Oral Surgery and Dental Implants in Patients with Chronic Kidney Disease: Scoping Review for Oral Health Status.

Abstract

The number of chronic kidney disease (CKD) patients requiring renal replacement therapy is increasing, often exhibiting oral manifestations including periodontal disease, gingival hyperplasia, altered saliva composition, and uremic stomatitis. Uremic stomatitis, xerostomia, and candidiasis are very frequent, particularly among patients undergoing dialysis or kidney transplant recipients. CKD patients also experience profound alterations in bone metabolism inherent in the homeostasis of calcium, phosphorus, vitamin D, parathyroid hormone, and fibroblast growth factor (FGF). These alterations lead to demineralization of the jaw bones, reduced bone trabeculae, reduced cortical bone thickness, fibrocystic bone lesions, bone fractures, and delayed wound healing post-tooth extraction. Consequently, oral health management of elderly hemodialysis patients poses serious clinical problems. This review focused on the oral health and rehabilitation of patients with CKD or on dialysis.