Gingivitis Control in Children, Adolescents and Young Adults With Chronic Kidney Disease by a Need-Related Programme: A Randomised Clinical Trial.

IF 1.6 4区 医学 Q3 DENTISTRY, ORAL SURGERY & MEDICINE
Karolin C Höfer, Witte Hanna, Graf Isabelle, Golka Anna, Adams Anne, Anna Greta Barbe, Lutz Thorsten Weber, Michael J Noack
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引用次数: 0

Abstract

Objectives: Children and young patients with chronic kidney disease (CKD) are at persistent risk of gingivitis despite usual preventive measures. This clinical study aimed to determine the efficacy of an intensive oral preventive programme (OPP) for young patients with CKD in treating plaque-induced gingivitis modified by systemic factors.

Methods: Young patients with CKD (N = 30) were recruited/randomised to a need-related OPP (n = 15) or treatment as usual (TAU) including mainly motivation and instructions (controls, n = 15) followed by a single intensive prophylactic appointment after 3 months. For the OPP group, depending on the baseline degree of inflammation (PBI) professional mechanical plaque removal, local chlorhexidine gel application and mouth rinse were applied at need-related appointments focussing on local plaque control and reduction in inflammation.

Results: After 3 months OPP, lower plaque indices were found (2.62-0.66, p < 0.05) in contrast to TAU (2.32-2.05, p > 0.05) with differences between study groups (p < 0.05). Regarding gingivitis, lower PBI values than baseline were observed in OPP (1.03-0.05, p < 0.05) than TAU (1.15-1.00; p > 0.05); OPP reductions (effect size) were higher than after a single intensive appointment (1.00-0.36; p < 0.05). Degree of immunosuppressive therapy did not differ between groups throughout the study.

Conclusions: Young patients with CKD suffer from generalised gingivitis with increased bleeding sites. This moderate degree of inflammation shows a normal distribution of high and low plaque responders, with no pattern of impact for the degree of immunosuppression. Effectiveness and duration of preventive measures follow a dose-response principle. Therefore, need-related preventive measures should be implemented and maintained in future regular care for CKD patients.

Trial registration: German Clinical Trials Register, registration number: DRKS00010580.

通过需求相关计划控制慢性肾病儿童、青少年和年轻人的牙龈炎:随机临床试验
目的:尽管采取了常规预防措施,但慢性肾脏病(CKD)儿童和年轻患者仍有患牙龈炎的持续风险。这项临床研究旨在确定针对慢性肾脏病年轻患者的强化口腔预防计划(OPP)在治疗由全身因素引起的斑块型牙龈炎方面的疗效:招募/随机分配患有慢性肾脏病的年轻患者(30 人)参加与需求相关的口腔预防计划(15 人)或常规治疗(TAU),其中常规治疗主要包括激励和指导(对照组,15 人),3 个月后进行一次强化预防预约。对于OPP组,根据基线炎症程度(PBI),在需要时进行专业的机械清除牙菌斑、局部涂抹洗必泰凝胶和漱口,重点是控制局部牙菌斑和减少炎症:结果:经过 3 个月的 OPP,发现牙菌斑指数降低(2.62-0.66,P 0.05),研究组之间存在差异(P 0.05);OPP 降低(效应大小)高于单次强化预约后(1.00-0.36;P 结论:年轻的慢性肾脏病(CKD)患者在口腔溃疡和牙周病方面面临着巨大的挑战:患有慢性肾脏病的年轻患者患有全身性牙龈炎,出血部位增多。这种中度炎症表现为高斑块反应者和低斑块反应者的正常分布,对免疫抑制程度没有影响。预防措施的效果和持续时间遵循剂量反应原则。因此,在今后为慢性肾脏病患者提供常规护理时,应实施并坚持与需求相关的预防措施:试验注册:德国临床试验注册中心,注册号:DRKS00010580:DRKS00010580.
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来源期刊
International journal of dental hygiene
International journal of dental hygiene DENTISTRY, ORAL SURGERY & MEDICINE-
CiteScore
4.00
自引率
8.30%
发文量
78
审稿时长
>12 weeks
期刊介绍: International Journal of Dental Hygiene is the official scientific peer-reviewed journal of the International Federation of Dental Hygienists (IFDH). The journal brings the latest scientific news, high quality commissioned reviews as well as clinical, professional and educational developmental and legislative news to the profession world-wide. Thus, it acts as a forum for exchange of relevant information and enhancement of the profession with the purpose of promoting oral health for patients and communities. The aim of the International Journal of Dental Hygiene is to provide a forum for exchange of scientific knowledge in the field of oral health and dental hygiene. A further aim is to support and facilitate the application of new knowledge into clinical practice. The journal welcomes original research, reviews and case reports as well as clinical, professional, educational and legislative news to the profession world-wide.
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