Abstract: 【Abstract】Objective To investigate oral changes and oral diseases and the relationship between oral health condition and micro- inflammatory state in maintenance hemodialysis (MHD) patients. Methods We recruited 85 MHD patients and 85 healthy adults as controls for this study. Their general condition, serum hsCRP, other laboratory examinations, and oral status were recorded. The relationship between periodontal disease index (PDI) and hsCRP was analyzed in MHD patients. MHD patients were then divided into healthy dental condition with mild caries group (group A), and healthy dental condition with severe caries group (group B), healthy periodontal condition or mild periodontal disease group (group C), and moderate and severe periodontal disease group (group D). Results of laboratory examinations were compared between MHD patients and healthy controls. Results The prevalence of caries was 68.2% in MHD patients. There were no statistically differences in prevalence of caries, caries not filled yet, missing teeth, and decayed, missing and filled teeth index (DMFT) between MHD patients and healthy controls (P>0.05). Filled teeth were lower in MHD patients (1.3) than in healthy controls (1.7) (P<0.05). The prevalence of periodontal disease was 83.5% in MHD patients. Debris index was 2.1 and 1.2, calculus index was 1.5 and 0.8, PDI was 3.9 and 1.9 in MHD patients group and healthy control group, respectively, significantly higher in MHD patients group (P<0.05). In MHD patients, the aggravation of periodontal disease was related to gender, diabetes mellitus, and dialysis age (P<0.05). Logistic regression demonstrated that dialysis age and diabetes mellitus were the risk factors for the aggravation of periodontal disease (P＜0.01) in MHD patients. Dialysis age was positively correlated with PDI (P＜0.05). Serum hsCRP was indifferent between group A and group B (P＞0.05), but was higher in group D (16.0±6.9 mmol/L) than in group C (11.1±7.4 mmol/L) (P＜0.01). Serum hsCRP and PDI were positively correlated (P＜0.05). In the nutrition indices, MBI was 24.2±1.3 and 22.1±1.5, ALB was 40.8±4.5g/L and 38.7±3.6g/L in group D and group C, respectively (P＜0.05). Conclusions Poor oral hygiene and higher prevalence of periodontal disease were frequently seen in MHD patients. Their periodontal
disease aggravated with the increase of dialysis age. Chronic and severe periodontal disease may be one of the factors resulting in micro-inflammation status in MHD patients.

Key words: maintenance hemodialysis, periodontal disease, dental decay, C reactive protein, micro-inflammation.