Fluid dynamics of gingiva and gingival health in children with end stage renal failure

Objectives: Impaired homeostasis and fluid balance are important physiopathological alterations in patients with chronic renal failure which may adversely affect the fluid dynamics and health status of tissues and organs. There are insufficient data about this phenomenon in periodontal tissues. The aim of this study was to evaluate the fluid dynamics of gingiva in children with end stage renal failure (ESRF), correlating this entity with gingival health in the same patient group. Design: Fifteen paediatric ESRF patients undergoing peritoneal dialysis (test group) and 15 systemically healthy children (control group) who were without periodontitis participated in the study. Fluid dynamics of gingiva were assessed via the gingival crevicular fluid (GCF) volume and tissue osmotic pressure (GOP) levels in the groups. GCF volume was measured using a Periotron 8000 (R), whereas GOP was measured using a digital osmometer. Silness and Loe Plaque index (PI) and, Loe and Silness gingival index (GI) scores were utilized to determine the gingival health status in the study population. Results: There were increases in the GCF volume and GOP of the test group compared to those of the control group (p < 0.01). The PI and GI scores were higher in the test group than in the control group (p < 0.01). Strong and positive correlations were found between GI and GCF volume, GI and GOP and, GCF volume and GOP in both groups (p < 0.01). Conclusions: Our findings suggest that the fluid dynamics of gingiva may alter in children with ESRF, and this phenomenon may consequently affect the gingival health of these patients. (c) 2007 Elsevier Ltd. All rights reserved.