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Abstract
Chronic kidney disease (CKD) affects 8–13% of the global population and has become one of the largest burdens on healthcare systems around the world. Peritoneal dialysis is one of the ultimate treatments for patients with severe CKD. Recently, increasing severe periodontal problems have been found in CKD patients. Periodontitis has been identified as a new variable risk factor for CKD. The aim of this study was to investigate the periodontal status and severity of alveolar bone loss in CKD patients with peritoneal dialysis (PD). One hundred and six patients undergoing PD (PD group) and 97 systemically healthy periodontitis patients (control group) were enrolled. The differences in the dimensions of the alveolar bone between two groups were compared, and the distribution of alveolar bone defects was analyzed by cone-beam computed tomography (CBCT). Gingival index (GI), plaque index (PLI), periodontal probing depth (PPD), and attachment loss (AL) were recorded. The levels of inflammatory factors in gingival crevicular fluid were assessed by ELISA. Compared to control group, there was a higher degree of alveolar bone loss in maxillary premolars, maxillary 2nd molar and mandibular 1st molar in patients with PD (p < 0.05). A comparison of bone loss in different sites revealed that the area with the highest degree of bone loss were on the mesial-buccal, mid-buccal, distal-buccal, and mesial-lingual site in PD patients. The expression levels of inflammatory factors were higher in PD group (p < 0.01). In conclusion, PD patients presented more severe periodontal and inflammatory status than systemically healthy periodontitis patients. The loss of the alveolar bone differed between the two groups. Different sites and teeth exhibited a diverse degree of bone loss. This study highlights that clinicians should pay close attention to periodontal status of peritoneal dialysis patients and provides a new thinking to improve healthcare for CKD.
Highlights
Periodontitis is a chronic inflammatory and destructive disease characterized by periodontal tissue damage
The results revealed that bone resorptions in the mesio-buccal, mid-buccal, distalbuccal, mesio-lingual, and mid-lingual site of the peritoneal dialysis (PD) group were statistical significantly greater than that of the control group (Table 6)
The results of this study found that oral hygiene, degree of periodontitis, and alveolar bone resorption were more pronounced in PD patients than in the periodontitis population
Summary
Periodontitis is a chronic inflammatory and destructive disease characterized by periodontal tissue damage. Recent global burden of disease studies have shown that severe periodontitis is the sixth-most prevalent disease worldwide (Tonetti et al, 2017; Hickey et al, 2020). Since the 1990s, the link between periodontal health and systemic conditions has been increasingly noted, leading to the development of “Periodontal Medicine.”. Periodontitis is thought to affect several common systemic conditions such as chronic kidney disease (CKD), cardiovascular disease (CVD), and diabetes mellitus. Periodontal medicine establishes a two-way relationship between periodontal disease and overall health (Monsarrat et al, 2016). The relationship between periodontitis and CKD has become a research hotspot
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