Novacek G, Plachetzky U, Pötzi R, Lentner S, Slavicek R, Gangl A, Ferenci P
Department of Internal Medicine IV, University of Vienna, Austria.
J Hepatol. 1995 May;22(5):576-82. doi: 10.1016/0168-8278(95)80453-6.
BACKGROUND/AIMS: Bacterial infections are frequent complications in patients with cirrhosis, especially in alcoholics. A potential source of infection may be dental foci. The aim of the study was to assess the role of cirrhosis and chronic alcoholism in the development of dental or periodontal disease.
Dental and periodontal examinations were performed prospectively in 97 patients with cirrhosis (alcoholic: 64, nonalcoholic: 33), in 68 alcoholics without cirrhosis and in 71 healthy subjects (subdivided into age groups: 21-30, 31-40, 41-50, and 51-60 years).
Measures of oral hygiene (p < 0.01), dental care (p < 0.001), and periodontal parameters were worse and the number of teeth requiring treatment (p < 0.001) was higher in alcoholics with or without cirrhosis than in healthy subjects and nonalcoholic patients with cirrhosis. Alcoholics had a lower total number of teeth than patients without alcohol abuse and healthy controls (p < 0.05). The dental and periodontal status of patients with nonalcoholic cirrhosis did not differ from the control group. The severity and duration of liver disease had no influence on dental and peridontal disease.
The presence of cirrhosis itself, therefore, is not a predisposing factor for dental and periodontal diseases. In alcoholics, these diseases appear to be caused primarily by bad oral hygiene and poor dental care.
背景/目的：细菌感染是肝硬化患者常见的并发症，尤其是在酗酒者中。感染的一个潜在来源可能是牙病灶。本研究的目的是评估肝硬化和慢性酒精中毒在牙齿或牙周疾病发生中的作用。
对97例肝硬化患者（酒精性肝硬化：64例，非酒精性肝硬化：33例）、68例无肝硬化的酗酒者和71例健康受试者（分为21 - 30岁、31 - 40岁、41 - 50岁和51 - 60岁年龄组）进行前瞻性的牙齿和牙周检查。
有或无肝硬化的酗酒者的口腔卫生指标（p < 0.01）、牙齿护理情况（p < 0.001）和牙周参数较差，需要治疗的牙齿数量（p < 0.001）高于健康受试者和非酒精性肝硬化患者。酗酒者的牙齿总数低于无酒精滥用的患者和健康对照组（p < 0.05）。非酒精性肝硬化患者的牙齿和牙周状况与对照组无差异。肝病的严重程度和病程对牙齿和牙周疾病没有影响。
因此，肝硬化本身并非牙齿和牙周疾病的易感因素。在酗酒者中，这些疾病似乎主要由不良的口腔卫生和较差的牙齿护理引起。
