1Division of Hematology, Department of Internal Medicine, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia; 2Division of Gastroenterology and Hepatology, Department of Internal Medicine, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia; 3Department of Periodontology, Zagreb Dental Policlinic, Zagreb, Croatia; 4Department of Periodontology, School of Dental Medicine, University of Zagreb, Zagreb, Croatia.
Acta Clin Croat. 2022 Feb;60(3):510-518. doi: 10.20471/acc.2021.60.03.22.
Recent clinical and scientific evidence confirms the negative impact of long-term periodontitis on the clinical course and progression of various liver diseases. Periodontitis is a chronic, slow-progressing infectious disease of the tooth supporting tissues caused mainly by the gram-negative bacteria and These specific pathogens can be easily translocated from oral cavity to the intestine. Disruption of the intestine microbiota composition by orally derived periodontal pathogenic bacteria has recently been suggested to be a causal mechanism between periodontitis and liver disease. Furthermore, both diseases have the ability to induce an inflammatory response and lead to the creation of inflammatory mediators through which they may influence each other. Recent epidemiologic studies have demonstrated that individuals with liver cirrhosis have considerably poorer periodontal clinical parameters than those without cirrhosis. Periodontal therapy in cirrhosis patients favorably modulates oral and gut microbiome, the course of systemic inflammation, cirrhosis prognostic factors, and cognitive function. Therefore, future clinical researches should be focused on detailed examination of the biological mechanisms, strength and direction of the association between advanced liver disease and periodontitis.
近期的临床和科学证据证实了长期牙周炎对各种肝脏疾病的临床病程和进展的负面影响。牙周炎是一种主要由革兰氏阴性菌引起的慢性、缓慢进展的牙齿支持组织传染病。这些特定的病原体可以很容易地从口腔转移到肠道。最近有人提出,由口腔来源的牙周致病菌引起的肠道微生物群落组成的破坏可能是牙周炎和肝病之间的因果机制。此外,这两种疾病都有能力引发炎症反应,并通过产生炎症介质相互影响。最近的流行病学研究表明,肝硬化患者的牙周临床参数明显差于无肝硬化患者。肝硬化患者的牙周治疗可改善口腔和肠道微生物群、全身炎症的病程、肝硬化预后因素和认知功能。因此,未来的临床研究应集中于详细检查晚期肝病和牙周炎之间的关联的生物学机制、强度和方向。