肝移植前后的口腔发现和口腔行为 - 一项单中心横断面研究。
Oral findings and dental behaviour before and after liver transplantation - a single-centre cross-sectional study.
机构信息
Department of General, Visceral and Pediatric Surgery, University Medical Center Göttingen, Göttingen, Germany.
Department of Cariology, Endodontology and Periodontology, University of Leipzig, Leipzig, Germany.
出版信息
Int Dent J. 2017 Aug;67(4):244-251. doi: 10.1111/idj.12290. Epub 2017 Mar 10.
OBJECTIVE
The aim of this single-centre, cross-sectional study was to evaluate dental, periodontal and mycological findings, as well as oral behaviour, in patients before (pre-LTx) and after (post-LTx) liver transplantation.
METHODS
A total of 47 patients pre-LTx and 119 patients post-LTx were asked to participate. Oral health behaviour was assessed using a standardised questionnaire. Oral examinations included dental [decayed, missing and filled teeth (DMFT) index] and periodontal [papillary bleeding index (PBI), periodontal probing depth (PPD) and clinical attachment loss (CAL)] findings. For Candida screening, swabs from the oral mucosa were cultured. Statistical analysis was performed using the Student's t-test or the Mann-Whitney U-test, depending on whether or not the data followed a normal distribution; Fisher's exact test was also performed. The significance level was α = 5%.
RESULTS
A total of 110 patients were included (pre-LTx, n = 35; post-LTx, n = 75). Different patients were investigated in the post-LTx and pre-LTx groups. Lack of use of supplemental oral-hygiene aids was noted. Between-group comparisons failed to find significant overall differences in DMFT and periodontal status. The post-LTx group showed fewer decayed teeth (P = 0.03). A total of 86% of patients pre-LTx and 84% of patients post-LTx were found to need dental treatment, and 60% of patients pre-LTx and 55% of patients post-LTx showed a need for periodontal treatment. The prevalence of Candida albicans was high; however, there were no statistically significant differences between the groups in regard to fungal infection.
CONCLUSION
Improved dental care pre- and post-transplant, including screening for fungal infections, is recommended to avoid systemic infections in LTx patients. Increased attention to oral health care, and interdisciplinary collaboration to provide guidance, is needed to improve the oral health of patients before and after LTx.
目的
本单中心横断面研究旨在评估肝移植前后（术前[pre-LTx]和术后[post-LTx]）患者的口腔、牙周和真菌学情况以及口腔行为。
方法
共邀请了 47 名 pre-LTx 患者和 119 名 post-LTx 患者参与。采用标准化问卷评估口腔健康行为。口腔检查包括口腔（龋齿、缺失和充填牙（DMFT）指数）和牙周（牙龈出血指数（PBI）、牙周探诊深度（PPD）和临床附着丧失（CAL））。为了进行 Candida 筛查，对口腔黏膜拭子进行培养。统计分析采用学生 t 检验或曼-惠特尼 U 检验，取决于数据是否服从正态分布；还进行了 Fisher 确切检验。显著性水平为 α = 5%。
结果
共纳入 110 例患者（pre-LTx，n=35；post-LTx，n=75）。post-LTx 组和 pre-LTx 组的患者不同。未使用补充口腔卫生用具。两组间比较，DMFT 和牙周状况无总体差异。post-LTx 组的龋齿数量较少（P=0.03）。86%的 pre-LTx 患者和 84%的 post-LTx 患者需要进行牙科治疗，60%的 pre-LTx 患者和 55%的 post-LTx 患者需要进行牙周治疗。白色念珠菌的患病率较高；然而，两组之间在真菌感染方面无统计学差异。
结论
建议在肝移植前后加强口腔护理，包括筛查真菌感染，以避免 LTx 患者的全身感染。需要更多关注口腔保健，并开展跨学科合作提供指导，以改善 LTx 前后患者的口腔健康。
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