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Parodontalzustand, parodontale Bakterienlast sowie pH-Wert und Pufferkapazität des Speichels bei dialysepflichtigen Patienten mit und ohne diabetisches Syndrom – Eine klinische Querschnittsstudie

Dental and periodontal health, microbiological and salivary conditions in hemodialysis patients with or without diabetes

Sandra Schwabe
Doctoral thesis
Date of Examination: 2016-11-14
Date of issue: 2016-10-19
Advisor: Ziebolz, Dirk PD Dr.
Referee: Ziebolz, Dirk PD Dr.
Referee: Koziolek, Michael Prof. Dr.
Referee: Mausberg, Rainer Prof. Dr.

Persistent Address: http://hdl.handle.net/11858/00-1735-0000-002B-7C31-6

 

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Abstract

English

Aim of this clinical study was to evaluate the periodontal situation and periodontal microbiological findings of hemodialysis patients (HD) with or without diabetes mellitus. 159 Hemodialysis patients were included and divided according to pre-existing diabetes status: diabetes mellitus (DM, n=66, 70.5±10.2 years, m=43) or no DM (nDM n=93, 66.7±13.0 years, m=59). Dental examination included dental findings (DMF-T) and periodontal situation (pocket probing depth [PPD], clinical attachment loss [CAL]). Periodontal condition (PPD and/or CAL) was classified into healthy/mild, moderate or severe periodontitis. Subgingival biofilm samples were taken from deepest pockets and pooled. Microbiological analysis of periodontal pathogens was carried out using PCR. Statistical analysis: t-Test and Wilcoxon-Test; level of significance: α=5%. 30 HD-patients were toothless (DM=13, nDM=17). The mean DMF-T showed no statistically significant difference between DM- (20.4±6.0) and nDM-patients (21.2±5.4; p=0.44); especially with higher number of missing teeth in nDM (M-T: DM=10.8±7.8, nDM=12.8±8.6; p=0.18). 96% of DM- and 97% of nDM-patients have moderate to severe periodontitis (moderate: DM=19, nDM=32; severe: DM=32, nDM=42; p>0.05). Microbiological analysis showed higher prevalence of periodontal bacteria in nDM-patients; Fusobacterium nucleatum (DM: 96%, nDM: 98%), Parvimonas micros (DM: 67%, nDM: 73%) and Tannerella forsythia (DM: 50%, nDM: 62%) were the most frequent bacteria. Only for Porphyromonas gingivalis (DM: 25%, nDM: 47%), Parvimonas micros and Eubacterium nucleatum (DM: 0%, nDM: 10%) a statistical difference was determined (p<0.05).   HD-patients showed an inadequate periodontal health independently of pre-existing diabetes status. Furthermore, periodontal pathogens were seen more frequently in nDM-HD-patients.
Keywords: oral health; diabetes; dialysis
Schlagwörter: Mundgesundheit; Diabetes; Dialyse
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