Chaudhry, Ahmed
(2019)
The effects of non-surgical periodontal therapy (NSPT) on periodontal parameters, levels of inflammatory markers and kidney function indicators in chronic kidney disease patients with chronic periodontitis.
Masters thesis, Universiti Sains Malaysia.
Abstract
Chronic kidney disease (CKD) is associated with periodontal disease due to
the hyperinflammatory state in both conditions. Hence periodontal disease has
emerged as a non-traditional risk factor for CKD. Non-surgical periodontal therapy
(NSPT) is a standard treatment for periodontitis. However, limited is known about the
effect of NSPT on periodontal parameters in pre-dialysis CKD patients with chronic
periodontitis (CP) in our local population. This study was aimed to investigate and
compare the effects of non-surgical periodontal therapy (NSPT) on clinical periodontal
parameters and the levels of inflammatory markers (hs-CRP, IL-6) in CKD patients
with CP and CP only patients. Moreover, the aim was to determine the effects of NSPT
on kidney function indicators in CKD and CP patients. A total of 66 patients which
consisted of 33 chronic periodontitis patient with no medical illness (Group 1) and 33
pre-dialysis CKD stage III and IV patients with chronic periodontitis (Group 2) were
enrolled. Clinical periodontal parameters including periodontal pocket depth (PPD),
clinical attachment loss (CAL), gingival bleeding index (GBI) and plaque score (PS)
were evaluated during the first visit and six weeks following NSPT (second visit).
Blood samples were also obtained during both visits for the analysis of hs-CRP, IL-6,
serum urea and serum creatinine (for estimation of GFR).CKD patients with chronic
periodontitis (group 2) had shown significantly higher (p<0.05) levels of clinical
periodontal parameters at baseline as compared to the patients with chronic
periodontitis only (group 1). Inflammatory markers (hs-CRP and IL-6) levels were
also found significantly higher (p<0.05) in group 2 as compared to group 1 patients.
Significant reduction (p<0.05) was recorded in all the clinical periodontal parameters
and inflammatory markers in both groups following NSPT. However, the mean
difference of 0.27 for serum urea levels and 0.21 for eGFR showed mild improvement
of kidney function in group 2 patients following NSPT. The clinical periodontal
parameters and levels of inflammatory markers improved in both the groups following
NSPT. Although kidney function indicators showed no significant difference
following NSPT, there was a slight improvement. Thus NSPT may play a role be
helpful in halting the progression of CKD Therefore, the periodontal health of CKD
patients’ needs to be monitored and screened for early dental interventions.
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