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2007, Number 5

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Rev Med Inst Mex Seguro Soc 2007; 45 (5)

Periodontal disease in type 2 diabetes patients with and without chronic renal failure and dialysis

Rosa-García E, Irigoyen-Camacho ME, Aranda-Romo S, Cruz-Mérida S, Mondragón-Padilla A

Language: Spanish
References: 49
Page: 437-446
PDF size: 153.73 Kb.


ABSTRACT

Objective: To estimate and compare periodontal disease prevalence (PD) in two groups of patients with type 2 diabetes (T2D), with and without end stage renal disease (ESRD) and dialysis.
Material and methods: Using a cross sectional design, two groups of patients with type 2 diabetes were examined in two general hospitals belonging to Instituto Mexicano del Seguro Social in San Luis Potosí. Group A were patients with ESRD and dialysis; Group B, patients with serum creatinine ‹ 2.0 mg/dL. The WHO Community Periodontal Index (CPI) was used to assess PD. 233 patients were examined among which 172 had functional tooth, suitable for PD evaluation.
Results: 71 patients integrated group A; their mean age was 56.2 ± 11.8 years. 101 patients integrated group B, their mean age was 56.7 ± 11.9 years (p = 0.768). Elapsed time from T2D diagnosis was 221 ± 86 months for group A, and 126 ± 101 months for group B (p ‹ 0.001). Poor oral hygiene was found in 39.8 % of group A patients, and 34.6 % of group B patients (p = 0.133). PD prevalence, with CPI scores 3 and 4, was 63.4 % for group A, and 72.3 % for group B (p = 0.216). Multiple linear regression analysis found PD severity associated to ageing (p ‹ 0.001), poor oral hygiene (p ‹ 0.001) and for group A a shorter time from T2D diagnosis to ESRD (p = 0.0315). ESRD hemodialysis patient´s PD was more severe than that of peritoneal dialysis patients (p ‹ 0.03).
Conclusions: both groups had high prevalence of PD and poor oral hygiene. Patients treated with haemodialysis had more severe PD than peritoneal dialysis patients. A shorter time from DM diagnosis to ESRD was found associated to more severe PD.


REFERENCES

  1. Powers AC. Diabetes mellitus. En: Kasper DL, Braunwald E, Fauci AS, Hauser SL, Longo DL, Jameson JL, editores. Harrison,s principles of internal medicine. New York, USA: McGraw-Hill; 2005. p. 2152-2180.

  2. Olaiz G, Rojas R, Barquera S, Shamah T, Aguilar C, Cravioto P, et al. Encuesta Nacional de Salud 2000. Tomo 2. La salud de los adultos. Cuernavaca, Morelos, México. Instituto Nacional de Salud Pública, 2003. p. 93-104.

  3. Vázquez-Martínez JL, Gómez-Dantés S, Fernández-Cantón S. Diabetes mellitus en población adulta del IMSS. Resultados de la Encuesta Nacional de Salud 2000. Rev Med IMSS 2006;44(1):13-26.

  4. División Técnica de Información Estadística en Salud. Principales causas de muerte en el grupo de edad general según sexo (total nacional 2002). México: Instituto Mexicano del Seguro Social; 2002.

  5. Manfredi M, McCullough MJ, Vescovi P, Al-Kaarawi ZM, Porter SR. Update on diabetes mellitus and related oral disease. Oral Dis 2004; 10:187-200.

  6. Collin HL, Niskanen L, Uusisitupa M, Töyry J, Collin P, Koivisto AM, et al. Oral symptoms and signs in elderly patients with type 2 diabetes mellitus. A focus in diabetic neuropathy. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2000; 90:299-305.

  7. American Academy of Periodontology. Diabetes and periodontal diseases. Committee on Research, Science and Therapy. J Periodontol 2000; 71:664-678.

  8. Tervonen T, Oliver RC. Long-term control of diabetes mellitus and periodontitis. J Clin Periodontol 1993;20:431-435.

  9. Hugoson A, Thorstensson H, Falk H, Kuylenstierna J. Periodontal conditions in insulin-dependent diabetics. J Clin Periodontol 1989;16: 215-223.

  10. Jiménez-García G, Herrera-Echauri R, Borges-Yáñez SA. Severidad y extensión de periodontitis en sujetos adultos que acudieron a la clínica de admisión de la División de Estudios de Posgrado e Investigación, UNAM. Práctica Odontológica 1995;16:29-35.

  11. Borges-Yáñez SA, Irigoyen-Camacho ME, Maupomé G. Risk factors and prevalence of periodontitis in community-dwelling elders in Mexico. J Clin Periodontol 2006;33:184-194.

  12. Shlossman M, Knowler WC, Pettitt DJ, Genco RJ. Type 2 diabetes mellitus and periodontal disease. JADA 1990;121:532-536.

  13. Bai M, Ciglar I, Grani M, Planak D, Šutalo J. Dental status in a group of adult diabetic patients. Community Dent Oral Epidemiol 1989; 17:313-316.

  14. Cueto-Manzano AM, Cortés-Sanabria L, Martínez-Ramírez HR, Rojas-Campos E, Barragán G, Alfaro G, et al. Detection of early nephropathy in Mexican patients with type 2 diabetes mellitus. Kidney Int Suppl 2005;97:S40-S45.

  15. Amato D, Álvarez AC, Castañeda LR, Rodríguez E, Ávila DM, Arreola F, et al. Prevalence of chronic kidney disease in an urban Mexican population. Kidney Int 2005(suppl 97);68:S11-S17.

  16. Kho HS, Lee SW, Chung SCh, Kim YK. Oral manifestations and salivary flow rate, pH, and buffer capacity in patients with end-stage renal disease undergoing hemodialysis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1999;88: 316-319.

  17. Chuang SF, Sung JM, Kuo SCh, Huang JJ, Lee SY. Oral and dental manifestations in diabetic and nondiabetic uremic patients receiving hemodialysis. Oral Surg Oral Med Oral Pathol Oral Radiol Endond 2005;99:689-695.

  18. Al-Wahadni A, Al-Omari MA. Dental diseases in a Jordanian population on renal dialysis. Quintessence International 2003;34:343-347.

  19. Proctor R, Kumar N, Stein A, Moles D, Porter S. Oral and dental aspects of chronic renal failure. J Dent Res 2005;84:199-208.

  20. Gavaldá C, Bagán JV, Scully C, Silvestre FJ, Milián MA, Jimenez Y. Renal hemodialysis patients: oral, salivary, dental and periodontal findings in 105 adult cases. Oral Dis 1999;5:299-302.

  21. Naugle K, Darby ML, Bauman DB, Lineberger LT, Powers R. The oral health status of individuals on renal dialysis. Ann Periodontol 1998; 3:197-205.

  22. Khocht A. Periodontitis associated with chronic renal failure: A case report. J Periodontol 1996; 67:1206-1209.

  23. Tollefsen T, Johansen JR. The periodontal status in patients before and after renal allotransplantation. J Periodontal Res 1985;20:227-236.

  24. Kshirsagar AV, Moss KL, Elter JR, Beck JDE, Offenbacher S, Falk RJ. Periodontal disease is associated with renal insufficiency in the atherosclerosis risk in communities (ARIC) study. Am J Kidney Dis 2005;45:650-657.

  25. Encuestas de la salud bucodental: métodos básicos. Organización Mundial de la Salud. 4 ed. 1977. p. 36-39.

  26. Green JC, Vermillon JR. The simplified oral hygiene index. J Am Diet Assoc 1964;68:7-13.

  27. Khader YS, Dauod AS, El-Qaderi SS, Alkafajei A, Batayha WQ. Periodontal status of diabetics compared with nondiabetics: a meta-analysis. J Diabetes Complications 2006;20:59-68.

  28. Sastrowijoto SH, Hillemans P, van Steenbergen TJM, Abraham-Inpijn L, Graaff J. Periodontal condition and microbiology of healthy and disease periodontal pockets in type 1 diabetes mellitus patients. J Clin Periodontol 1989;16:316-322.

  29. Klassen JT, Krasko BM. The dental health status of dialysis patients. J Can Dent Assoc 2002;68:34-38.

  30. Attasi F. Oral home care and the reasons for seeking dental care by individuals on renal dialysis. J Contemp Dent Pract 2002;3:1-8.

  31. Galili D, Kaufman E, Leviner E, Lowental U. The attitude of chronic hemodialysis patients toward dental treatment. Oral Surg 1983;56:602-602.

  32. Franek E, Blaschyk R, Kolonko A, Mazur-Psonka L, Langowska-Adamczyk H, Drugacz J, et al. Oral hygiene in haemodialyzed patients with chronic renal failure. Wiad Lek 2006;59:184-188.

  33. Epstein SR, Mandel I, Scopp IW. Salivary composition and calculus formation in patients undergoing hemodialysis. J Periodontol 1980;51:336-338.

  34. Kitsou VK, Konstantinidis A, Siamopoulos KC. Chronic renal failure and periodontal disease. Renal Failure 2000;22:307-318.

  35. Tsai C, Hayes C, Taylor GW. Glycemic control of type 2 diabetes and severe periodontal disease in the US adult population. Community Dent Oral Epidemiol 2002;30:182-192.

  36. Eigner TL, Justak TJ, Bennett WM. Achieving oral health in patients with renal failure and transplants. J Am Dent Assoc 1986;113:112-114.

  37. Bots CP, Poorterman JHG, Brand HS, Kalsbeek H, Van Amerongen BM, Veerman ECI, et al. The oral health status of dentate patients with chronic renal failure undergoing dialysis therapy. Oral Dis 2006;12:176-180.

  38. Taylor GW, Burt B, Becker MP, Genco RJ, Shlossman M, Knowler WC, et al. Severe periodontitis and risk for poor glycemic control in patients with non-insulin-dependent diabetes mellitus. J Periodontol 1996;67:1085-1093.

  39. Bridges RB, Anderson JW, Saxe SR, Gregory K, Bridges SR. Periodontal status of diabetic and non-diabetic men: effects of smoking, glycemic control, and socioeconomic factors. J Periodontol 1996;67:1185-1192.

  40. Nathan DM, Cleary PA, Backlund JY, Genuth SM, Lachin JM, Orchard TJ, et al. Intensive diabetes treatment and cardiovascular disease in patients with type I diabetes. Diabetes control and complications trial/epidemiology of diabetes interventions and complications (DCCT/EDIC). Study research group. N Engl J Med 2005;353: 2643-2653.

  41. Effect on intensive therapy on the microvascular complications of type I diabetes mellitus. Writing team for the diabetes control and complications trial/epidemiology of diabetes interventions and complications research group. JAMA 2002;287: 2563-2569.

  42. Tight blood pressure control and risk of macrovascular and microvascular complications in type 2 diabetes: UKPDS 38. United Kingdom Prospective Diabetes Study Group. BMJ 1998;317: 703-713.

  43. Thorstensson H, Kuylenstierna J, Hugoson A. A medical status and complications in relation to periodontal disease experience in insulin-dependent diabetics. J Clin Periodontol 1996;23:194-202.

  44. Spahr A, Klein E, Khuseyinova N, Boeckh C, Muche R, Kunze M, et al. Periodontal infections and coronary heart disease. Role of periodontal bacteria and importance of total pathogen burden in the coronary event and periodontal disease (CORODONT) study. Arch Intern Med 2006; 166:554-559.

  45. Craig RG, Spittle MA, Levin N W. Importance of periodontal disease in the kidney patient. Blood Purif 2002;20:113-119.

  46. Saremi A, Nelson RG, Tulloch-Reid M, Hanson RL, Sievers ML, Taylor GW, et al. Periodontal disease and mortality in type 2 diabetes. Diabetes Care 2005;28:27-32.

  47. Marakoglu I, Kahraman UG, Demirer S, Sezer H. Periodontal status of chronic renal failure patients. Yonsei Med 2003;44:648-652.

  48. Duran I, Erdemir EO. Periodontal treatment needs of patients with renal disease receiving haemodialysis. Int Dent J 2004;54:274-278.

  49. Yamalik N, Delilbasi L, Gulay H, Caglayan F, Haberal M, Caglayan G. The histological investigation of gingival from patients with chronic renal failure, renal transplant and periodontitis: a light and electron microscopic study. J Periodontol 1991;62:737-744.




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