The Oral Cavity State in Renal Transplant Recipients

Svrha: Bolesnicima s transplantiranim čvrstim organom mogu se pojaviti mnogobrojne i različite komplikacije u ustima zbog oslabljene imunosti i nuspojava na lijekove. Svrha ovog istraživanja bila je ispitati učestalost i vrstu oralnih lezija kod bolesnika s transplantiranim bubregom, odrediti stanje zuba i oralne higijene, oralne lezije povezane s lijekovima koje pacijenti uzimaju prije transplantacije i nakon te operacije, te koliko često pacijenti u poslijetransplantacijskom razdoblju posjećuju stomatologa. Ispitanici i postupci: Istraživanje je trajalo dvije godine, a uključeno je bilo 100 ispitanika s transplantiranim bubregom tijekom njihovih redovitih kontrola u Zavodu za nefrologiju i dijalizu KBC-a Zagreb i u Zavodu za oralnu medicinu Stomatološkog fakulteta Sveučilišta u Zagrebu te 100 nasumce odabranih kontrolnih ispitanika iz Zavoda za endodonciju i restaurativnu stomatologiju Stomatološkog fakulteta Sveučilišta u Zagrebu. Rezultati: Rezultati su pokazali značajno veću učestalost oralnih lezija kod bolesnika s transplantiranim bubregom (31 %) u usporedbi s kontrolnim ispitanicima. Najčešće promjene bile su eritem, keratotične lezije na sluznici i hiperplazija gingive. Prosječna vrijednost KEP indeksa bila je značajno niža kod bolesnika s transplantiranim bubregom negoli u kontrolnoj skupini. Trećina bolesnika imala je subjektivni osjećaj suhoće usta. Oralna higijena sveukupno je bila loša i samo malobrojni ispitanici koristili su se dodatnim proizvodima za higijenu usta. Većina pacijenata nakon transplantacije nije posjetila stomatologa. Zaključak: Bolesnici s presađenim bubregom trebaju sveobuhvatnu i redovitu stomatološku skrb prije transplantacije i nakon nje, a doktor dentalne medicine neizostavno treba biti član multidisciplinarnog tima medicinskih stručnjaka.Aim: Patients with a solid organ transplant can have many different complications in the mouth, as a result of immunosuppression and side effects of drugs. The aim of this study was to examine the frequency and type of oral lesions in renal transplant patients, dental status, oral hygiene, oral lesions related to drugs which patients take and the time of transplantation as well as the frequency of patient’s visits to the dentist in the post-transplant period. Material and methods: The study was performed in a period of two years and included 100 subjects with a renal transplant during their regular control visits to the Department of Nephrology and Dialysis, Clinical Hospital Centre Zagreb and the Department of Oral Medicine, School of Dental Medicine, University of Zagreb and 100 randomly selected control subjects at the Department of Endodontics and Restorative Dentistry, School of Dental Medicine, University of Zagreb. Results: Results showed a significantly higher incidence of oral lesions in patients with renal transplant (31%) compared to control subjects. The most frequent were erythematous (inflammatory changes), keratotic lesions and gingival hyperplasia. The average DMFT index was significantly lower in patients with renal transplant than in the control group. One third of patients had a subjective feeling of dry mouth. Oral hygiene was poor overall, and only a small number of subjects used the additional sustainers for oral hygiene. Most patients did not visit the dentist after the transplantation. Conclusion: Renal transplant patients need a comprehensive and regular dental care during the pre- and post-transplant period and a doctor of dental medicine should be part of a multidisciplinary team of medical specialists