Anand A C, Pardal P K, Sachdev V P
Classified Specialist (Medicine and Gastroenterology), Command Hospital (Western Command) Chandimandir-134 107.
Classified Specialist (Psychiatry), Command Hospital (Western Command) Chandimandir-134 107.
Med J Armed Forces India. 2001 Jan;57(1):26-30. doi: 10.1016/S0377-1237(01)80085-X. Epub 2011 Jul 21.
Bacterial infections are frequent complications in patients with chronic liver disease (CLD). A potential source of infection may be dental foci. This study was carried out to assess the association of CLD with dental caries and periodontal disease. Dental caries and periodontal examinations were performed prospectively in patients with CLD (group A) and controls without any liver disease (group B). Similar examination was also carried out in alcoholics without liver disease (group C) as well as in cases with portal hypertension but no liver disease (group D) i.e. patients with Non Cirrhotic Portal Fibrosis and Extrahepatic portal obstruction. A total of 231 subjects (Group A:83, group B: 75, group C:46 and group D:27) were studied. Group A included 32 cases with chronic hepatitis B&C, 26 with alcoholic cirrhosis, 14 with postnecrotic cirrhosis, and 11 with cryptogenic cirrhosis. Measures of oral hygiene (p < 0.01), dental care (p < 0.001), and periodontal parameters were worse and the number of teeth requiring treatment (p < 0.05) was higher in alcoholics with or without cirrhosis than in healthy subjects and nonalcoholic patients with cirrhosis. Alcoholics had a lower, total number of teeth than patients without alcohol abuse and healthy controls (p < 0.01). The dental caries and periodontal status of patients with nonalcoholic cirrhosis did not differ significantly from group B. The severity and duration of liver disease had no influence on dental caries and periodontal disease. The presence of chronic alcohol abuse rather than cirrhosis or portal hypertension is a major predisposing factor for dental caries and periodontal diseases. In alcoholics, these diseases appear to be caused primarily by bad oral hygiene and poor dental care.
细菌感染是慢性肝病（CLD）患者常见的并发症。感染的一个潜在来源可能是牙病灶。本研究旨在评估CLD与龋齿和牙周疾病之间的关联。对CLD患者（A组）和无任何肝病的对照组（B组）进行了前瞻性的龋齿和牙周检查。对无肝病的酗酒者（C组）以及有门静脉高压但无肝病的患者（D组），即非肝硬化门静脉纤维化和肝外门静脉阻塞患者，也进行了类似检查。共研究了231名受试者（A组：83例，B组：75例，C组：46例，D组：27例）。A组包括32例慢性乙型和丙型肝炎患者、26例酒精性肝硬化患者、14例坏死后肝硬化患者和11例隐源性肝硬化患者。与健康受试者和非酒精性肝硬化患者相比，有或无肝硬化的酗酒者的口腔卫生指标（p < 0.01）、牙齿护理情况（p < 0.001）和牙周参数较差，需要治疗的牙齿数量较多（p < 0.05）。酗酒者的牙齿总数低于无酗酒史的患者和健康对照组（p < 0.01）。非酒精性肝硬化患者的龋齿和牙周状况与B组无显著差异。肝病的严重程度和持续时间对龋齿和牙周疾病没有影响。慢性酗酒而非肝硬化或门静脉高压是龋齿和牙周疾病的主要诱发因素。在酗酒者中，这些疾病似乎主要是由不良的口腔卫生和较差的牙齿护理引起的。
