evidence that chronic kidney diseases are influenced by periodontal health. The aim of the work was to evaluate the dental needs by the usage of clinical assessment of periodontal tissues of patients suffering from end-stage chronic kidney disease, arterial hypertension or/and diabetes mellitus.
Material and methods: 228 patients underwent the research. 180 patients were hemodialized in Diaverum dialysis stations (42 of them were diagnosed with end stage chronic disease, 79 with the end stage chronic disease and arterial hypertension, 16 with end stage chronic kidney disease and diabetes, 43 with end-stage chronic disease, arterial hypertension and diabetes) and 48 patients of the Conservative Dentistry with Endodontics Clinic of Academic Centre of Dentistry of Silesian Medical University in Bytom and patients of the dentistry division of Arnika Clinic in Zabrze not diagnosed with any of the aforementioned diseases. The scheme of the research comprised 2 parts: analysis of the general health and assessment of the periodontal status which contain the following indices: Periodontal Probing Depth (PPD), Clinical Attachment Lost (CAL), Bleeding Index or Bleeding on Probing Index (BI or BOP), Community Periodontal Index for Treatment Needs (CPITN).
Results: Significantly lower percentage of patients with healthy periodontal tissues and higher percentage with periodontal pockets deeper than 3.5 mm and the loss of trainers connective of 5 mm or higher were in the examined group. The values of the bleeding index were significantly lower in control group. The analysis of the CPITN index indicates higher percentage of patients qualified as CPI 1 or 2 in the control group while in the examined one most of the patients turned out to require specialist periodontal treatment.
Conclusions: there is a direct relationship between periodontal status and end-stage renal disease which typically includes other chronical civilization ailments. It is important to develop a scheme for the easy and rapid examination of periodontal status, to determine the treatment needs in this area, which will allow precise assignment of long-term dialyzed patients to the range of prophylactic and therapeutic procedures.
Keywords: diabetes mellitus; end-stage chronic kidney disease; hypertension; periodontal status.