Lins L, Bittencourt P L, Evangelista M A, Lins R, Codes L, Cavalcanti A R, Paraná R, Bastos J
Bahiana School of Medicine and Public Health, Salvador, Bahia, Brazil.
Transplant Proc. 2011 May;43(4):1319-21. doi: 10.1016/j.transproceed.2011.03.063.
Infections are a frequent cause of morbidity and mortality among postoperative liver transplant (OLT) patients and a leading cause of decompensated chronic liver disease (CLD) among patients awaiting the procedure. Oral lesions that are frequently observed in subjects with CLD may represent foci for systemic infections before and after OLT.
To evaluate the oral health profile of patients with CLD awaiting OLT.
One hundred thirty one patients including 100 males of overall mean age 49.5 ± 10.8 years with CLD were listed for OLT and examined for oral health status according to a established protocol.
One hundred thirty (99%) patients were partially edentulous; 66 (51%) had chewing difficulties; and 63 (48%) experienced reduced salivary flow. With respect to periodontal disease and oral infections, 68 (25%) had periodontitis, 63 (48%) had periapical lesion, 64 (49%) had abscesses, and 59 (45%) had root fragments. Loss of follow-up was observed in 21 subjects. Among the 110 other patients, 63 (57%) underwent dental treatments with complications in only two cases. Interestingly, mortality was significantly lower among treated (31%) versus nontreated patient (79%; P<.001).
Poor oral health status observed in most CLD patients may represent a source of systemic infections before and after OLT. Treatment of such lesions was feasible in the majority of the patients and seemed to be associated with a reduction in mortality.
感染是肝移植术后患者发病和死亡的常见原因，也是等待肝移植手术的慢性肝病（CLD）患者失代偿的主要原因。CLD患者中常见的口腔病变可能是肝移植前后全身感染的病灶。
评估等待肝移植的CLD患者的口腔健康状况。
131例患者（包括100例男性，CLD患者总体平均年龄49.5±10.8岁）被列入肝移植名单，并根据既定方案检查口腔健康状况。
130例（99%）患者部分缺牙；66例（51%）有咀嚼困难；63例（48%）唾液分泌减少。关于牙周病和口腔感染，68例（25%）有牙周炎，63例（48%）有根尖周病变，64例（49%）有脓肿，59例（45%）有牙根碎片。21例患者失访。在其他110例患者中，63例（57%）接受了牙科治疗，仅2例出现并发症。有趣的是，接受治疗的患者死亡率（31%）明显低于未接受治疗的患者（79%；P<0.001）。
大多数CLD患者口腔健康状况不佳可能是肝移植前后全身感染的来源。在大多数患者中治疗此类病变是可行的，并且似乎与死亡率降低有关。
