EFFECTS OF NON-SURGICAL PERIODONTAL TREATMENT ON CHRONIC KIDNEY DISEASE PATIENTS STAGE 3-5 NON-DIALYSED AT THE YAOUNDE UNIVERSITY HOSPITAL CENTER

EWANG ABRAHAM EBONG
Bucco Dental Medicine, University of Yaounde 1
June, 2018
 

Abstract

Introduction
Subjects with chronic kidney disease (CKD) stage 3-5 non-dialyzed experience a high prevalence and severity of periodontal disease. An advanced stage of CKD is associated with a high prevalence of periodontitis and on the other hand, periodontitis might result in CKD in these subjects. Many studies have reported that treatment of periodontitis in subjects with CKD improve the periodontal health and ameliorate the glomerular filtration rate (eGFR) control. Adequate response has been observed treating periodontitis by scaling and root planning (SRP) in subjects with CKD. Thus the aim of this study was to follow the periodontal healing response after Non-surgical periodontal treatment (NSPT) in subjects with CKD stage 3-5 non-dialyzed, verify changes in biological parameters with improved periodontal health.

Methods.


A quasi experimental study design before-and-after, clinical trial was carried out at the Yaoundé University Hospital center (YUHC). Subjects with CKD stage 3-5 non-dialyzed and moderate to severe chronic periodontitis define by 4 teeth with more than one site with clinical attachment loss ≥4mm and periodontal depth ≥5mm were included. They were treated by non-surgical therapy which consisted of deep cleaning of teeth surfaces, polishing and irrigation of pockets. Appointments were given 6 weeks after treatment for assessment of disease recurrence and retreatment if needed. Periodontal parameters (Gingival bleeding index, plaque index, probing depth and Clinical attachment loss) and biological parameters (eGFR, PCR, high sensitivity C
- reactive protein) were assessed at baseline and at 3 months of therapy.

Result.


Thirty subjects were assessed at baseline amongst which only 19 completed the study. After

3 months post therapy, there was a significant reduction in all periodontal parameters, plaque index (PI) decreases from 91.00(±15.32)% to 10.79(±9.06)% with mean change of
80.21(±13.66)% (p=<0.001),probing depth (PD) decreased from 5.79(±2.07)mm to

3.32(±1.60) mm with mean change after 3 months of 2.42(±0.76) mm (p=<0.001), clinical attachment loss (CAL) decreases from 3.79(±1.31) mm to 2.11(±0.99) mm with mean change of 1.68(±0.67) mm (p=<0.001), and gingival bleeding index (GBI) decreases from
78.21(±26.37) % to 6.32(±7.96)% with mean change of 71.89(±23.01) % (p=<0.001). The mean eGFR increase from to 24.11(±16.22) mL/min/1.73m2 to 34.05(±20.42) mL/min/1.73m2



with statistical significant difference (p=<0.01) as well as the mean of CRP reduce from

11.11(±14.09) mg/l to 6.00(±5.19) mg/l (p=<0.044). However the mean PCR reduced from

1.47(±3.37) mg/g to 1.26(±2.25) mg/g without statistical significant difference (p>0.05).


Conclusions.


The scaling-root planning and polishing (SRP) resulted in significant benefits in the treatment of chronic periodontitis and improvement of glomerular filtration rate as well as biological inflammatory syndrome.


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