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      Renal hemodialysis patients: oral, salivary, dental and periodontal findings in 105 adult cases.

      Oral Diseases
      Adult, Case-Control Studies, DMF Index, Dental Calculus, etiology, Dental Plaque, Female, Humans, Kidney Failure, Chronic, complications, therapy, Male, Middle Aged, Oral Hygiene Index, Periodontal Attachment Loss, Periodontal Index, Renal Dialysis, adverse effects, Saliva, secretion, Xerostomia

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          Abstract

          A study of the dental, periodontal, oral mucosal and salivary condition of adult patients with chronic renal failure (CRF) receiving hemodialysis (HD). A total of 105 patients on HD were studied, together with 53 healthy age and sex-matched controls. Indices employed included carious, absent and obturated teeth index (CAO index), plaque index, calculus index and loss of periodontal attachment. Whole and parotid salivary secretions were also measured. The CAO index was not significantly higher among HD patients than controls (14.9 +/- 8.7 vs 13.3 +/- 7.9, respectively; t = 1.1; P = 0.3). However, plaque and calculus indices were significantly higher in HD patients (2.1 +/- 0.8 and 2.3 +/- 0.6, respectively) than controls (1.3 +/- 0.8 and 1.6 +/- 0.9) (P < 0.001). Loss of periodontal attachment was similar in both groups (4.9 +/- 2.5 vs 4.2 +/- 2.5 in the HD patients and controls, respectively) (t = 1.8; P = 0.07). There was no more oral mucosal pathology in HD patients than in controls (chi-square = 5.8; P = 0.3). Stimulated salivary secretion was significantly higher in controls than HD patients for both whole (t = -5.2; P < 0.001) and parotid (t = -2.6; P = 0.01) salivas. The results show significantly higher plaque and calculus indices and lower salivary secretion among the HD patients than in healthy controls.

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          A comparison of whole mouth resting and stimulated salivary measurement procedures.

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            Salivary composition and calculus formation in patients undergoing hemodialysis.

            The purpose of this report is to provide further information regarding oral changes in patients with chronic renal disease who are undergoing hemodialysis. Quantitative changes in salivary flow rate and alterations in the composition of stimulated and unstimulated sliva were studied along with the rate of formation of supragingival calculus. Results revealed a lower salivary flow rate and increased salivary urea concentration in the dialysis group. Dialysis patients also formed more heavy calculus.
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              Dental considerations for the patient with renal disease receiving hemodialysis.

              An increasing number of Americans are living with end-stage renal disease. This disease has many implications for dentistry, in terms of oral manifestations and management of afflicted patients. The authors present pertinent information to help dentists treat patients who exhibit the oral and systemic manifestations of renal disease, from the onset of renal impairment through hemodialysis.
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