Publication: Kronik böbrek hastalığı olan çocuk hastalarda ağız-diş sağlığının değerlendirilmesi
Abstract
Amaç: Farklı evrelerde Kronik Böbrek Hastalığı(KBH) olan; diyaliz alan ve transplantasyon yapılan çocuklar ile sağlıklı çocukların ağız-diş sağlığı bulguları ve tükürük parametreleri ile hastalıkla ilişkili yaşam kalitelerinin karşılaştırmalı olarak incelenmesi ve KBH’li çocuklarda bazı serum biyobelirteçlerinin değerlendirilmesi amaçlanmıştır. Gereç ve Yöntem: Bir Araştırma Hastanesi Çocuk Nefroloji Kliniği’nde takip edilen 4-17 yaş arası 82 KBH’li ve 85 sağlıklı çocuğun ağız-içi muayeneleri yapılarak DMFT/ dft, ICDAS II, Debris İndeksi(DI), Kalkulus İndeksi(CI), ve Basitleştirilmiş Oral Hijyen İndeksi(OHI-S), Modifiye Gingival İndeks(MGI), Gelişimsel Mine Defektleri(DDE), Büyük Azı Keser Hipomineralizasyonu(BAKH) skorları kaydedildi. Genel Amaçlı Sağlıkla İlişkili Yaşam Kalitesi Ölçeği(KINDLR) ile yaşam kaliteleri değerlendirildi. 43 KBH’li ve 40 sağlıklı çocuktan alınan tükürük örneklerinde tükürük akış hızı(TAH), pH, tamponlama kapasitesi(TAK), total oksidan(TOS) ve antioksidan kapasiteleri(TAS), üre, kalsiyum(Ca), potasyum(K), fosfor(P) ile serum üre, Ca ve P parametreleri incelendi. Bulguların istatistiksel analizleri SPSS 22 kullanılarak p<0,05 anlamlılık düzeyinde değerlendirildi. Bulgular: KBH’li (44 erkek/ 38 kız) çocukların yaş ortalaması 11,79 ± 3,45 ve sağlıklı (49 erkek/ 36 kız) çocukların ise 11,14 ± 2,89. KBH’li çocukların DMFT/ dft değerleri, sağlıklı çocuklardan düşüktür (p=0,001). DI, CI, OHI-S ve şiddetli MGI sağlıklı çocuklardan yüksek olup aralarındaki fark istatistiksel olarak anlamlıdır (p=0,001). DDE’de sınırlı opasitelerin prevalansı KBH’li çocuklarda (%65,9), sağlıklı çocuklardan (%25,9) yüksektir (p=0,001). KBH’li çocukların %14,6’sında, sağlıklı çocukların %8,2’sinde BAKH görülmüştür (p>0,05). KBH’li çocukların TAH, Ca ve TAS seviyeleri sağlıklı çocuklardan düşük; TAK, pH, üre, K, P ve TOS seviyeleri ise yüksek bulunmuştur (p=0,001). KINDLR skorları, sağlıklı çocuklardan daha düşük bulunmuştur (p=0,001). Sonuç: KBH’nin çocuklarda, ağız-diş sağlığı üzerindeki etkileri çeşitli yönleri ile gösterilmiştir. Çocuk diş hekimleri ve pediyatrik nefrologlar, erken teşhis ve koruyucu önlemlerle bu etkileri en aza indirip bu çocukların genel yaşam kalitesini artırabilir.
Objective: The aim of this study is to compare the oral health findings, salivary parameters and disease-related quality of life of children with different stages of Chronic Kidney Disease(CKD), those undergoing dialysis and transplantation, with healthy children, and to evaluate certain serum biomarkers in children with CKD. Materials and Method: Oral examinations were performed on 82 children aged 4-17 years with CKD and 85 healthy children from the Pediatric Nephrology Clinic at Marmara University School of Medicine. The indices recorded included DMFT/ dft, ICDAS II, Debris Index(DI), Calculus Index(CI), Simplified Oral Hygiene Index(OHI-S), Modified Gingival Index(MGI), Developmental Defects of Enamel(DDE), and Molar Incisor Hypomineralization(MIH). Quality of life was assessed using the KINDLR questionnaire. Saliva samples from 43 children with CKD and 40 healthy children were analyzed for salivary flow rate(SFR), pH, buffering capacity(BC), total oxidant status(TOS), total antioxidant status(TAS), urea, calcium(Ca), potassium(K), phosphorus(P), as well as serum urea, Ca, and P. Statistical analyses were performed using SPSS 22 with p<0,05 considered significant. Results: The mean age of children with CKD (44 boys/ 38 girls) was 11,79 ± 3,45 years, and of healthy children (49 boys/ 36 girls) was 11,14 ± 2,89 years. DMFT/ dft values were lower in children with CKD (p=0,001). DI, CI, OHI-S, and severe MGI were higher in healthy children (p=0,001). The prevalence of limited opacities in DDE was higher in children with CKD (65,9%) compared to healthy children (25,9%) (p=0,001). MIH was observed in 14,6% of children with CKD and 8,2% of healthy children (p>0,05). Children with CKD had lower SFR, Ca and TAS levels and higher BC, pH, urea, K, P and TOS levels (p=0,001). KINDLR scores were lower in children with CKD (p=0,001). Conclusion: CKD has various impacts on the oral health of children. Early diagnosis and preventive measures by pediatric dentists and nephrologists can minimize these effects and improve the overall quality of life for these children.
Objective: The aim of this study is to compare the oral health findings, salivary parameters and disease-related quality of life of children with different stages of Chronic Kidney Disease(CKD), those undergoing dialysis and transplantation, with healthy children, and to evaluate certain serum biomarkers in children with CKD. Materials and Method: Oral examinations were performed on 82 children aged 4-17 years with CKD and 85 healthy children from the Pediatric Nephrology Clinic at Marmara University School of Medicine. The indices recorded included DMFT/ dft, ICDAS II, Debris Index(DI), Calculus Index(CI), Simplified Oral Hygiene Index(OHI-S), Modified Gingival Index(MGI), Developmental Defects of Enamel(DDE), and Molar Incisor Hypomineralization(MIH). Quality of life was assessed using the KINDLR questionnaire. Saliva samples from 43 children with CKD and 40 healthy children were analyzed for salivary flow rate(SFR), pH, buffering capacity(BC), total oxidant status(TOS), total antioxidant status(TAS), urea, calcium(Ca), potassium(K), phosphorus(P), as well as serum urea, Ca, and P. Statistical analyses were performed using SPSS 22 with p<0,05 considered significant. Results: The mean age of children with CKD (44 boys/ 38 girls) was 11,79 ± 3,45 years, and of healthy children (49 boys/ 36 girls) was 11,14 ± 2,89 years. DMFT/ dft values were lower in children with CKD (p=0,001). DI, CI, OHI-S, and severe MGI were higher in healthy children (p=0,001). The prevalence of limited opacities in DDE was higher in children with CKD (65,9%) compared to healthy children (25,9%) (p=0,001). MIH was observed in 14,6% of children with CKD and 8,2% of healthy children (p>0,05). Children with CKD had lower SFR, Ca and TAS levels and higher BC, pH, urea, K, P and TOS levels (p=0,001). KINDLR scores were lower in children with CKD (p=0,001). Conclusion: CKD has various impacts on the oral health of children. Early diagnosis and preventive measures by pediatric dentists and nephrologists can minimize these effects and improve the overall quality of life for these children.