臨牀透析 Vol.27 No.6(6-2)


特集名 透析患者の歯科領域疾患
題名 透析と歯周病 (2) 透析患者の歯周組織所見
発刊年月 2011年 06月
著者 大石 慶二 徳島大学大学院ヘルスバイオサイエンス研究部歯周歯内治療学分野
著者 永田 俊彦 徳島大学大学院ヘルスバイオサイエンス研究部歯周歯内治療学分野
【 要旨 】 歯周病は細菌性プラークを主たる原因とする歯周組織の慢性炎症であり,全身の状態がその進行に影響する多因子性疾患である.臨床的には,歯肉の発赤・腫脹,歯石沈着,口臭,歯肉退縮,歯の動揺などの症状がみられ,進行すると最終的に歯を喪失する.われわれの調査では,透析患者は歯周病罹患度が高く,とくに糖尿病性腎症患者では著明に歯周病が進行していた.一方,透析年数や血中副甲状腺ホルモン(PTH)濃度と歯周病の指標には関連が認められなかった.近年,歯周病は慢性炎症因子として全身の状態を悪化させる可能性が示唆されていることから,透析患者では歯周病を適切に治療することが重要と考えられる.
Theme Oral Diseases and Oral Care in Dialysis Patients
Title Periodontal conditions in dialysis patients
Author Keiji Oishi Department of Periodontology and Endodontology, Institute of Health Biosciences, The University of Tokushima Graduate School of Oral Sciences
Author Toshihiko Nagata Department of Periodontology and Endodontology, Institute of Health Biosciences, The University of Tokushima Graduate School of Oral Sciences
[ Summary ] Periodontal disease is a chronic inflammatory disease caused by bacterial plaque. The progression of periodontal disease is affected by various systemic conditions. Clinical characteristics of the disease include redness and swelling of the gingiva, calculus deposition, bad breath, gingival recession, and tooth mobility. Progression of the disease results in tooth loss. In our previous investigation, dialysis patients exhibited a higher prevalence of periodontal disease. This was especially so in patients with diabetic nephropathy, who's periodontal tissue breakdown was severe. However, the duration of dialysis or blood levels of parathyroid hormone did not demonstrate any association with the indices of periodontal disease, suggesting that diabetic factors may be more predominant than dialysis related factors in the progression of periodontal disease. Recently, several studies have demonstrated that periodontal disease may aggravate systemic conditions, being a factor in chronic inflammatory conditions. Proper treatment of periodontal disease in dialysis patients is important to maintain oral, as well as general health.
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