CHRONIC APICAL PERIODONTITIS IN CHRONIC KIDNEY DISEASE PATIENTS
condition in the chronic kidney disease , the cardiovascular disease . Atherosclerosis is a multifactorial disease , which occurs at young ages and evolves with age . The presence of cholesterol crystals is also recognized in atherosclerotic plaques in humans . Slutzki-Goldberg et al . 13 conducted a study in which they evaluated the possible link between age and cholesterol deposits in periapical lesions . They have examined the biopsies of lesions identified in a group of teenagers and one of elderly and found that there is a significantly increased incidence of cholesterol deposits in periapical biopsies performed in elderly individuals , where serum cholesterol levels were elevated . The cholesterol crystal formation mechanism is probably similar to the genesis of atherosclerosis . Chronic apical periodontitis is an acute or chronic inflammatory lesion , present around the apex of a tooth and caused by a bacterial infection of the endodontic system . Histologically , it is represented by a periapical inflammatory response that occurs after the resorption of the adjacent support bone and local infiltration of inflammatory cells . 14 Thus , the significant associations , between lower serum albumin values and the high number of periapical lesions , from this study were not statistically surprising given that hypoalbuminemia (< 3.5 mg / dL ) can be caused by acute or chronic inflammatory responses .
5 . Conclusions This descriptive study showed that chronic apical periodontitis is highly prevalent in patients with chronic kidney disease , but future research is required to determine whether endodontic diseases are worsened by the chronic kidney disease or vice versa . The detection of some abnormal cholesterol and albumin levels during the regular investigations of patients with chronic renal failure , require a mandatory dental visits that will be associated with a radiological examination to detect chronic apical periodontitis . Most often silent from a clinical point of view , chronic apical periodontitis is diagnosed accidentally or following an acute exacerbation . These are powerful outbreaks of infection with diverse microbial flora camped at this level , able to cause amplification of the inflammatory response in the chronic kidney disease . The results obtained in our study emphasize the importance of radiological examinations for all patients , prior to kidney transplantation , since they may have teeth with inflammatory lesions , which cannot be clinically detected . According to the World Health Organization , health is an essential part of the social , economic and personal development of the individual and an important component of the quality of life . Especially in patients with CKD , the health of the oral cavity must be permanently assisted and improved in order to maintain a good overall body condition .
Acknowledgments The authors declare no conflict of interest related to this study . There are no conflicts of interest and no financial interests to be disclosed .
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