CARIES RESISTANCE IN CHILDREN WITH CHRONIC RENAL-FAILURE - PLAQUE PH, SALIVARY PH, AND SALIVARY COMPOSITION
CARIES RESISTANCE IN CHILDREN WITH CHRONIC RENAL-FAILURE - PLAQUE PH, SALIVARY PH, AND SALIVARY COMPOSITION
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DOI：
10.1203/00006450-198508000-00003
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发表时间：
1985-01-01
影响因子：
3.6
通讯作者：
CRALL, J
中科院分区：
文献类型：
--
作者：
PETERSON, S;WOODHEAD, J;CRALL, J
为了解慢性肾功能衰竭患者龋病患病率低的原因，研究了影响龋病发生的唾液和牙菌斑的性质。在慢性肾功能衰竭（n = 10）和成功肾移植（n = 11）的儿童和青少年中，以及在两个对照组的健康儿童（n = 15）和许多龋齿（n = 15）中，评价了碳水化合物暴露前后的菌斑pH值、唾液pH值和唾液成分。血清尿素氮浓度升高者唾液尿素氮浓度均升高。慢性肾功能衰竭受试者唾液尿素氮浓度显著高于移植受试者。斑块pH值与唾液尿素氮浓度直接相关，慢性肾功能衰竭患者的pH值明显高于移植组或对照组。唾液尿素氮浓度占斑块pH值变异的大部分;唾液pH值和唾液P的贡献可以忽略不计。碳水化合物暴露后的绝对pH值下降在各组之间没有差异，但由于慢性肾衰竭受试者的基线斑块pH值升高，最低pH值未达到致龋水平。数据支持这一假设，即慢性肾功能衰竭患者的龋齿相对较少，是由于尿素代谢的代谢终产物改变了斑块。数据进一步表明，肾功能正常的移植患者患龋的风险可能会增加，特别是如果存在釉质发育不全和口腔卫生不良。
Properties of salva and of dental plaque which affect the caries process were studied in an effort to understand the low prevalence of caries in patients with chronic renal failure. Plaque pH, before and following carbohydrate exposure, saliva pH, and saliva composition were evaluated in children and adolescents with chronic renal failure (n = 10) and successful renal transplantation (n = 11), and in 2 comparison groups of healthy children with few caries (n = 15) and numerous caries (n = 15). Salivary urea nitrogen concentration was elevated in all subjects with elevated serum urea nitrogen concentration. Chronic renal failure subjects had significantly higher salivary urea nitrogen concentration than transplanted subjects. Plaque pH correlated directly with salivary urea nitrogen concentration and was significantly more alkaline in chronic renal failure than transplant or comparison groups. Salivary urea nitrogen concentration accounted for the majority of variability in plaque pH; salivary pH and salivary P contributed negligibly. Absolute pH drop following carbohydrate exposure did not differ among groups, but because baseline plaque pH was elevated for chronic renal failure subjects, minimum pH did not attain cariogenic levels. Data support the hypothesis that the relative paucity of caries in patients with chronic renal failure results from alteration of plaque by metabolic end products of urea metabolism. Data further suggest that tranplanted patients whose renal function is normal may be at increased risk of caries, especially if enamel hypoplasia is present and oral hygiene is poor.