Costa Fernando Oliveira, Cortelli Sheila Cavalca, Cortelli José Roberto, Lages Eugênio José Pereira, Pereira Gustavo Henrique Mattos, Costa Adriana Moreira, Cota Luís Otávio Miranda
School of Dentistry, Department of Periodontology, Federal University of Minas Gerais, Antônio Carlos Avenue, 6627, Pampulha, PO Box 359, Belo Horizonte, Minas Gerais, 31270-901, Brazil.
Department of Dentistry, Periodontics Research Division, University of Taubaté, São Paulo, Brazil.
Clin Oral Investig. 2022 Apr;26(4):3563-3572. doi: 10.1007/s00784-021-04324-6. Epub 2021 Dec 2.
The objective of this study was to evaluate the potential association between liver cirrhosis and peri-implant diseases, as well as the influence of different risk indicators on this association.
This case-control study included 64 cases with liver cirrhosis and 128 controls without liver diseases that presented the same socio-demographic and economic profile. The specific inclusion criteria were the following: aged group of 35-55 years and presenting at least one osseointegrated implant functioning for >5 years. A full-mouth peri-implant and periodontal examination was performed and risk variables were recorded. The association between risk variables and the occurrence of peri-implant diseases was tested through univariate analysis and multivariate logistic regression, stratified by alcohol status. Additionally, a mediation analysis was performed to examine the mediating effect of age with peri-implantitis.
A high prevalence of peri-implantitis (29.7%) was observed among cases when compared to controls (18.0%). Individuals with cirrhosis presented ~2.5 higher chance of having peri-implantitis than controls (p<0.001). Significant variables associated with the occurrence of peri-implantitis in the final logistic model were the following: cirrhosis, alcohol use, age (>55 years), male sex, smoking, periodontitis, and number of ≤14.
An important risk association between liver cirrhosis and peri-implantitis was reported. Future studies with a larger sample size controlling for the patient- and implant-related confounders are needed to better understand the link between peri-implantitis and liver cirrhosis.
Cirrhosis individuals, age, and periodontitis, as well as alcohol use and smoking interaction, should be considered as potential risk indicators for peri-implantitis.
本研究旨在评估肝硬化与种植体周围疾病之间的潜在关联，以及不同风险指标对这种关联的影响。
本病例对照研究纳入了64例肝硬化患者和128例无肝脏疾病的对照者，两组具有相同的社会人口统计学和经济特征。具体纳入标准如下：年龄在35 - 55岁之间，且至少有一枚骨结合种植体已使用超过5年。进行了全口种植体周围和牙周检查，并记录风险变量。通过单因素分析和多因素逻辑回归对风险变量与种植体周围疾病的发生之间的关联进行了检验，并按饮酒状况进行分层。此外，还进行了中介分析以检验年龄对种植体周炎的中介作用。
与对照组（18.0%）相比，病例组中种植体周炎的患病率较高（29.7%）。肝硬化患者发生种植体周炎的几率比对照组高约2.5倍（p<0.001）。最终逻辑模型中与种植体周炎发生相关的显著变量如下：肝硬化、饮酒、年龄（>55岁）、男性、吸烟、牙周炎以及牙齿数量≤14颗。
报告了肝硬化与种植体周炎之间存在重要的风险关联。需要开展更大样本量的研究，控制患者和种植体相关的混杂因素，以更好地理解种植体周炎与肝硬化之间的联系。
肝硬化患者、年龄、牙周炎以及饮酒和吸烟的相互作用应被视为种植体周炎的潜在风险指标。
