Graduate School of Dentistry, Chung Shan Medical University, Taichung, Taiwan.
School of Dentistry, Chung Shan Medical University, Taichung, Taiwan.
J Periodontal Res. 2018 Oct;53(5):785-792. doi: 10.1111/jre.12567. Epub 2018 May 18.
The purpose of this study was to investigate the relationship between periodontitis, dental scaling (DS) and pyogenic liver abscesses (PLAs).
A nationwide population-based case-control study was applied using data from the National Health Insurance Research Database in Taiwan. We identified and enrolled 691 PLA patients, who were individually matched by age and sex to 2764 controls.
Conditional logistic regression was applied to estimate adjusted odds ratios (aORs) in patients with exposure to periodontitis and DS before PLA. After adjusting for other confounding factors, periodontitis remained a risk factor for PLA among patients aged 20-40 years, with an aOR of 2.31 (95% confidence interval [CI] = 1.37-3.90, P = .0018). In addition, the average aOR for PLA was significantly lower among patients with one DS (aOR = 0.76, 95% CI = 0.59-0.96) and more than one DS (aOR = 0.61, 95% CI = 0.39-0.95) within 1 year before the index date.
According to these results, we concluded that adult patients with periodontitis aged <50 years old are more at risk for PLA than controls, particularly when they have no DS. Moreover, from 20 years of age, non-periodontal patients subjected to at least 2 DS per year are less at risk for PLA than controls.
本研究旨在探讨牙周炎、牙周洁治（DS）与化脓性肝脓肿（PLA）之间的关系。
本研究采用台湾全民健康保险研究数据库中的数据，进行了一项全国性的基于人群的病例对照研究。我们共确定并纳入了 691 例 PLA 患者，每位患者均与年龄和性别相匹配的 2764 例对照者相匹配。
采用条件逻辑回归估计了 PLA 患者在发生 PLA 之前接触牙周炎和 DS 的调整后优势比（aOR）。在调整其他混杂因素后，牙周炎仍然是 20-40 岁 PLA 患者的一个危险因素，其 aOR 为 2.31（95%置信区间[CI]：1.37-3.90，P=0.0018）。此外，在索引日期前 1 年内接受过 1 次 DS（aOR=0.76，95%CI=0.59-0.96）和超过 1 次 DS（aOR=0.61，95%CI=0.39-0.95）的患者，其 PLA 的平均 aOR 显著降低。
根据这些结果，我们得出结论，<50 岁的成年牙周炎患者发生 PLA 的风险高于对照组，尤其是在他们没有 DS 的情况下。此外，从 20 岁开始，每年至少接受 2 次牙周洁治的非牙周炎患者发生 PLA 的风险低于对照组。
