Clinical and Radiographic Oral Manifestations in Pediatric Patients with Chronic Renal Failure on Dialysis Therapy

Objective: To describe clinical and radiological oral manifestations in children with chronic renal failure on dialysis therapy and the relationship with disease, period of dialysis, and history of secondary hyperparathyroidism. Methods: A comparative study of 2 independent groups, including thirty- three children with chronic renal failure on dialysis (between 7-16 years old) and 33 children without chronic renal failure and with similar characteristics was conducted. Intraoral examinations, including a smear of oral mucosa and digital panoramic maxillary radiographs, were performed. Results: Among children with chronic renal failure, 16 (48.5%) had xerostomia, 18 (54.5%) had uremic breath, 16 (48.5%) showed changes in oral mucosa, 24 (72.7%) had regular oral hygiene with a low rate of dental caries, 20 (60.6%) had enamel hypoplasia, 25 (75.8%) tested positive for Candida hyphae, 5 (15.2%) had changes in the shape of the mandibular cortex, and 14 (42.4%) had signs of osteopenia in the jaws. Conclusion: We found significant differences between the groups with and without chronic renal failure for xerostomia, uremic breath, changes in oral mucosa, enamel hypoplasia, dental caries, mandibular cortical shape, and signs of osteopenia. Moreover, we observed significant relationships between several aforementioned findings and the period of kidney disease, duration of dialysis, and presence of osteodystrophy.