The prevalence of atherosclerotic complications (myocardial infarction, stroke, and sudden death) is increased in end-stage renal disease (ESRD) patients, especially in haemodialysis patients. Increasing evidence suggests that both in general population and in dialysis patients, systemic inflammation plays a dominant role in the pathogenesis of atherosclerotic complications. In general population, also, evidence shows that moderate to severe periodontitis can contribute to inflammatory burden by increasing serum CRP levels and may increase the prevalence of atherosclerotic events. Moreover, the results of some new interventional studies reveal that effective phase I periodontal therapy may decrease serum CRP levels, the most important acute phase protein, monitored as a systemic marker of inflammation and endothelial dysfunction as well, used as an initial predictor of atherosclerotic events. Considering that moderate to severe periodontal diseases have a higher prevalence in CKD and in dialysis population and that periodontal examination is not part of the standard medical assessment, destructive periodontitis might be an ignored source of systemic inflammation in end-stage renal disease patients and may add to the chronic inflammatory status in CKD.

Gingival condition in Bucharest schoolchildren population was associated to social gradients. School dental services are also another factor that seems to be related with gingivitis.

Background. The aim of our study was to assess the subgingival profile of 9 periodontal pathogens, by means of real-time PCR, in a group of predialysis chronic kidney disease patients with and without periodontal disease and to identify the risk factors associated with periodontal disease in these patients. Material and Methods. This is a single centre cross-sectional cohort study performed on 70 CKD patients. Patients received a full-mouth periodontal examination and the following parameters were assessed: periodontal pocket depth (PPD), clinical attachment level, bleeding on probing, and plaque index; subgingival biofilm samples were collected from the deepest periodontal pocket of each quadrant and were pooled in one transporting unit. Clinical data were drawn from the medical file of the patients. Results. T. denticola (P = 0.001), T. forsythia (P < 0.001), and P. micros (P = 0.003) are significantly associated with periodontal disease in CKD subjects but in a multivariate model only age and T. forsythia remain independent risk factors for periodontal disease in patients with CKD. Conclusions. In our cohort, age and T. forsythia are independently associated with periodontitis in CKD patients. Within the limits of this study, CKD was not significantly associated with a particular subgingival periodontal pathogens profile in periodontitis patients.

Background. The paper describes the case of a 62 years non-smoking male patient who was referred to the Department of Periodontology, “Carol Davila” University of Medicine and Pharmacy, complaining of gingival overgrowth. The patient’s medical history revealed that he suffers from autosomal dominant polycystic kidney disease chronic renal failure and hypertension; the patient was under treatment with amlodipine, a calcium channel blocker for 18 months. Case presentation. The patient underwent cause-related periodontal therapy and flap surgery in areas where only partial resolution of the gingival overgrowth was obtained after completion of initial phase therapy; amlodipine was not substituted because of medical reasons. Results. We obtained complete resolution of the gingival enlargement, even without any change in the causative drug regimen; the patient was placed in a maintenance program, with regular appointments at 3 months; he successfully managed to maintain periodontal and oral health. Conclusions. If possible, all patients who are about to receive calcium channel blockers, should have a detailed periodontal assessment performed and if any periodontal disease discovered, treated properly. In case of established gingival overgrowth, non-surgical and/or surgical periodontal therapy could induce partial or complete remission of enlargement. Change of medication is also an option.