Indian Journal of Public Health Research & Development

Open Access Open Access  Restricted Access Subscription Access
Open Access Open Access Open Access  Restricted Access Restricted Access Subscription Access

Intraoral Periapical Radiographic Changes of Teeth and Jaw Bones in Chronic Renal Failure Patients - an Observational Case-control Study


Affiliations
1 A.V. Super Specialty Dental Hospital, Near Amberpet Masjid; Amberpet; Hyderabad; Andhra Pradesh, India
     

   Subscribe/Renew Journal


Background: Chronic renal failure is an important health care problem throughout the world, with a prevalence of 7852 cases per million population (p.m.p) in India. Patients afflicted by this medical condition can visit a general dentist's office with number of clinical as well radiological manifestations. This study is undertaken to observe the soft radiologic changes occurring in teeth and jaw bones through Intraoral Periapical Radiographs (IOPA) which could be warning signs for undiagnosed kidney disease in these patients.

Methods: IOPA radiographs of 30 patients present in the initial stage of chronic renal failure (CRF) and have not undergone dialysis and 30 control group were taken in to the study. Maxillofacial radiologists measured the changes in the morphological features of the lamina dura, trabecular pattern, pulp size and radiographic density presenting in the teeth and jaw bones.

Results: In patients with CRF the significant changes were observed in lamina dura in the maxilla (93.3% of cases and 43.3% in controls; p=<0.0001) as well as mandible (83.3% of case and 33.3% of controls; p=<0.0001) when compared with controls. Changes in the trabecular pattern of both maxilla (86.6% of cases and 43.3% of controls; p=<0.001) and mandible (86.6% in cases and 10% in controls; p=<0.0001) were very evident in the case group when compared with controls. The radiographic density in case group showed significant change in maxilla (93.3% in cases&20% in controls; p=<0.0001) when compared to controls but interestingly negligible change was seen in mandible of both case and control groups (40% in cases and 23.3% of controls; p=0.1647).No significant change was observed in size of pulp chamber in both maxilla (86.6% in patients and 70% in controls; p=0.117)and mandible (63.3% in patients and 30% in controls; p=0.0096) in both case and control groups.

Conclusions: The results suggest that changes IOPA radiographic changes in Lamina dura, trabecular pattern and overall radiographic density can be a good prognostic tool for assessment and management CRF patients.


Keywords

IOPA, Lamina Dura, Trabecular Pattern, Radiographic Density, Pulp Chamber
Subscription Login to verify subscription
User
Notifications
Font Size


  • De Rossi SS, Glick M. Dental considerations for the patient with renal disease receiving hemodialysis. J Am Dent Assoc. 1996 Feb;127(2): 211-29.

  • Davidovich E, Davidovits M, Eidelman E, Schwarz Z, Bimstein E. Pathophysiology, therapy, and oral implications of renal failure in children and adolescents: an update. Pediatr Dent. 2005 Mar-Apr; 27(2):98-106.

  • De la Rosa García E, Mondragón Padilla A, Aranda Romo S, Bustamante Ramírez MA. Oral mucosa symptoms, signs and lesions, in end stage renal disease and non-end stage renal disease diabetic patients. Med Oral Patol Oral Cir Bucal. 2006 Nov 1;11(6): E467-73.

  • Proctor R, Kumar N, Stein A, Moles D, Porter S. Oral and dental aspects of chronic renal failure. J Dent Res. 2005 Mar; 84(3):199-208.

  • Gudapati A, Ahmed P, Rada R. Dental management of patients with renal failure. Gen Dent. 2002 Nov-Dec; 50(6):508-510.

  • Kerr AR. Update on renal disease for the dental practitioner. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2001 Jul;92(1):9-16.

  • Klassen JT, Krasko BM. The dental health status of dialysis patients Can Dent Assoc. 2002 Jan;68(1):34-38.

  • Proctor R, Kumar N, Stein A, Moles D, Porter S. Oral and dental aspects of chronic renal failure. J Dent Res 2005;84(3):199–208.

  • De la Rosa-García E, Mondragón-Padilla A, Irigoyen-Camacho ME, Bustamante-Ramírez MA. Oral lesions in a group of kidney transplant patients. Med Oral Patol Oral Cir Bucal. 2005 May-Jul; 10(3):196-204.

  • Ciavarella D, Guiglia R, Campisi G, Di Cosola M, Di Liberto C, Sabatucci A, et al. Update on gingival overgrowth by cyclosporine in Renal transplants. Med Oral Patol Oral Cir Bucal. 2007 Jan 1; 12(1):E19-25.Oct;32(10):1076-1082.

  • Davidovich E, Schwarz Z, Davidovitch M, Eidelman E, Bimstein E. Oral findings and periodontal status in children, adolescents and young adults suffering from renal failure. J Clin Periodontol. 2005.

  • Sobrado Marinho JS, Tomás Carmona I, Loureiro A, Limeres Posse J, García Caballero L, Diz Dios P. Oral health status in patients with moderatesevere and terminal renal failure. Med Oral Patol Oral Cir Bucal. 2007 Aug 1;12(4):E305-310.

  • Bots CP, Poorterman JH, Brand HS, Kalsbeek H, Van Amerongen BM, Veerman EC, et al. The oral health status of dentate patients with chronic renal failure undergoing dialysis therapy. Oral Dis. 2006 Mar;12(2):176-180.

  • Roderick PJ, Jones I, Raleigh VS, McGeown M, Mallick N (1994). Population need for renal replacement therapy in Thames regions: ethnic dimension. Br Med J309:1111–1114.

  • Agarwal S.K, Dash S.C, Irshad M, Raju S, Singh R & Pandey R.M (2005).Prevalence of chronic renal failure in adults in Delhi, India. Nephrol. Dial. Transplant 20 (8):1638-1642. doi:10.1093/ ndt/gfh855.

  • Göran Söderholm, Leif Lysell, ÅUke Svensson. Changes in the jaws in chronic renal insufficiency and haemodialysis. Report of a case. J Clin Periodontol. 2005 Oct; 36-42.doi: 10.1111/j.1600- 051X.1974.tb01236.x

  • J. I. Chang, P.M. Som and W. Lawson (2005), Unique Imaging Findings in the Facial Bones of Renal Osteodystrophy. American Journal of Neuroradiology 28:608-609.

  • Bottomley WK, Cioffi RF, Martin AJ. Dental management of the patient treated by renal transplantation: preoperative and postoperative considerations. J Am Dent Assoc 1972; 85: 1330-1335.

  • Naylor GD, Fredericks MR. Pharmacologic considerations in the dental management of the patient with disorders of the renal system. Dent Clin North Amer 1996; 40:665-683.

  • Heard E Jr, Staples AF, Czerwinski AW. The dental patients with renal disease. Precautions and guidelines. J Am Dent Assoc 1978; 96:792-796.

  • Frankenthal S, Nakhoul F, Machtei EE, Green J, Ardekian L, Laufer D, Peled M. The effect of secondary hyperparathyroidism and hemodialysis therapy on alveolar bone and periodontium. J Clin Periodontol 2002; 29:479-483.

  • William H. Kelly, Michael K. Mirahmadi, James H. S. Simon, John T. Gorman. Radiographic changes of the jawbones in end stage renal disease. Elsevier Inc.1980 Oct; 372- 381.doi:10.1016/0030-4220(80)90423-5.

  • Charles E. Hutton. Intradental lesions and their reversal in a patient being treated for end-stage renal disease. Elsevier Inc 1985 Sep; 258- 261.doi:10.1016/0030-4220(85)90307-X


Abstract Views: 353

PDF Views: 0




  • Intraoral Periapical Radiographic Changes of Teeth and Jaw Bones in Chronic Renal Failure Patients - an Observational Case-control Study

Abstract Views: 353  |  PDF Views: 0

Authors

Prasanth Venela
A.V. Super Specialty Dental Hospital, Near Amberpet Masjid; Amberpet; Hyderabad; Andhra Pradesh, India
Priyanka Ammika
A.V. Super Specialty Dental Hospital, Near Amberpet Masjid; Amberpet; Hyderabad; Andhra Pradesh, India
Simhachalam Naidu
A.V. Super Specialty Dental Hospital, Near Amberpet Masjid; Amberpet; Hyderabad; Andhra Pradesh, India
M. Shantan Reddy
A.V. Super Specialty Dental Hospital, Near Amberpet Masjid; Amberpet; Hyderabad; Andhra Pradesh, India
A. Mallikarjun
A.V. Super Specialty Dental Hospital, Near Amberpet Masjid; Amberpet; Hyderabad; Andhra Pradesh, India
Farheen Sultana Pasha
A.V. Super Specialty Dental Hospital, Near Amberpet Masjid; Amberpet; Hyderabad; Andhra Pradesh, India

Abstract


Background: Chronic renal failure is an important health care problem throughout the world, with a prevalence of 7852 cases per million population (p.m.p) in India. Patients afflicted by this medical condition can visit a general dentist's office with number of clinical as well radiological manifestations. This study is undertaken to observe the soft radiologic changes occurring in teeth and jaw bones through Intraoral Periapical Radiographs (IOPA) which could be warning signs for undiagnosed kidney disease in these patients.

Methods: IOPA radiographs of 30 patients present in the initial stage of chronic renal failure (CRF) and have not undergone dialysis and 30 control group were taken in to the study. Maxillofacial radiologists measured the changes in the morphological features of the lamina dura, trabecular pattern, pulp size and radiographic density presenting in the teeth and jaw bones.

Results: In patients with CRF the significant changes were observed in lamina dura in the maxilla (93.3% of cases and 43.3% in controls; p=<0.0001) as well as mandible (83.3% of case and 33.3% of controls; p=<0.0001) when compared with controls. Changes in the trabecular pattern of both maxilla (86.6% of cases and 43.3% of controls; p=<0.001) and mandible (86.6% in cases and 10% in controls; p=<0.0001) were very evident in the case group when compared with controls. The radiographic density in case group showed significant change in maxilla (93.3% in cases&20% in controls; p=<0.0001) when compared to controls but interestingly negligible change was seen in mandible of both case and control groups (40% in cases and 23.3% of controls; p=0.1647).No significant change was observed in size of pulp chamber in both maxilla (86.6% in patients and 70% in controls; p=0.117)and mandible (63.3% in patients and 30% in controls; p=0.0096) in both case and control groups.

Conclusions: The results suggest that changes IOPA radiographic changes in Lamina dura, trabecular pattern and overall radiographic density can be a good prognostic tool for assessment and management CRF patients.


Keywords


IOPA, Lamina Dura, Trabecular Pattern, Radiographic Density, Pulp Chamber

References