Sandoval Marίa José, Zekeridou Alkisti, Spyropoulou Vasiliki, Courvoisier Delphine, Mombelli Andrea, McLin Valérie, Giannopoulou Catherine
Division of Periodontology, School of Dental Medicine, University of Geneva, Geneva, Switzerland.
Swiss Center for Liver Disease in Children, University Hospitals Geneva, Geneva, Switzerland.
Pediatr Transplant. 2017 Nov;21(7). doi: 10.1111/petr.13019. Epub 2017 Jul 3.
To evaluate oral health conditions in pediatric liver transplant recipients, with special focus on caries, green staining of the teeth, gingival bleeding, and gingival overgrowth. 40 patients (mean age 11.6 years) were examined at a routine follow-up visit, 6 months to 16 years after liver transplantation at the Swiss Center for Liver Disease in Children. After the medical examination, participants were further examined for the presence of dental caries, periodontal disease, GE, and GTC. The mean decay, missing, and filled teeth (dmft/DMFT) score was 3.8. 45% of the participants presented at least one carious lesion. Two-third of the participants had more than 20% of sites with the presence of plaque and gingival inflammation. Signs of GE were found in 18% and GTC in 30% of the participants. A positive correlation was identified between GTC and peak serum bilirubin (P<.001) and primary diagnosis of cholestatic disease (P=.04). Gingival inflammation was associated with plaque (P<.001), use of immunosuppressive medication (P=.04), and was more pronounced in children with cholestatic disease (P=.007). Children and young adults with liver transplants presented a rather poor oral health status. Liver transplant physicians should counsel patients for regular dental follow-up in order to avoid serious dental infections.
为评估小儿肝移植受者的口腔健康状况，特别关注龋齿、牙齿绿染、牙龈出血和牙龈增生情况。在瑞士儿童肝病中心，对40例患者（平均年龄11.6岁）进行了常规随访检查，这些患者在肝移植后6个月至16年。体格检查后，对参与者进一步检查是否存在龋齿、牙周疾病、牙龈退缩（GE）和牙龈增生（GTC）。龋失补牙（dmft/DMFT）平均得分3.8。45%的参与者至少有一处龋损。三分之二的参与者有超过20%的部位存在菌斑和牙龈炎症。18%的参与者有牙龈退缩迹象，30%的参与者有牙龈增生。牙龈增生与血清胆红素峰值（P<0.001）和胆汁淤积性疾病的初步诊断（P=0.04）呈正相关。牙龈炎症与菌斑（P<0.001）、免疫抑制药物的使用（P=0.04）有关，在胆汁淤积性疾病患儿中更为明显（P=0.007）。接受肝移植的儿童和年轻人口腔健康状况较差。肝移植医生应建议患者定期进行牙科随访，以避免严重的牙科感染。
