Routine and emergency management guidelines for the dental patient with renal disease and kidney transplant part 2

Saif, Imran; Adkins, Angela; Kewley, Victoria; Woywodt, Alexander; Brookes, Vanita

doi:10.12968/denu.2011.38.4.245

Cited by 12 publications

(7 citation statements)

References 10 publications

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“…An increased perception of the importance of oral health in ESRD patients and transplant candidates has been observed in the scientific community in the last twenty years. Over time, the dental protocols that have been proposed by various authors showed a growing attention to the psychological aspect of the patient and to the importance of maintaining good control of plaque and daily oral hygiene [ 5 , 6 , 9 , 16 , 31 , 40 ]. Due to the greatly increased incidence and severity of periodontitis in the hemodialysis population, the dentist should keep in mind that the lack of oral hygiene may put the patient at higher risk of local or disseminated infection because of the persisting daily episodes of bacteraemia from the oral cavity.…”

Section: Operative Protocolsmentioning

confidence: 99%

Dental Care for Patients with End-Stage Renal Disease and Undergoing Hemodialysis

Costantinides

Castronovo

Vettori

et al. 2018

International Journal of Dentistry

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Chronic renal failure is a progressive disease characterized by a gradual destruction of nephrons and a consequent reduction of kidney function. End-stage renal disease (ESRD) necessitates renal replacement therapy as peritoneal dialysis, hemodialysis, or transplantation. Patients affected by ESRD or in hemodialysis are at risk for developing a number of comorbidities including hypertension, anemia, risk of bleeding, susceptibility to infection, medication side effects, and oral manifestations associated with the disease itself and with hemodialysis treatment. In this context, oral diseases represent a potential and preventable cause of poor health outcomes in people with ESRD due to their relation to infection, inflammation, and malnutrition. The aim of this article was to review ESRD and hemodialysis-associated manifestations and to describe the dental operative protocols for patients awaiting kidney transplantation in light of the most recent literature.

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Section: Operative Protocolsmentioning

confidence: 99%

Dental Care for Patients with End-Stage Renal Disease and Undergoing Hemodialysis

Costantinides

Castronovo

Vettori

et al. 2018

International Journal of Dentistry

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“…52 In patients undergoing hemodialysis, potentially traumatic treatment should be scheduled after 6-10 h to avoid the bleeding tendency induced by the effect of heparin. 53…”

Section: Urinary System Diseasesmentioning

confidence: 99%

“…52 For example, nephrotoxic drugs should be banned while antibiotics are ordinarily administrated. 53 Though patients are more likely to suffer from hemorrhage, local hemostatic measures are generally used. 52 In patients undergoing hemodialysis, potentially traumatic treatment should be scheduled after 6-10 h to avoid the bleeding tendency induced by the effect of heparin.…”

Section: Urinary System Diseasesmentioning

confidence: 99%

“…When treating these patients, dental practitioners are supposed to focus on bleeding, infection, and drug administration 52 . For example, nephrotoxic drugs should be banned while antibiotics are ordinarily administrated 53 . Though patients are more likely to suffer from hemorrhage, local hemostatic measures are generally used 52 .…”

Section: Systemic Disorder Risk Factors and Related Precautionsmentioning

confidence: 99%

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Management of systemic risk factors ahead of dental implant therapy: A beard well lathered is half shaved

Zhou

Liu

et al. 2021

Journal of Leukocyte Biology

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As the most successful therapy for missing teeth, dental implant has become increasingly prevalent around the world. A lot of papers have reported diverse local risk factors affecting the success and survival rate of dental implants, either for a short or a long period. However, there are also many types of systemic disorders or relatively administrated medicine that may jeopardize the security and success of dental implant treatment. Additionally, the coronavirus disease 2019 pandemic also poses a challenge to dental implant clinicians. Some of these risk factors are clinically common but to some extent unfamiliar to dentists, thus optimal measurements are often lacking when they occur in dental clinics. In this review, we analyze potential systemic risk factors that may affect the success rate of dental implants. Some of them may affect bone mineral density or enhance the likelihood of local infection, thus impeding osseointegration. Others may even systemically increase the risk of the surgery and threaten patients’ life. In order to help novices receive high‐risk patients who need to get dental implant treatment in a more reasonable way, we accordingly review recent research results and clinical experiments to discuss promising precautions, such as stopping drugs that impact bone mineral density or the operation, and addressing any perturbations on vital signs.

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“…14 As preocupações, descritas por alguns autores, incluem alteração do metabolismo de drogas, da resposta imunológica e do metabolismo ósseo, risco aumentado de sangramento e risco aumentado para endocardite infecciosa (EI). [14][15][16][17][18] A EI foi reconhecida como uma complicação associada com a HD desde 1966, quando foram divulgados os primeiros relatos. Segundo a literatura, a incidência da EI é bastante variável (1,1% a 12%) e o risco de ocorrer nos indivíduos em HD é 17% maior que na população geral.…”

Section: 113 Introduçãounclassified

Reparação alveolar pós-exodôntica em indivíduos com insuficiência renal crônica submetidos à hemodiálise

Andrade¹

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Andrade NS. Post-extraction socket healing in subjects with chronic renal failure undergoing hemodialysis [thesis]. São Paulo: Universidade de São Paulo, Faculdade de Odontologia; 2018. Versão Original. Chronic kidney disease is the metabolic disorder resulting from progressive and irreversible decline of the renal function. The final stage of this disease is known as chronic kidney failure (CKF) that demands the start of renal replacement therapy, usually hemodialysis (HD). The clinical management of people with CKF can represent a challenge for dentists, especially when performing invasive dental procedures. Despite the lack of studies and clinical or scientific evidences that investigate the risk of post-extraction complications in people with CKF, several authors still recommend that dentists prescribe the use of prophylactic antibiotics to these individuals. Thus, our study aimed to assess clinically and radiographically the process of post-extraction socket healing in individuals with CKF submitted to HD, comparing to a control group without CKF, without the prescription of the prophylactic antibiotic. It was a prospective observational study that included 48 individuals with CKF in HD to compose the study group (SG) and 29 control subjects without CKF to form the control group (CG). The same dentist applied the questionnaire on medical history of the patient, conducted the clinical odontological exam and requested laboratory tests (hemogram, coagulogram, urea, creatinine, total calcium, alkaline phosphatase and parathyroid hormone). All participants were submitted to exodontia of erupted teeth, always by the same dental surgeons, without the use of prophylactic antibiotics, during the period from October 2016 to December 2018. Postoperative assessments were conducted 3, 7, 21 and 60 days after the extractions. On the SG, teeth extractions were performed in 65 distinct surgical times, totaling 87 extractions. On the CG, 76 extractions were performed in 36 surgical times. In SG there was a significant delay in surgical wound epithelization, which is observed 21 days after exodontia (29.9% versus 3.9%, p <0.001) and 2 hemorrhagic complications. We did not observe complications of infectious origins in any case for any group. The delay in alveolar epithelization on SG was significantly associated with a lower neutrophil count and wider HD time (p <0.05). Presence of bone spicules, 21 days after exodontia, was associated with lower values of serum calcium (p <0.05). In the radiographic evaluation of SG subjects, we observed a decreased bone density measured by the intensity of pixels and a lower complexity of the bone structure at the fractal dimension 60 days after exodontia, when compared to CG (p <0.001). We concluded that alveolar repair after extractions in individuals with CKF undergoing HD is similar to controls, with only a delay in the epithelization of the surgical wound that did not impact on the final repair of the alveolus. We can expect in some cases the occurrence of hemorrhagic events in individ...

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Routine and emergency management guidelines for the dental patient with renal disease and kidney transplant part 2

Abstract: This paper provides guidance to the special care dentist for the dental management of patients with renal disease, and highlights issues in patients who are either on dialysis or have a kidney transplant.

Cited by 12 publications

References 10 publications

Dental Care for Patients with End-Stage Renal Disease and Undergoing Hemodialysis

Dental Care for Patients with End-Stage Renal Disease and Undergoing Hemodialysis

Management of systemic risk factors ahead of dental implant therapy: A beard well lathered is half shaved

Reparação alveolar pós-exodôntica em indivíduos com insuficiência renal crônica submetidos à hemodiálise

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