Bony abnormalities in cone-beam computed tomography for chronic renal failure patients showing signs of chronic kidney disease-mineral and bone disorder
만성신부전 환자에서 일어나는 만성콩팥병-무기질뼈장애 관련 CBCT상의 골 이상
- 주제(키워드) Chronic renal failure , CBCT , mental index , mandibular cortical index , antegonial index , lamina dura loss
- 주제(DDC) 617.6
- 발행기관 아주대학교
- 지도교수 지숙
- 발행년도 2023
- 학위수여년월 2023. 8
- 학위명 석사
- 학과 및 전공 임상치의학대학원 임상치의학과
- 실제URI http://www.dcollection.net/handler/ajou/000000032839
- 본문언어 영어
- 저작권 아주대학교 논문은 저작권에 의해 보호받습니다.
초록/요약
Introduction: Patients with chronic renal failure (CRF) have abnormal bone metabolism which is called chronic kidney disease-mineral and bone disorder (CKD-MBD). The aim of this study was to assess bony abnormalities and radiomorphometric indices found and measured in dental cone-beam computed tomography (CBCT) of CRF patients and explore the possibility of using CBCT as one of the diagnostic tools to assess CRF. Material & methods: Medical records of patients who visited Ajou University Medical Center (AUMC) from January 1st, 2017 to March 1st, 2023 who were diagnosed as chronic renal failure (CRF) stage G5 were scanned. Among them, patients who visited AUMC dental hospital and have taken CBCT radiographs were selected for test group. Control group was selected from CBCT archive, with gender ratio and average age matching those of the test group and without any general health conditions which may affect bone metabolism. From CBCT of both CRF and control, mental index (MI), antegonial index (AI), panoramic mandibular index (PMI), pulp chamber size were compared using the two sample t-test or Wilcoxon rank sum test, and mandibular cortical index (MCI) classifications, soft tissue calcifications, loss of lamina dura were analyzed using the χ2 test. From the medical records, serum calcium (Ca, in mg/dL), phosphorus (P, in mg/dL), parathyroid hormone (PTH, in pg/mL), vitamin D (25(OH)D or 1,25(OH)2D, in ng/mL) and thyroid-stimulating hormone (TSH, ulU/m) of CRF group were reviewed and analyzed using the Pearson correlation and Spearman’s rank correlation between the serum levels and the radiomorphometric indices. Result: The test and control groups consisted of 94 patients, respectively. Lt MI, Rt AI, Lt AI were significantly lower in the CRF group than in the control. MCI class II and III were more prevalent in the CRF group. Lamina dura loss was more commonly found in the CRF group. Soft tissue calcifications were more prevalent in the test group than in the control group. Left AI with the serum phosphorus level, and MCI classifications with TSH both showed positive correlations which were statistically significant. Conclusion: CBCT showed bony abnormalities of CKD-MBD. If patients show abnormal calcifications and lowered bone quality, CBCT radiographs may reflect such condition and the dentists may be aware of the fact there may be a chance of renal osteodystrophy, which may prevent optimal osseous surgery and dental implant outcomes.
more목차
I. INTRODUCTION 1
II. MATERIALS AND METHODS 5
A. SUBJECTS 5
B. CBCT RADIOMORPHOMETRIC MEASUREMENTS 6
C. SERUM LEVEL 9
D. STATISTICAL ANALYSIS 9
Ⅲ. RESULTS 10
Ⅳ. DISCUSSION 19
Ⅴ. CONCLUSION 23
REFERENCES 24
