Turkiye Klinikleri Journal of Dental Sciences

.: ORIGINAL RESEARCH
Oral Aspects in Children with Nephrotic Syndrome
Nefrotik Sendromlu Çocuklarda Ağız Bulguları̇
K. Görkem ULU GÜZELa, Dilek YILMAZb, Filiz ABACIGİLc, Serhat PİRİNÇCİd
Department of
aPediatric Dentistry, Adnan Menderes University Faculty of Dentistry,
Departments of
bPediatric Nephrology,
cPublic Health, Aydın Adnan Menderes University Faculty of Medicine, Aydın
dUrla Community Health Center, İzmir
Turkiye Klinikleri J Dental Sci. 2018;24(3):183-9
doi: 10.5336/dentalsci.2018-61371
Article Language: EN
Full Text
ABSTRACT
Objective: Nephrotic syndrome (NS) is caused by different disorders that damage the kidneys. This damage leads to the excessive release of protein into the urine. Due to alterations in mineral metabolism in young patients with nephrotic syndrome, dental development, periodontal tissues, and alveolar bone may be disturbed. The aim of this study was to assess the oral health status in children with nephrotic syndrome and compare the results with a control group. Material and Methods: The study was carried out at the University of Adnan Menderes Department of Pediatric Dentistry and Pediatric Nephrology. The study was approved by the Ethics Board Committee of the University Hospital. The study group consisted of 38 children with nephrotic syndrome and 52 healthy children were in the control group. Prepared forms to obtain descriptive information and dental examination findings were used for assessment. The statistical differences between the control and study groups were determined using chi-square and student's T test. Results: Enamel hypoplasia was present in one child in the study group. Mean dmft, DMFT, plaque, and gingival indices of the study group were 3.85, 3.17, 1.62±0.794 and 1.14±0.63 respectively. The control group's dmft, DMFT, plaque and gingival indices were 5.45, 3.73, 1.19±0.93 and 0.63±0.71. The means of dmfs, dmft, DMFS, DMFT indices were found to be lower in the study group compared to the control group. However, this difference was not statistically significant. Plaque index (PI) and gingival index (GI) values were determined to be higher in the study group than in the control group. While the difference between PI values was not statistically significant, the difference between GI values was found to be statistically significant. Conclusion: It was concluded that despite the poor oral hygiene in nephrotic syndrome patients, we found a low incidence of tooth decay. It assumed that immune suppressive drugs in this group of patients could have a negative impact on the oral health. However; the use of vitamin D and calcium may prevent the dental problems which arise from NS treatment.

Keywords: Nephrotic syndrome; dental caries; plaque index; chronic renal diseaes
ÖZET
Amaç: Nefrotik sendrom (NS) çeşitli hastalıklar nedeniyle böbreklerin zarar görmesi sonucu gelişir. Bu hasara bağlı olarak idrarda çok fazla protein salınması ortaya çıkar. Nefrotik sendromlu genç hastalarda mineral metabolizmasındaki değişikliklere bağlı olarak diş gelişimi, periodontal dokular ve alveoler kemik de etkilenebilir. Bu çalışmanın amacı, nefrotik sendromu olan çocuklarda ağız-diş sağlığının değerlendirilmesi ve kontrol grubundaki çocuklar ile karşılaştırılmasıdır. Gereç ve Yöntemler: Bu araştırma, Adnan Menderes Üniversitesi (ADÜ) Diş Hekimliği Fakültesi Pedodonti Anabilim Dalı ve Tıp Fakültesi Çocuk Sağlığı ve Hastalıkları Anabilim Dalı'nda gerçekleştirilmiştir. Nefrotik sendromlu 38 çocuk çalışma grubu ve sistemik sağlıklı 52 çocuk kontrol grubu olarak oluşturulmuştur. Ağız içi muayene bulguları ve tanımlayıcı bilgileri elde etmek için hazırlanan formlar değerlendirme için kullanılmıştır. Kontrol ve çalışma grubu arasındaki istatistiksel farklılıklar ki-kare ve student's T testi ile değerlendirilmiştir. Bulgular: Çalışma grubundaki bir çocukta mine hipoplazisi gözlenmiştir. Çalışma grubunun dmft, DMFT, plak ve gingival indeks değerleri sırasıyla 3.85, 3.17, 1.62±0.79 ve 1.14±0.63; kontrol grubunun dmft, DMFT, plak ve gingival indeks değerleri sırasıyla. 5.45, 3.73, 1.19±0.93 and 0.63±0.71 olarak belirlenmiştir. Çalışma grubunda dmfs, dmft, DMFS, DMFT verileri kontrol grubuna göre daha düşük tespit edilmesine ragmen fark istatistiksel olarak anlamlı değildi. Plak indeksi (PI) ve Gingival indeks (GI) değerleri çalışma grubunda kontrol grubuna göre daha yüksek tespit edildi. PI değerleri arasındaki farklılık istatistiksel olarak anlamlılık göstermezken, GI değerlerindeki farklılık anlamlıydı. Sonuç: Nefrotik sendromlu hastalarda oral hijyen alışkanlıkları daha zayıf olmasına rağmen diş çürüğü insidansı daha düşük tespit edilmiştir. Bu hasta grubunda immun baskılayıcı ilaçların ağız sağlığını olumsuz yönde etkileyebileceği düşünülmekle birlikte, D vitamini ve kalsiyum kullanımının, NS tedavisinde gözlemlenebilecek dental problemleri engellediğini söyleyebiliriz.

Anahtar Kelimeler: Nefrotik sendrom; diş çürüğü; plak indeksi; kronik böbrek hastalıkları

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