Department of Oral and Maxillofacial Medicine, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran.
Oral and Dental Disease Research Center, Department of Oral and Maxillofacial Medicine, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran.
Biomed Res Int. 2018 Aug 26;2018:4280312. doi: 10.1155/2018/4280312. eCollection 2018.
Patients with chronic liver failure (CLF) are faced with many complications, because this organ is involved in various metabolic activities. Hepatic osteodystrophy is one of the major health issues encountered by this group of patients. The current study evaluated osteoporosis and bone changes in oral panoramic radiographies of cirrhotic patients.
In this study, 138 panoramic views of CLF patients, candidates for liver transplant (65 females, 73 males, aged 19-68 years) referred to Shiraz University Dental Clinic (Shiraz, Iran) for pretransplant oral examination, were evaluated. Also 138 healthy individuals (69 females, 69 males, aged 18-70 years) referred to the same clinic were examined. Abnormalities such as osteoporosis, pathologic radiolucencies, pathologic calcifications, tonsilloliths, condylar degeneration, and other findings in the alveolar bones were recorded.
Osteoporosis was a common finding in CLF patients (<0.001), and the probability of detecting low bone density in the panoramic view was 20.37 times higher among patients than healthy subjects. The probability of detecting pathologic jaw radiolucencies was 8.92 times higher in the case group than in the controls (<0.001). Other bone abnormalities such as condylar degeneration and idiopathic osteosclerosis were also more prevalent in CLF patients compared to healthy subjects (<0.001).
Cirrhotic patients are prone to osteoporosis of the alveolar bones. Also, pathologic jaw radiolucencies as a result of oral infections are more prevalent in this group of patients. Routine oral panoramic views are acceptable and cost-effective radiographies for use in detecting such abnormalities in the alveolar bones as well as overall dental health. These findings also support the importance of dental health examinations prior to liver transplantation to reduce the risk of organ rejection.
慢性肝功能衰竭（CLF）患者面临许多并发症，因为该器官参与了各种代谢活动。肝性骨营养不良症是该组患者遇到的主要健康问题之一。本研究评估了肝硬化患者口腔全景片中的骨质疏松症和骨变化。
在这项研究中，评估了 138 例 CLF 患者（65 名女性，73 名男性，年龄 19-68 岁）的口腔全景图，这些患者是为肝移植前的口腔检查而转诊到设拉子大学牙科诊所（伊朗设拉子）的。还检查了 138 名健康个体（69 名女性，69 名男性，年龄 18-70 岁）。记录了牙槽骨中的异常情况，例如骨质疏松症、病理性透亮区、病理性钙化、扁桃体结石、髁突退行性变和其他发现。
骨质疏松症在 CLF 患者中很常见（<0.001），并且在全景片中检测到低骨密度的可能性在患者中比健康受试者高 20.37 倍。在病例组中，检测到病理性颌骨透亮区的可能性比对照组高 8.92 倍（<0.001）。与健康受试者相比，CLF 患者中还存在其他骨骼异常，例如髁突退行性变和特发性骨硬化症（<0.001）。
肝硬化患者易发生牙槽骨骨质疏松症。此外，由于口腔感染而导致的病理性颌骨透亮区在该组患者中更为普遍。常规的口腔全景片是可接受的且具有成本效益的放射线检查，可用于检测牙槽骨中的此类异常以及整体牙齿健康状况。这些发现还支持在进行肝移植之前进行牙科健康检查的重要性，以降低器官排斥的风险。
