Correlação entre índices radiomorfométricos da mandíbula e parâmetros bioquímicos em pacientes com doença renal crônica e hiperparatireoidismo secundário severo
The objective was to correlate radiomorphometric indices with biochemical analyses, as an auxiliary method in the bone evaluation of 66 patients with chronic kidney disease and bone mineral disorder (CKD-BMD) and severe secondary hyperparathyroidism (HPTS), compared With 132 patients with control...
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| Formato: | doctoralThesis |
| Idioma: | pt_BR |
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| Endereço do item: | https://repositorio.ufrn.br/jspui/handle/123456789/26766 |
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| Resumo: | The objective was to correlate radiomorphometric indices with biochemical analyses,
as an auxiliary method in the bone evaluation of 66 patients with chronic kidney
disease and bone mineral disorder (CKD-BMD) and severe secondary
hyperparathyroidism (HPTS), compared With 132 patients with controls that do not
present chronic kidney disease (CKD) under similar periodontal conditions. Nine
radiomorphometric indices were used to evaluate bone quality and quantity, and four
biochemical parameters were obtained: Mental index (MI), Height mental foramen
(HMF), Total height mandibular (THM), Panoramic mandibular index (MPI), Original
height of mandible (OHM), alveolar bone resorption (ABR), distance from the mental
foramen to the alveolar bone crest (MF-ABC), mandibular cortical index (MCI),
trabecular bone pattern, parathyroid hormone (PTH), calcium (Ca), phosphorus (P)
and the product Ca x P (Ca x P). The inter-class correlation coefficient for the
quantitative variables (MI, HMF, THM, MPI, OHM, ABR and MF-ABC was used for
inter- and intra-observer agreement in qualitative variables (MCI and mandibular
bone pattern). The Kolmogorov-Smirnov test was used to verify the normality of the
data. The non-parametric Mann-Whitney U test was used to evaluate two
independent samples, the chi-square test for analysis of qualitative variables and
Spearman's correlation for analysis of quantitative variables. The tests were applied
at a significance level of 95%. There was a moderate negative and significant
correlation between MI, PMI and PTH (r = -0.55, p = <0.01 and r = -0.47, p = 0.01,
respectively) in female patients with CKD-BMD, as well as between THM, MF-ABC
and Ca x P (r = -0.38, p = 0.01 and r = -0.41, p = 0.04, respectively). The MCI and
bone trabecular pattern indicated changes in bone quality in male patients with CKDBMD (p = <0.01). In 50% and 47.37% of men showed the C3 and sparse
classifications with frosted glass appearance (respectively), whereas in women
39.29% and 39.29% (respectively). Radiomorphometric evaluation correlated with
biochemical parameters was an auxiliary and non-invasive method to detect possible
alterations in the cortex and mandibular bone trabeculation in male and female
patients with CKD-BMD. According to the results of this study, we conclude that the significant associations between the MI and PTH indexes, PMI and PTH, THM and
Ca x P and MF-ABC and Ca x P occurred predominantly in women, while the MCI
indices and bone trabecular pattern in patients with CKD-BMD occurred preferentially
in males, thus radiomorphometric indices could be used as ancillary strategies in the
diagnosis and treatment of CKD-BMD. The dentist, as a member of the
multidisciplinary team responsible for the treatment and reestablishment of patients
with CKD, who might or may not undergo kidney transplantation needs more and
more updated knowledge, guaranteeing the Follow-up to these individuals for long
periods of time, mainly to detect, prevent or decrease the occurrence of oral clinicalradiographic manifestations resulting from CKD-MBD. |
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