Methods: 135 children, and adolescents; were divided into groups: 1. renal disease with no previous dialysis, 2. under dialysis, 3. after dialysis and transplant, 4. with a transplant without previous dialysis, 5. control group of 38 healthy individuals. The CRF group comprised: 67 males and 30 females. Periodontal status was estimated measuring: plaque index, recession, gingival index, probing depth, attachment loss and gingival overgrowth. Dental parameters included enamel hypoplasia, pulp obliteration, and caries prevalence.
Results: Gingival index, bleeding on probing, probing depths and clinical attachment loss were significantly higher in CRF patients than in the control. Plaque index was significantly higher in the dialysis group and pre dialytic, diaylisis patients also had significantly higher plaque scores, compared to transplanted patients. Gingival overgrowth was significantly increased in the two transplanted groups, a slight increase in gingival growth was also found in the pre dialytic and dialysis groups. As to dental parameters, the DMFS of Control group was statistically higher than all the other groups; however severity of enamel hypoplasia was significantly lower in this group. Obliteration was absent in the control, and present in all CRF groups. Alveolar bone loss was present only in 12% of the individuals with renal osteodysthrophy. Length of kidney disease and duration of dialysis significantly affected the severity of the oral findings.
Conclusions: The severity of oral findings correlates with the duration of end stage renal failure as well as certain treatment modalities. CRF patients showed a higher incidence of periodontal disease than the control group. Gingival overgrowth is prominent in patients treated with Nifedipine in addition to Cyclosporine or Tacrolimus. Lower caries prevalence and pulp obliteration are found in CRF patients.