Apical Periodontitis, Chronic Kidney Diseases
Conditions
Brief summary
The purpose of this prospective study is to determine the effect of non-surgical root canal treatment in chronic kidney disease patients and healthy patients with apical periodontitis.
Detailed description
It has been found that there is an association between prevalence of odontogenic infection and systemic diseases. An elevated level of systemic cytokines has been observed in conjunction with both AP and CKD . The proinflammatory status and impaired immune response associated with systemic diseases (chronic kidney disease ) can affect the reparative response of the dental pulp and periapical healing. One study observed significant positive relation between number of diagnosed AP and urea serum level . A 4.35-mg/dL increase in the urea serum level could be expected per 1-unit increase in the number of teeth with AP. Improving oral health care through nonsurgical endodontic treatment(NSET) may improve the systemic inflammatory status and improve renal function. The aim of this prospective study is to determine the effect of non-surgical root canal treatment in chronic kidney disease patients and healthy patients with apical periodontitis 1. Clinical and radiographic success rate will be considered as primary outcome, will be checked at baseline,6months,12months follow up.Periapical status will be checked according to periapical index given by Orstavik 2. Reduction in inflammatory(hsCRP) and kidney makers(serum urea , creatinine , eGFR) will be considered as secondary outcome, will be checked at baseline,3months,6months follow up.
Interventions
PROCEDUREroot canal treatment in Ckd patients
root canal treatment in teeth with apical periodontitis to observe periapical healing , and change in eGFR ,blood urea and creatinine and HSCRP
PROCEDUREroot canal treatment in healthy patients
root canal treatment in teeth with apical periodontitis to observe periapical healing and change in HSCRP
Sponsors
Postgraduate Institute of Dental Sciences Rohtak
Study design
Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
1- Known patient of Chronic Kidney Disease \[CKD Stages 1,2,3,4,5 with mature permanent teeth. 2\. Age18year or older . 3. ≥ to 12 natural teeth (excluding 3rd molars) 4 The periapical index (PAI) was used to evaluate the periapical status patients with PAI ≥3 are included in the study.
Exclusion criteria
1. Patients having systemic disorders other than chronic kidney disease (e.g HIV; Diabetes mellitus; Coronary heart disease; no history of secondary hyperparathyroidism) 2. Patients with periodontitis , pocket depth and CAL\>5mm( stage 3 ,4) will be excluded. 3. Pregnancy; lactation & contraceptives. 4. Patients taking antibiotics, statins, corticosteroids and aspirin which can affect the level of inflammatory markers in past one month.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Periapical Index(PAI) | 12MONTHS | Periodical status will be assessed in periodical radiograph and scoring of periapical index will be done according to size and periphery of peri-apical radiolucency with coding 1 to 5 |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| eGFR | 3-6MONTHS | BY BLOOD SAMPLE measured in mL/min/1.73m2 |
| serum creatinine | 3-6MONTHS | BY BLOOD SAMPLE measured in mg/dL |
| hs-CRP | 3-6MONTHS | HIGH SENSITIVE C-reactive protein measured by ELISA kit in mg/L |
| Blood urea | 3-6MONTHS | measured by collecting blood sample in mg/dL |
Countries
India
Contacts
Primary ContactSHWETA MITTAL, MDS
Backup ContactSANJAY TEWARI, MDS
Outcome results
None listed