Raghava K Vijay, Shivananda H, Mundinamane Darshan, Boloor Vinita, Thomas Biju
Department of Periodontics, Sri Rajiv Gandhi College of Dental Sciences, Cholanagar, Hebbal, RT Nagar, Bengaluru-560032 Karnataka, India.
J Contemp Dent Pract. 2013 Mar 1;14(2):179-82. doi: 10.5005/jp-journals-10024-1296.
Bacterial infections are common complicating findings in course of liver cirrhosis, most of them being Gram-negative. Similarly periodontal pathogens are also mostly Gram-negative bacteria hence the objective was to evaluate the periodontal status in alcoholic liver cirrhosis patients and to compare the periodontal status of alcoholic liver cirrhosis patients in: a. Smokers with periodontitis and b. Nonsmokers with periodontitis.
A total of 150 patients made up the sample of this study. The sample size was divided into four groups. The first two groups comprised of 50 patients each comprising of patients with periodontitis who were nonsmokers and patients with periodontitis who were smokers respectively and the next two groups comprised of 25 patients each, which included patients diagnosed as suffering from alcoholic liver cirrhosis who are nonsmokers and patients diagnosed as suffering from alcoholic liver cirrhosis who are smokers. Screening examination included a proper medical history, dental history and Russell's periodontal index was done to evaluate and compare the periodontal status among the selected groups.
The data obtained was subjected to statistical analysis using the ANOVA Fisher's F-test. Multiple group comparisons were made using the Tukey's HSD test.
Conclusions that can be drawn from this study are: 1. Alcoholic liver cirrhosis patients demonstrated greater alveolar bone loss and increased periodontal destruction. 2. There is very high statistically significant difference on periodontal destruction in alcoholic liver cirrhosis patients (with or without smokers) when compared to the control group.
Periodontal diseases are bacterial infections associated with a bacterial load or insult to the host that elicits a strong inflammatory response cumulating to produce significant pathologic alterations in the systemic status of the host. Alcoholic liver cirrhosis patients as a consequence of liver dysfunction have elevated levels of serum cytokines. These are involved in the destructive process of periodontal disease probably through enhancement of collagenase and metalloproteinase activity. Hence, a study has been planned to evaluate periodontal status in patients with alcoholic liver cirrhosis.
细菌感染是肝硬化病程中常见的并发症,其中大多数为革兰氏阴性菌。同样,牙周病原体也大多是革兰氏阴性菌,因此本研究的目的是评估酒精性肝硬化患者的牙周状况,并比较酒精性肝硬化患者在以下两种情况下的牙周状况:a. 患有牙周炎的吸烟者;b. 患有牙周炎的非吸烟者。
本研究样本共150例患者。样本量分为四组。前两组每组50例患者,分别为患有牙周炎的非吸烟者和患有牙周炎的吸烟者,后两组每组25例患者,分别为被诊断为酒精性肝硬化的非吸烟者和被诊断为酒精性肝硬化的吸烟者。筛查检查包括详细的病史、牙科病史,并采用罗素牙周指数来评估和比较所选组之间的牙周状况。
所获得的数据采用方差分析中的费舍尔F检验进行统计分析。多组比较采用图基 Honestly Significant Difference检验。
本研究可得出以下结论:1. 酒精性肝硬化患者牙槽骨吸收更严重,牙周破坏增加。2. 与对照组相比,酒精性肝硬化患者(无论是否吸烟)的牙周破坏在统计学上有非常显著的差异。
牙周疾病是与细菌负荷或对宿主的侵害相关的细菌感染,会引发强烈的炎症反应,累积起来会在宿主的全身状况中产生显著的病理改变。酒精性肝硬化患者由于肝功能障碍,血清细胞因子水平升高。这些细胞因子可能通过增强胶原酶和金属蛋白酶的活性参与牙周疾病的破坏过程。因此,已计划开展一项研究来评估酒精性肝硬化患者的牙周状况。