Research On Periodontal Status And BMD Of Mandibular Of The Peritoneal Dialysis Patients

Objective To compare the difference of periodontal status and mandibular density between peritoneal dialysis patients and normal population, then to provide guidance for clinical diagnosis and treatment of peritoneal dialysis patients.Methods1.41 peritoneal dialysis patients as Research Group and 40 healthy adults whoes Age and gender matched with Research Group as Control Group were included in present study. Oral hygiene status was assessed using a Simplified Oral Hygiene Index(OHI-S),OHI-S including DI ? CI. periodontal status was assessed using gingival index(GI)GI1 and probing depth(PD) PD1 which come from teeth site 16?11?31?36?46. besides,collected gingival crevicular fluid(GCF) from 46 teeth site,then tested the TNF–? and IL–1? concentration in GCF by Enzyme-Linked Immunosorbent Assay(ELISA). moreover, the correlation between TNF–??IL–1?concentration and the measurement indicators from 46 teeth site was researched.Then data were analyzed by the software SPSS17.0.2. 30 peritoneal dialysis patients as Research Group and 31 healthy adults whoes Age and gender matched with Research Group as Control Group were included in present study. The panoramic tomography was taken for the measurement of superior PMI(s PMI) and inferior PMI(i PMI) in two groups. The dual-energy X-ray absorptiometry(DXA) was used to detect BMD of lumbar spine bone. Data were compared between two groups. The correlations between BMD of lumbar spine bone and s PMI, i PMI were analyzed.Results1.DI and CI in research group were higher than that in control group, The difference was statistically significant, p<0.05. In the aspect of oral health maintenance, in Research Group only 12.2% of the people could persist brushing daily more than twice, but that ratio was 67.5% in the control group, The difference between the two groups was statistically significant(?=25.91,p<0.01); meanwhile,in Research Group only 26.8% of the people could brush for Three minutes every time, but That ratio was 52.5% in the control group, the difference was statistically significant(?=5.58,p<0.05).2.Periodontal clinical indicators GI1 and PD1 in Research Group were higher than Those in Control Group, the differences between the two groups were statistical significance, P < 0.05.PD2?GI2?VGCF(Volume of gingival crevicular fluid,VGCF)and concentration of TNF–? and IL–1? in GCF come from 46 teeth site in Research Group were Higher than Those in the Control Group,All indicators' differences were statistical significance, P < 0.05.3.There were positive correlations between concentration of IL–1? and GI2(r=0.412,p<0.001)?PD2(r=0.347,p<0.001)?VGCF(r=0.297,p<0.01); positive correlations were also observed between concentration of TNF–? and GI2(r=0.374,p<0.001)?PD2(r=0.278,P<0.05)?VGCF(r=0.321,P<0.01).4.All indicators including s PMI ? i PMI and BMD of lumbar spine bone were significantly lower in Research Group than those in Control Group,differences were statistical significance,P < 0.01.5. There was a positive correlation between BMD of lumbar spine bone and s PMI(r=0.439, P < 0.05) and i PMI(r =0.389, P < 0.05).6. The BMD of lumbar spine bone was significantly lower in female than that of male both in research group and in control group(P < 0.01). However,There were no significant differences on values of s PMI and i PMI between male and female patients in research group and in control group(P >0.05).Conclusions1.Compared with the normal, the Debris and Calculus of Peritoneal dialysis patient was more, the Oral hygiene was poorer; In the aspect of oral health maintenance,Dialysis patients had shorter brushing time, low frequency of brushing, Oral hygiene education in peritoneal dialysis patients should be strengthened to improve the oral hygiene status.2.The periodontal status of peritoneal dialysis patients was worse than the normal person, peritoneal dialysis patients should regularly do periodontal maintenance to improve the periodontal health status.3. Clinical examination indicators such as GCF?PD?GI can assess concentration of TNF–? and IL–1? in GCF, which Has the advantages of simple and fast.4.The BMD of mandibular and lumbar spine bone was lower in peritoneal dialysis patients than that of the normal people. when Peritoneal dialysis patients were implemented Oral implant surgery, We Should take the corresponding measures to increase the bone mineral density. we should also monitor the change of BMD of whole body in the peritoneal dialysis patients to prevent the occurrence of fractures.5. PMI is a simple and effective method to detect the BMD of mandibular bone,which can also reflect the BMD of lumbar spine bone in peritoneal dialysis patients in some way.6.The BMD of lumbar spine bone in women was lower than that in In men, but mandible of BMD in different sexes was not obvious. The phenomenon that BMD of the lumbar spine is not consistent with BMD of mandibular needs further study.