CHRONIC APICAL PERIODONTITIS IN CHRONIC KIDNEY DISEASE PATIENTS
Figure 1. Prevalence of chronic apical periodontitis in the group of patients
and in other specialties. Apical periodontitis are oral inflammatory disorders associated with systemic inflammatory changes. Endodontic infections are characterized by the presence of some soluble bacterial products with a strong pro-inflammatory potential. Lipopolysaccharides, present and released from the gram-negative cell walls, are components of endodontic bacteria best described to induce cytokines and other inflammatory components as IFNγ, IL-1 α and β, IL6, IL8, TNFα. 3 The purpose of this study was to evaluate the prevalence of chronic apical periodontitis in a group of chronic kidney disease patients and their relationship with the parameters related to the renal function.
2. Materials and methods
51 predialysed adults were included in this study that was approved by the Ethical Committee of the“ Carol Davila” University of Medicine and Pharmacy, number 31 on August 9, 2014. They were known for at least one year to have CKD( GFR < 60 ml / min / 1.73 m ²), had the ability to understand the protocol and signed the informed consent form. Bimaxillary edentulous patients under immunosuppressive treatment, those with mental retardation, mental illness or malignancy, pregnant or lactating women were excluded. The medical parameters were extracted from the observation charts of the hospital using a registration form that included: age, gender, residence, education level, smoker / non-smoker status, the diagnosis of basic kidney disease, current level eGFRs, the stage of CKD, association or not with diabetes or not, acid-base balance parameters of bone mineral metabolism, anthropometric and biochemical parameters of nutritional status, hematological changes and state of systemic inflammation. Panoramic radiographs were performed to diagnose chronic periapical dental infections or other pathology existing in the bone tissue. Retroalveolar X-rays were indicated by the contributor specialist radiologist after seeing the orthopantomograms, for those cases where he considered them to correctly diagnose chronic apical periodontitis. Chronic apical periodontitis has been diagnosed by the presence of any radiolucent areas detected in the apical third of teeth. The diagrams were made using Microsoft Excel 2007, and the statistical analysis was performed using SPSS statistical analysis software version 19. Statistical correlations between variables were tested by using the tool Analyze→Correlate→Bivariate.
3. Results
Chronic apical periodontitis was diagnosed radiographically and confirmed by the presence of any radiolucent areas detected in the apical third of teeth. Thus, 29.41 % of patients had no periapical lesion, 33.33 % had one periapical lesion, 17.64 % had 2 periapical lesions and the remaining 19.62 % had at least three periapical lesions( Fig. 1). Chronic apical periodontitis were not statistically significantly associated with any of the demographic variables( Table 1). In exchange, lower serum albumin levels were significantly associated with a greater number of periapical lesions. In addition, the large number of chronic apical periodontitis was significantly associated with high values of cholesterol. There was evidenced no significant relationship between chronic apical periodontitis on the one hand, and smoking, diabetes or body mass index( BMI), on the other hand( Table 2). The presence of apical lesions was not associated with any estimated glomerular filtration rate, or the chronic kidney disease stage( Table 3).
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