|
1
|
Nagy H, Saleh W, Kannishy GE, Youssef JM. Correlation of the oral health and biochemical profile in hemodialysis patients with end-stage renal diseases. Odontology 2025:10.1007/s10266-025-01071-y. [PMID: 40097880 DOI: 10.1007/s10266-025-01071-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2024] [Accepted: 02/03/2025] [Indexed: 03/19/2025]
Abstract
The current study aims to investigate the oral health of end-stage renal diseases (ESRD) patients undergoing hemodialysis and to correlate it with the biochemical profile of the patients. The current study included 43 ESRD patients on regular hemodialysis. The oral hygiene status, dental, and periodontal health were measured by the following indices: decayed, missed, and filled teeth (DMFT) index, visible plaque index (VPI), and Russell periodontal index (RPI). Several biochemical, hormonal, and hematological parameters were evaluated for each patient. The correlation of the oral health status with the biochemical profile of the patients was measured. The mean age of the participants in the current study was (51.67 ± 14.7) years. About 81% of the participants were hypertensive (35), 19% were diabetic (8), and 28% showed HCV positivity (12). VPI showed 30% of patients had fair oral hygiene and 44% had poor oral hygiene. According to RPI, periodontitis was detected in more than 95% of patients. It was significantly correlated with the age and body mass index (BMI) of the patients. DMFT index was significantly positively correlated to RPI and serum transferrin saturation. RPI scores showed a significant correlation between the ages of the patients and their BMI. VPI significantly correlated with serum calcium, but not with other biochemical variables. ESRD patients treated with hemodialysis showed several oral health concerns. Most of these patients had periodontitis, which was more frequent in diabetics and elderly patients. Advanced grades of periodontitis were associated with older age and increased BMI.
Collapse
Affiliation(s)
- Hosam Nagy
- Oral Medicine, Periodontology, Diagnosis and Oral Radiology Department, Faculty of Dentistry, Mansoura University, Mansoura City, 33516, Egypt
| | - Wafaa Saleh
- Oral Medicine, Periodontology, Diagnosis and Oral Radiology Department, Faculty of Dentistry, Mansoura University, Mansoura City, 33516, Egypt.
| | - Ghada El Kannishy
- Internal Medicine Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Jilan Mohamed Youssef
- Oral Medicine, Periodontology, Diagnosis and Oral Radiology Department, Faculty of Dentistry, Mansoura University, Mansoura City, 33516, Egypt
| |
Collapse
|
|
2
|
Hudson D, Ayares G, Taboun Z, Malhi G, Idalsoaga F, Mortuza R, Souyet M, Ramirez-Cadiz C, Díaz LA, Arrese M, Arab JP. Periodontal disease and cirrhosis: current concepts and future prospects. EGASTROENTEROLOGY 2025; 3:e100140. [PMID: 40160254 PMCID: PMC11950965 DOI: 10.1136/egastro-2024-100140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/24/2024] [Accepted: 02/05/2025] [Indexed: 04/02/2025]
Abstract
Periodontal diseases are prevalent among the general population and are associated with several systemic conditions, such as chronic kidney disease and type 2 diabetes mellitus. Chronic liver disease and cirrhosis have also been linked with periodontal disease, an association with complex underlying mechanisms, and with potential prognostic implications. Multiple factors can explain this relevant association, including nutritional factors, alcohol consumption, disruption of the oral-gut-liver axis and associated dysbiosis. Additionally, patients with liver disease have been observed to exhibit poorer oral hygiene practices compared with the general population, potentially predisposing them to the development of periodontal disease. Therefore, it is recommended that all patients with liver disease undergo screening and subsequent treatment for periodontal disease. Treatment of periodontal disease in patients with cirrhosis may help reduce liver-derived inflammatory damage, with recent research indicating a potential benefit in terms of reduced mortality. However, further studies on periodontal disease treatment in patients with liver disease are still warranted to determine optimal management strategies. This narrative review describes current concepts on the association between periodontal disease and chronic liver disease.
Collapse
Affiliation(s)
- David Hudson
- Division of Gastroenterology, Department of Medicine, Schulich School of Medicine, Western University & London Health Sciences Centre, London, Ontario, Canada
| | - Gustavo Ayares
- Departamento de Gastroenterologia, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Zahra Taboun
- Department of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Gurpreet Malhi
- Division of Gastroenterology, Department of Medicine, Schulich School of Medicine, Western University & London Health Sciences Centre, London, Ontario, Canada
| | - Francisco Idalsoaga
- Division of Gastroenterology, Department of Medicine, Schulich School of Medicine, Western University & London Health Sciences Centre, London, Ontario, Canada
- Departamento de Gastroenterologia, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Rokhsana Mortuza
- Division of Gastroenterology, Department of Medicine, Schulich School of Medicine, Western University & London Health Sciences Centre, London, Ontario, Canada
| | - Maite Souyet
- Escuela de Odontología, Facultad de Medicina y Ciencias de la Salud, Universidad Mayor, Santiago, Chile
- Escuela de Odontología, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Carolina Ramirez-Cadiz
- Department of Anesthesiology, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA
| | - Luis Antonio Díaz
- Departamento de Gastroenterologia, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
- MASLD Research Center, Division of Gastroenterology and Hepatology, University of California San Diego, San Diego, California, USA
| | - Marco Arrese
- Departamento de Gastroenterologia, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Juan Pablo Arab
- Departamento de Gastroenterologia, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
- Division of Gastroenterology, Hepatology, and Nutrition, Department of Internal Medicine, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA
| |
Collapse
|
|
3
|
Mahmood MK, Fatih MT, Kurda HA, Mahmood NK, Shareef FU, Faraidun H, Tassery H, Tardivo D, Lan R, Noori ZF, Qadir BH, Hassan AD. Role of viruses in periodontitis: An extensive review of herpesviruses, human immunodeficiency virus, coronavirus-19, papillomavirus and hepatitis viruses. World J Virol 2024; 13:99070. [PMID: 39722755 PMCID: PMC11551682 DOI: 10.5501/wjv.v13.i4.99070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2024] [Revised: 09/02/2024] [Accepted: 09/19/2024] [Indexed: 10/18/2024] Open
Abstract
Periodontitis is the inflammation of the supporting structures around the dentition. Several microbial agents, mostly bacteria, have been identified as causative factors for periodontal disease. On the other hand, oral cavity is a rich reservoir for viruses since it contains a wide variety of cell types that can be targeted by viruses. Traditionally, the focus of research about the oral flora has been on bacteria because the most widespread oral diseases, like periodontitis and dental caries, are outcomes of bacterial infection. However, recently and especially after the emergence of coronavirus disease 2019, there is a growing tendency toward including viruses also into the scope of oral microbiome investigations. The global high prevalence of periodontitis and viral infections may point out to a concomitant or synergistic effect between the two. Although the exact nature of the mechanism still is not clearly understood, this could be speculated through the manipulation of the immune system by viruses; hence facilitating the furthermore colonization of the oral tissues by bacteria. This review provides an extensive and detailed update on the role of the most common viruses including herpes family (herpes simplex, varicella-zoster, Epstein-Barr, cytomegalovirus), Human papillomaviruses, Human immunodeficiency virus and severe acute respiratory syndrome coronavirus 2 in the initiation, progression and prognosis of periodontitis.
Collapse
Affiliation(s)
| | - Mohammed Taib Fatih
- College of Dentistry, Komar University of Science and technology, Sulaimani 46001, Iraq
| | | | - Nwsiba Khalid Mahmood
- Department of Biology, College of Science, Sulaimani University, Sulaimani 46001, Iraq
| | - Farman Uthman Shareef
- Department of Medical Laboratory Science, College of Science, Charmo University, Chamchamal/Sulaimani 46001, Iraq
| | - Hemin Faraidun
- Department of Biology, University of Freiburg, Mina Biotech, Freiburg 79098, Germany
| | - Herve Tassery
- Department of Odontology, Timone Hospital, Aix Marseille University, APHM, Marseille 13000, France, LBN Laboratory, Montpellier 34000, France
| | - Delphine Tardivo
- Department of Odontology, Timone Hospital, Aix Marseille University, APHM, CNRS, EFS, ADES, Marseille 13000, France
| | - Romain Lan
- Department of Odontology, Timone Hospital, Aix Marseille University, APHM, CNRS, EFS, ADES, Marseille 13000, France
| | - Zana Fuad Noori
- Department of Dentistry, American University of Sulaimani Iraq AUIS, Sulaimani 46001, Iraq
| | - Balen Hamid Qadir
- College of Dentistry, Komar University of Science and technology, Sulaimani 46001, Iraq
| | - Arman Dlshad Hassan
- Department of Biomedical Science, University of Denver, Denver, CO 80014, United States
| |
Collapse
|
|
4
|
Chen X, Song J, Sun J, Zhang J, Chen X, Zeng C, Hu J, Chang X, Jin F, Luo S, Chen Z, Luo Y. Hepatitis B infection is associated with periodontitis: the national health and nutrition examination survey (2009-2014). BMC Oral Health 2024; 24:815. [PMID: 39020311 PMCID: PMC11256453 DOI: 10.1186/s12903-024-04489-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 06/17/2024] [Indexed: 07/19/2024] Open
Abstract
BACKGROUND Current research has been inconclusive regarding whether hepatitis B infection is associated with an increased risk of periodontitis. This study aims to test the null hypothesis that no association exists between hepatitis B infection and an increased risk of periodontitis using the National Health and Nutrition Examination Survey (2009-2014). METHODS We performed a cross-sectional study using the National Health and Nutrition Examination Survey (NHANES) database (2009-2014) to assess the rate of the prevalence of periodontitis in patients with and without hepatitis B infection. Participants who had tested for hepatitis B and periodontitis were included. The included participants were divided into no/mild periodontitis and moderate/severe periodontitis groups according to their periodontal status. The association between hepatitis B infection and chronic periodontitis was evaluated by multivariable regression analyses adjusting for age, gender, race/ethnicity, education level, income-to-poverty ratio, smoking, alcohol, BMI, ALT, AST, creatinine, hypertension, and diabetes. RESULTS A total of 5957 participants were included and divided into two groups: inactive periodontitis group (n = 3444) and active periodontitis group (n = 2513). The results showed that participants with hepatitis B had a higher risk of periodontitis. After adjusting for covariables, adults with hepatitis B infection were 38% more likely to have periodontitis compared to those without hepatitis B infection (95% Confidence Interval [CI]:1.085-1.754). CONCLUSIONS In general, the results suggest that CHB is positively associated with the more severe periodontitis. These results suggest that people with hepatitis B infection should take good periodontal care measures to avoid the occurrence and development of periodontitis.
Collapse
Affiliation(s)
- XianRun Chen
- School of Stomatology, Zunyi Medical University, Zunyi, China
- Department of Prosthodontics, Guiyang Stomatological Hospital, Guiyang, China
| | - Jukun Song
- Department of Oral and Maxillofacial Surgery, The Affiliated Stomatological Hospital of Guizhou Medical University, Guiyang, China
| | - JiangLing Sun
- Department of Endodontics, Guiyang Stomatological Hospital, Guiyang, China
| | - JiQin Zhang
- School of Stomatology, Zunyi Medical University, Zunyi, China
- Department of Prosthodontics, Guiyang Stomatological Hospital, Guiyang, China
| | - XingJin Chen
- School of Stomatology, Zunyi Medical University, Zunyi, China
- Department of Endodontics, Guiyang Stomatological Hospital, Guiyang, China
| | - ChongWen Zeng
- School of Stomatology, Zunyi Medical University, Zunyi, China
- Department of Endodontics, Guiyang Stomatological Hospital, Guiyang, China
| | - JiaXin Hu
- School of Stomatology, Zunyi Medical University, Zunyi, China
- Department of Prosthodontics, Guiyang Stomatological Hospital, Guiyang, China
| | - XingTao Chang
- School of Stomatology, Zunyi Medical University, Zunyi, China
- Department of Prosthodontics, Guiyang Stomatological Hospital, Guiyang, China
| | - FuQian Jin
- Department of Endodontics, Guiyang Stomatological Hospital, Guiyang, China
| | - SiYang Luo
- Department of Prosthodontics, Guiyang Stomatological Hospital, Guiyang, China
| | - Zhu Chen
- School of Stomatology, Zunyi Medical University, Zunyi, China.
- Department of Endodontics, Guiyang Stomatological Hospital, Guiyang, China.
| | - Yi Luo
- School of Stomatology, Zunyi Medical University, Zunyi, China.
- Department of Prosthodontics, Guiyang Stomatological Hospital, Guiyang, China.
| |
Collapse
|
|
5
|
Fang T, Liu L, Mao S, Jiang Z, Cao Y, Pan J. Association between virus infection and periodontitis: Evidence from the National Health and Nutrition Examination Survey 2009-2014. J Med Virol 2024; 96:e29784. [PMID: 38975662 DOI: 10.1002/jmv.29784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2024] [Revised: 06/13/2024] [Accepted: 06/25/2024] [Indexed: 07/09/2024]
Abstract
Periodontitis is a cumulative inflammatory disease associated with multiple health conditions and various systemic diseases. As a common disease, virus infection along with its consequences has become a serious health burden. The study aims to evaluate the relationship between common viruses including hepatitis virus, human immunodeficiency virus (HIV), herpes simplex virus (HSV), human papillomavirus (HPV), and periodontitis. The data from the US National Health and Nutrition Examination Survey (NHANES) 2009-2014 was adopted and screened through, including 10 714 participants. Generalized linear regression was conducted to verify the relationships between the virus infections and periodontitis. Moreover, we also performed analyses in age and gender subgroups. The results suggested that the infection of HCV, HSV-1, and HSV-2 was significantly associated with the prevalence of periodontitis (odds ratio [OR] 1.46, 95% confidence interval [CI] 1.26-1.70; OR 1.09, 95% CI 1.05-1.13; OR 1.06, 95% CI 1.01 - 1.11, respectively) and risk of developing moderate or severe periodontitis (OR 1.51, 95% CI 1.29-1.77; OR 1.08, 95% CI 1.04-1.12; OR 1.05, 95% CI 1.01-1.10, respectively) after adjusting all relevant co-factors. Subgroup analyses revealed a steady association between periodontitis and hepatitis C virus (HCV) or HSV-1 infection, while the relationship between HSV-2 and HPV infection can also be found in some subgroups. The presence of HCV and HSV infection was found to be significantly associated with the prevalence of periodontitis, including moderate or severe cases. Moreover, the association of periodontitis and HPV infection can also be observed in people < 35 years.
Collapse
Affiliation(s)
- Tongfeng Fang
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Liu Liu
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
- Department of Conservative Dentistry and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Suning Mao
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Zhishen Jiang
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
- Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Yubin Cao
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
- Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, China
- Department of Evidence-based Stomatology, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Jian Pan
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
- Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| |
Collapse
|
|
6
|
Chen X, Zeng Z, Xiao L. The association between periodontitis and hepatitis virus infection: a cross-sectional study utilizing data from the NHANES database (2003-2018). Public Health 2024; 226:114-121. [PMID: 38056398 DOI: 10.1016/j.puhe.2023.11.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 10/16/2023] [Accepted: 11/05/2023] [Indexed: 12/08/2023]
Abstract
OBJECTIVES Periodontitis and hepatitis virus infection significantly impact individuals' well-being and are prevalent public health concerns globally. Given the current scarcity of large-scale cross-sectional epidemiological studies, this study seeks to enrich the evidence base by examining the link between these two conditions. STUDY DESIGN AND METHODS A cross-sectional study was conducted using data from the National Health and Nutrition Examination Survey (NHANES) spanning the years 2003-2018. A multivariate logistic regression analysis was performed to assess the association between periodontitis and hepatitis virus infection, adjusting for the potential confounding factors. Subsequently, a stratified analysis was conducted to explore the relationship between periodontitis and hepatitis virus infection based on age, gender, race, marital status, alcohol consumption, smoking status, and the presence of chronic diseases. RESULTS In this study, which included 5755 participants, there was a positive association between hepatitis virus infection and periodontitis (odds ratio [OR]: 2.609 [95% confidence interval (CI): 1.513, 4.499]). Furthermore, a significant association was observed between moderate periodontitis and hepatitis virus infection (OR: 2.136 [95% CI: 1.194, 3.822]), and this association was even stronger for severe periodontitis (OR: 3.583 [95% CI: 1.779, 7.217]). Importantly, this positive association between hepatitis virus infection and periodontitis was consistent across different subgroups. CONCLUSIONS This study presents evidence of a significant association between periodontitis and hepatitis virus infection. These findings highlight the crucial importance of integrating periodontal health and liver health considerations into public health interventions. Further research is necessary to elucidate the underlying mechanisms and develop targeted interventions for effectively managing periodontitis and hepatitis virus infection.
Collapse
Affiliation(s)
- X Chen
- Department of Clinical Laboratory Medicine Center, Shenzhen Hospital, Southern Medical University, 518000, Shenzhen, Guangdong, China
| | - Z Zeng
- The First Affiliated Hospital(Shenzhen People's Hospital), Southern University of Science and Technology, Shenzhen, 518055, China.
| | - L Xiao
- Department of Clinical Laboratory Medicine Center, Shenzhen Hospital, Southern Medical University, 518000, Shenzhen, Guangdong, China.
| |
Collapse
|
|
7
|
Fiorillo L, Minervini G, Laino L, Peditto M, Cicciù M, Cervino G. Hepatitis-virus-positive patients management in dental office. Minerva Dent Oral Sci 2023; 72:312-318. [PMID: 37255308 DOI: 10.23736/s2724-6329.23.04803-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
BACKGROUND Hepatitis is a condition characterized by inflammation of the liver, which can be caused by several viruses including hepatitis A, B, C, D and E. This condition can affect the oral health of patients and increase the risk of complications during dental management. The clinical management of hepatitis patients in the dental setting requires a comprehensive and individualized approach to ensure safety and optimal treatment outcomes. This article aims to provide a comprehensive overview of the current literature on the dental management of patients with different forms of hepatitis. METHODS The article focuses on the specific challenges associated with dental treatments in hepatitis patients, including increased risk of infection and bleeding. Additionally, the article provides recommendations for dental practitioners, including infection control measures, communication with medical providers, and the use of prophylactic antibiotics. RESULTS The authors show that the dental management of patients with hepatitis requires a thorough understanding of the specific challenges associated with this condition, as well as the implementation of appropriate preventive measures to ensure the safety and well-being of these patients. CONCLUSIONS Further research is needed to better understand the impact of hepatitis on oral health and the most effective approaches to managing dental treatments in this patient population.
Collapse
Affiliation(s)
- Luca Fiorillo
- Department of Biomedical and Dental Sciences, Morphological and Functional Images, University of Messina, Messina, Italy -
- Multidisciplinary Department of Medical-Surgical and Odontostomatological Specialties, Luigi Vanvitelli University of Campania, Naples, Italy -
- Department of Prosthodontics, Dr. D.Y. Patil Dental College and Hospital, Dr. D.Y. Patil Vidyapeeth, Pimpri, India -
| | - Giuseppe Minervini
- Multidisciplinary Department of Medical-Surgical and Odontostomatological Specialties, Luigi Vanvitelli University of Campania, Naples, Italy
| | - Luigi Laino
- Multidisciplinary Department of Medical-Surgical and Odontostomatological Specialties, Luigi Vanvitelli University of Campania, Naples, Italy
| | - Matteo Peditto
- Department of Biomedical and Dental Sciences, Morphological and Functional Images, University of Messina, Messina, Italy
| | - Marco Cicciù
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, Catania, Italy
| | - Gabriele Cervino
- Department of Biomedical and Dental Sciences, Morphological and Functional Images, University of Messina, Messina, Italy
| |
Collapse
|
|
8
|
Bie M, Wu P, Zhou J, Li Y, Zhao L. Periodontal health status in cirrhotic patients: a systematic review and meta-analysis. BMC Oral Health 2023; 23:362. [PMID: 37277748 DOI: 10.1186/s12903-023-03052-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 05/15/2023] [Indexed: 06/07/2023] Open
Abstract
OBJECTIVES Liver cirrhosis is a disease with widespread prevalence and high mortality. Oral manifestations, particularly periodontal-related manifestations such as bleeding gums, red and swollen gums, are common in cirrhotic patients but may often be overshadowed by other systemic complications, making them easy to ignore. So this article conducts a systematic review and meta-analysis of periodontal health status in patients with cirrhosis. MATERIAL AND METHODS We performed electronic searches on the following databases: PubMed, EMBASE, Scopus, Web of Science, and Cochrane Library. Risk of bias evaluation was carried out according to the Fowkes and Fulton guidelines. Meta-analyses were performed with tests for sensitivity and statistical heterogeneity. RESULTS Of the 368 potentially eligible articles, 12 studies were included for qualitative analysis, and 9 contributed to the meta-analysis. In terms of periodontal-related parameters, cirrhotic patients presented a greater mean of clinical attachment loss (CAL) (weighted mean differences [WMD] = 1.078, 95% confidence interval [95% CI]: 0.546-1.609, p < 0.001), probing depth (PD) (WMD = 0.796, 95% CI: 0.158 to 1.434, p = 0.015) and alveolar bone loss (ABL) (WMD = 3.465, 95% CI: 2.946-3.984, p < 0.001) than those without, while no statistical difference was found in the papillary bleeding index (PBI) (WMD = 0.166, 95% CI: -0546 to 0.878, p = 0.647) and bleeding on probing (BOP) (WMD = 4.913, 95% CI: -3.099 to 12.926, p = 0.229). The prevalence of periodontitis was higher in cirrhotic patients than in the control group (odds ratio [OR] = 2.630, 95% CI: 1.531-4.520, p < 0.001). CONCLUSIONS The results indicate that cirrhotic patients have poor periodontal conditions and a higher prevalence of periodontitis. We advocate that they should receive regular oral hygiene and basic periodontal treatment.
Collapse
Affiliation(s)
- Mengyao Bie
- Department of Periodontics, West China Hospital of Stomatology, Sichuan University, NO.14 Ren Min South Road 3Rd Section, Chengdu, 610041, Sichuan, China
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Chengdu, China
| | - Peiyao Wu
- Department of Periodontics, West China Hospital of Stomatology, Sichuan University, NO.14 Ren Min South Road 3Rd Section, Chengdu, 610041, Sichuan, China
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Chengdu, China
| | - Jieyu Zhou
- Department of Periodontics, West China Hospital of Stomatology, Sichuan University, NO.14 Ren Min South Road 3Rd Section, Chengdu, 610041, Sichuan, China
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Chengdu, China
| | - Yan Li
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Chengdu, China
| | - Lei Zhao
- Department of Periodontics, West China Hospital of Stomatology, Sichuan University, NO.14 Ren Min South Road 3Rd Section, Chengdu, 610041, Sichuan, China.
| |
Collapse
|
|
9
|
Ismail R, Elansary A, Ezzatt O, Hamed M, Gamil Y. Hepatitis C associated oral lesions: A hospital-based retrospective case control study in Egypt. J Int Oral Health 2023; 15:52. [DOI: 10.4103/jioh.jioh_160_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/04/2023] Open
|
|
10
|
Albuquerque-Souza E, Sahingur SE. Periodontitis, chronic liver diseases, and the emerging oral-gut-liver axis. Periodontol 2000 2022; 89:125-141. [PMID: 35244954 PMCID: PMC9314012 DOI: 10.1111/prd.12427] [Citation(s) in RCA: 65] [Impact Index Per Article: 21.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The liver carries out a wide range of functions ranging from the control of metabolites, nutrient storage, and detoxification to immunosurveillance. While inflammation is essential for the tissue remodeling and maintenance of homeostasis and normal liver physiology, constant exposure to dietary and microbial products creates a niche for potentially prolonged immune activation and unresolved inflammation in susceptible host. Failure to restrain inflammation can lead to development of chronic liver diseases characterized by fibrosis, cirrhosis and eventually liver failure. The liver maintains close interactions with numerous organs which can influence its metabolism and physiology. It is also known that oral cavity microenvironment can influence the physiological conditions of other organs and emerging evidence implicates that this could be true for the liver as well. Presence of chronic inflammation and dysbiotic microbiota is a common feature leading to clinical pathology both in periodontitis and chronic liver diseases (CLDs). In fact, known CLDs appear to have some relationship with periodontitis, which impacts the onset or progression of these conditions in a bidirectional crosstalk. In this review, we explore the emerging association between oral‐gut‐liver axis focusing on periodontitis and common CLDs including nonalcoholic fatty liver disease, chronic viral hepatitis, liver cirrhosis, and hepatocellular cancer. We highlight the immune pathways and oral microbiome interactions which can link oral cavity and liver health and offer perspectives for future research.
Collapse
Affiliation(s)
- Emmanuel Albuquerque-Souza
- Department of Periodontics, School of Dental Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Sinem E Sahingur
- Department of Periodontics, School of Dental Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| |
Collapse
|
|
11
|
NLRP3 Inflammasome Expression in Gingival Crevicular Fluid of Patients with Periodontitis and Chronic Hepatitis C. Mediators Inflamm 2021; 2021:6917919. [PMID: 34840527 PMCID: PMC8626199 DOI: 10.1155/2021/6917919] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 11/01/2021] [Accepted: 11/10/2021] [Indexed: 12/13/2022] Open
Abstract
The study is aimed at assessing the impact that periodontal disease and chronic hepatitis C could have on gingival crevicular fluid levels of the NLRP3 inflammasome, caspase-1 (CASP-1), and interleukin-18 (IL-18) and at evaluating whether the increased local inflammatory reaction with clinical periodontal consequences is correlated to their upregulation. Patients were divided into four groups, according to their periodontal status and previously diagnosed hepatitis C, as follows: (i) CHC group, chronic hepatitis C patients; (ii) P group, periodontal disease patients, systemically healthy; (iii) CHC + P group, patients suffering from both conditions; and (iv) H group, systemically and periodontally healthy controls. Gingival crevicular samples were collected for quantitative analysis of the NLRP3 inflammasome, CASP-1, and IL-18. CHC + P patients expressed the worse periodontal status and the highest NLRP3, CASP-1, and IL-18 levels, the difference being statistically significant (p < 0.05). The P group patients also expressed significantly more elevated NLRP3, CASP-1, and IL-18 levels, as compared to nonperiodontal patients (CHC and H groups). Chronic hepatitis C and periodontal disease could have a significant influence on the upregulation of NLRP3 inflammasome and its components, possibly contributing to an increased local inflammatory reaction and clinical periodontal consequences.
Collapse
|
|
12
|
Effects of Hepatitis C Virus Elimination by Direct-Acting Antiviral Agents on the Occurrence of Oral Lichen Planus and Periodontal Pathogen Load: A Preliminary Report. Int J Dent 2021; 2021:8925879. [PMID: 34804168 PMCID: PMC8601815 DOI: 10.1155/2021/8925879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 09/21/2021] [Accepted: 10/25/2021] [Indexed: 11/18/2022] Open
Abstract
Objective The association between hepatitis C virus (HCV) and oral lichen planus (OLP) is well known, but the association with periodontal disease has been reported less often. The purpose of this study was to investigate the effects of periodontal bacteria and OLP lesions before and after HCV elimination. Subjects and Methods. The subjects were four OLP patients (mean age 72.5 years) with HCV infection. Six types of periodontal bacteria (Aggregatibacter actinomycetemcomitans, Prevotella intermedia, Porphyromonas gingivalis, Tannerella forsythia, Treponema denticola, and Fusobacterium nucleatum) were quantified in saliva, and changes in OLP were examined before and after elimination of HCV by antiviral therapy. Biochemical blood tests also were performed. Results The total number of periodontal bacteria, the numbers of P. gingivalis, T. forsythia, T. denticola, and F. nucleatum, and the risk of presenting with the red-complex bacteria (P. gingivalis, T. forsythia, and T.denticola), leading to periodontal disease progression, decreased after HCV elimination. OLP disappeared in three of the four patients and decreased in the other after sustained virological responses (SVRs). Conclusion HCV elimination not only improved OLP lesions but also reduced the number of periodontal pathogens and the amount of red-complex periodontal pathogens.
Collapse
|
|
13
|
Cocero N, Caratori E, Martini S, Carossa S. Can Plasma Rich in Growth Factors Expedite Healing of Postextraction Tooth Sockets in Patients Undergoing Urgent Liver Transplantation? J Oral Maxillofac Surg 2020; 79:305-312. [PMID: 33091403 DOI: 10.1016/j.joms.2020.09.033] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 09/20/2020] [Accepted: 09/21/2020] [Indexed: 11/18/2022]
Abstract
PURPOSE Infections foster morbidity and mortality after liver transplantation (LT). Pre-LT eradication of oral infectious foci is not always possible for patients needing an urgent LT because postextraction sockets must be healed before the patient is operated, and this requires at least 3 weeks. To accelerate healing, we tested the effect of plasma-rich growth factor (PRGF), a highly concentrated form of autogenous platelets on healing. MATERIALS AND METHODS Prospective case-control split-mouth study for more than 100 candidates for LT needing routine extractions of 2 homologous teeth: a socket was to be treated with PRGF, whereas its match (control [CTRL]) was to undergo natural healing. The outcome of interest was the socket size derived from the measurements on the transversal diameters and deepest level of penetration on the PRGF and CTRL sides after extraction and on day 7, 14, and 21 postextraction. The primary predictor was treatment status (PRGF vs CTRL); secondary predictors, the tooth extracted and patient's features. The statistical analysis used nonparametric tests and best subset regression. RESULTS All measurements evidenced a significantly (P < .0001) more advanced closure on the PRGF side than the CTRL side. One week after extraction, PRGF sockets were reduced to 12% (molars) and 6% (nonmolars) of the original wound versus 32 and 20% for CTRL, respectively. The percentage of PRGF sockets with size less than or equal to 5% was 7% for molars and 44% for nonmolars versus 0 and 12% for CTRL (P < .0001), respectively. The percentages with size less than or equal to 10% were 37% for molars and 81% for nonmolars on the PRGF side versus 2 and 26% on the CTRL side, respectively. These percentages showed a significant decrease for smoking patients. CONCLUSIONS The outcome of our trial showed that PRGF significantly accelerates closure of postextraction sockets. Its use, at least in patients who occupy top positions in the LT waiting list, is recommended.
Collapse
Affiliation(s)
- Nadia Cocero
- Senior Consultant, Oral Surgery Section of the Dental School of the University of Torino at the Azienda Ospedaliera Città della Salute e della Scienza of Torino, Turin, Italy.
| | - Eleonora Caratori
- Resident, Oral Surgery Section of the Dental School of the University of Torino at the Azienda Ospedaliera Città della Salute e della Scienza of Torino, Turin, Italy
| | - Silvia Martini
- Resident, Gastrohepatology Unit, AOU Città della Salute e della Scienza di Torino, Turin, Italy
| | - Stefano Carossa
- Department Head, Department of Surgical Sciences of the Dental School of the University of Torino, Turin, Italy
| |
Collapse
|
|
14
|
Baum SH, Ha-Phuoc AK, Mohr C. Treatment of odontogenic abscesses: comparison of primary and secondary removal of the odontogenic focus and antibiotic therapy. Oral Maxillofac Surg 2020; 24:163-172. [PMID: 32162130 DOI: 10.1007/s10006-020-00835-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Accepted: 02/26/2020] [Indexed: 06/10/2023]
Abstract
PURPOSE To examine the time of removal of the odontogenic focus, antibiotic therapy and risk factors in odontogenic abscesses. PATIENTS From January 2012 to December 2015, inpatients undergoing incision due to odontogenic abscesses were identified in a retrospective study. All the patients were evaluated for time of removal of the odontogenic focus, antibiotic therapy, germ spectrum, complications and risk factors. RESULTS Two hundred ten patients completed the study. In 89 cases (42.4%), the odontogenic focus was removed as part of the abscess treatment (group A). In 121 cases (57.6%), the focus was secondarily removed (group B). On average, 2 ± 4 teeth were removed in group A, and 6 ± 5 teeth in group B (p < 0.0001). An average of 1.2 ± 0.4 surgical interventions were performed in group A, and 2 ± 0.2 operations in group B (p < 0.0001). Microbiological examination was positive in one-third of the cases (70 cases). Most commonly, streptococci (27%) were isolated. A resistance screening was possible in 57 of the detected germs (68.7%). In 89% of these patients, the combination of ampicillin-sulbactam was effective. The hospital stay was 4.8 ± 2 days for group A and 7.6 ± 3 days for group B (p < 0.0001). The clinical evaluation revealed 12 intermediate (5.7%) and three long-term (1.4%) complications. The long-term complications included a recurrence in two cases (1%) and an osteomyelitis in one case (0.5%). A logistic regression analysis identified no significant risk factor in relation to these complications. CONCLUSION The study shows that a primary removal of the odontogenic focus may have advantages over a secondary removal: (1) fewer operations, (2) shorter hospital stay and (3) shorter antibiotic therapy. Broad-spectrum penicillins in combination with beta-lactamase inhibitors are a possible, sufficient antibiotic regimen. Long-term complications are rare. No risk factors are identified in relation to these complications.
Collapse
Affiliation(s)
- Sven Holger Baum
- Department of Oral and Maxillofacial Surgery, University of Duisburg-Essen, Kliniken-Essen-Mitte, Henricistr. 92, 45136, Essen, Germany.
| | - An-Khoa Ha-Phuoc
- Department of Oral and Maxillofacial Surgery, University of Duisburg-Essen, Kliniken-Essen-Mitte, Henricistr. 92, 45136, Essen, Germany
| | - Christopher Mohr
- Department of Oral and Maxillofacial Surgery, University of Duisburg-Essen, Kliniken-Essen-Mitte, Henricistr. 92, 45136, Essen, Germany
| |
Collapse
|
|
15
|
Bowes C, Page G, Wassall R, Lloyd C. The need for further oral health research surrounding the provision of dental treatment for people with drug dependency. Br Dent J 2019; 227:58-60. [PMID: 31300786 DOI: 10.1038/s41415-019-0469-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The aim of this article is to highlight the need for further research in providing dental care for people with drug dependency. The association between people who misuse substances and dental disease is widely known occurrence, yet there have been few studies conducted in the UK surrounding this issue due to the nature of the cohort. Further to this, there are a multitude of barriers to accessing/seeking dental care that exist for those with drug dependency. Going forward, there is a need for the development of a new service model where dental care is part of a multidisciplinary team working towards treating people with drug dependency in a holistic way.
Collapse
Affiliation(s)
- Charlotte Bowes
- Newcastle University, Restorative Dentistry, Dental Hospital, Newcastle, UK.
| | - Geoff Page
- University of York, Department of Social Policy and Social Work, York, UK
| | - Rebecca Wassall
- Newcastle University, School of Dental Sciences, Newcastle, UK
| | - Charlie Lloyd
- University of York, Social Policy and Criminal Justice, Director of Graduate School, York, UK
| |
Collapse
|
|
16
|
Wu IJ, Chang TS, Hwang SL, Chen MY. Effects of oral hygiene programme and home phone counselling for hepatitis C patients receiving antiviral treatment. J Adv Nurs 2018; 75:1010-1017. [PMID: 30375059 DOI: 10.1111/jan.13896] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Revised: 08/23/2018] [Accepted: 10/02/2018] [Indexed: 12/12/2022]
Abstract
AIMS To explore the effectiveness of an oral hygiene programme combined with home phone counselling on hepatitis C patients during antiviral treatment. BACKGROUND Hepatitis C virus infection is the leading cause of liver diseases. Evidence indicates that the antiviral treatment for hepatitis C virus infection has been successful, albeit its many side effects, such as discomfort symptoms of oral ulcers, which, in turn, leads to discontinued treatment. Inappropriate oral hygiene may worsen the side effects and increase the risk of dropping out of the treatment. DESIGN A quasi-experimental pre-post-test design was used. METHODS The oral hygiene programme was based on a standardized protocol of oral health care combined with home phone counselling. The participants were recruited from an outpatient clinic between August 2016 and July 2017. The generalized estimating equation was used for repeated measures of oral health behaviour, oral health status and discomfort symptoms. FINDINGS Thirty-four participants completed this study. The findings indicated that the oral hygiene programme significantly improved tooth brushing, use of dental floss and oral comfort. The result showed that the participants' oral health status significantly improved in 3 months. CONCLUSIONS This pilot study supports the finding that an oral hygiene programme can reduce oral discomfort, improve oral hygiene behaviour, and enhance the oral health status of hepatitis C patients receiving treatment. This is a simple and low-cost programme, which can be performed at home easily and boosts the completion of antiviral treatment.
Collapse
Affiliation(s)
- I-Jung Wu
- Department of Nursing, Chang Jung Christian University, Tainan, Taiwan
| | - Te-Sheng Chang
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Chang Gung Memorial Hospital, Chiayi, Taiwan.,College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Su-Lun Hwang
- Department of Nursing, Chang Gung University of Science and Technology, Chiayi, Taiwan
| | - Mei-Yen Chen
- Department of Nursing, Chang Gung University of Science and Technology, Chiayi, Taiwan.,Department of Nursing, Chang Gung University, Taoyuan, Taiwan.,Department of Cardiology, Chang Gung Memorial Hospital, Chiayi, Taiwan
| |
Collapse
|
|
17
|
Braga Diniz JM, Espaladori MC, Souza E Silva ME, Brito LCN, Vieira LQ, Ribeiro Sobrinho AP. Immunological profile of teeth with inflammatory periapical disease from chronic liver disease patients. Int Endod J 2018; 52:149-157. [PMID: 30091243 DOI: 10.1111/iej.12992] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Accepted: 08/05/2018] [Indexed: 12/15/2022]
Abstract
AIM To evaluate the mRNA expression levels of the cytokines interferon-γ, tumour necrosis factor-α, interleukin (IL)-1β, IL-10, IL-6, VEGF, and AGT and the chemokine CCL2/MCP-1 in periapical interstitial fluid associated with root canal infections before and after the reduction of the bacterial load using a cleaning procedure. METHODOLOGY The case group included 11 patients with chronic liver disease, and the control group included 11 healthy patients. Clinical samples were taken from teeth with pulp necrosis. After cleaning and drying the canal, three paper points were introduced into the root canal and passed through the root apex (2 mm) into the periapical tissues for 1 min. The samples were collected immediately after root canal cleaning and 7 days later to characterize those gene expression levels using real-time PCR. The data were subjected to the Shapiro-Wilk and the Wilcoxon tests. RESULTS In the control group, significantly increased expression of the pro-inflammatory cytokines IFN-γ and TNF-α was observed in teeth with restrained bacterial loads (day 7) (P < 0.05). Similarly, increased TNF-α expression was found on day 7 in the liver group (P < 0.05). No differences were observed in the expression levels of the IL-1β, IL-10 and, IL-6, MCP-1/CCL-2 and VEGF between the first collection (day 0) and second collection (day 7), over time in either group. CONCLUSION Chronic liver disease patients exhibited sufficient immunologic ability showing relatively similar expression levels of cytokines, chemokines and angiogenic factors in periapical samples compared with the responses from no-chronic liver disease patients. The outcomes of this study suggest that liver impairment did not compromise the periapical immune response.
Collapse
Affiliation(s)
- J M Braga Diniz
- Department of Operative Dentistry, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - M C Espaladori
- Department of Operative Dentistry, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - M E Souza E Silva
- Department of Operative Dentistry, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - L C N Brito
- Faculty of Dentistry, University of Itaúna, Itaúna, Brazil
| | - L Q Vieira
- Department of Biochemistry and Immunology, Institute of Biological Sciences, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
| | - A P Ribeiro Sobrinho
- Department of Operative Dentistry, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil
| |
Collapse
|
|
18
|
Hepatitis C Infection and Periodontal Disease: Is there a Common Immunological Link? J Immunol Res 2018; 2018:8720101. [PMID: 29725605 PMCID: PMC5872607 DOI: 10.1155/2018/8720101] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Revised: 12/31/2017] [Accepted: 01/03/2018] [Indexed: 02/07/2023] Open
Abstract
Hepatitis C virus (HCV) infections could have an important impact on the oral health status of patients, favoring conditions such as periodontal disease and oral cancer. The review of the existing scientific literature written in English was performed, searching for oral and periodontal manifestations of HCV infection and its impact on the oral fluids. HCV infection can determine direct extrahepatic manifestations at the oral and periodontal level including oral lichen planus, Sjögren-like sialadenitis, and oral cancer. The changes caused by the infection in the subjects' immune system, diet, and lifestyle can facilitate the development of oral conditions such as periodontal disease. Important changes also occur in the composition of the infected patients' saliva and gingival fluid. HCV-infected patients need to be carefully monitored in terms of oral health since the infection with the virus can result in oral complications. The cellular and molecular particularities of the gingival fluid of HCV-infected patients can answer some questions regarding its impact upon periodontium impairment and whether this refers to a possible bidirectional relationship, with hepatic biomarker adjustments being induced by the periodontal patients' inflammatory status.
Collapse
|
|
19
|
Abstract
BACKGROUND There is a gap in the scientific literature about the association between oral health and the health-related quality of life of patients on the liver transplantation waiting list. The aim of this work was to describe aspects of oral health and quality of life of patients on a liver transplantation waiting list. METHODS This was a cross-sectional study among 116 patients with chronic hepatic disease: 29 on a liver transplantation waiting list (Model for End-Stage Liver Disease score ≥15) and 87 under monitoring in a gastroenterology service in a Brazilian university hospital. Oral health was evaluated according to criteria recommended by the World Health Organization and by the European Association of Dental Public Health. Health-related quality of life was evaluated by means of the 36-Item Short-Form Health Survey (SF-36). RESULTS Patients on the liver transplantation waiting list presented poorer health-related quality of life than those who were not on the list in the domains physical functioning, role physical, bodily pain, general health perceptions, and social functioning and in the physical component summary. Periodontitis affected 72.4% of the patients on the liver transplantation waiting list, but only 27.6% of the patients not on that list. Reduced salivary flow was associated with poorer mental health component summary in hepatitis C patients. CONCLUSIONS Patients on the liver transplantation waiting list presented poorer health-related quality of life than those who were not on the list, mainly in the indicators concerning physical health, as well as higher frequencies of decayed teeth and periodontitis. The mental health component summary was associated with reduced salivary flow in hepatitis C patients.
Collapse
|
|
20
|
Yoon DL, Kim YG, Cho JH, Lee SK, Lee JM. Long-term evaluation of teeth and implants during the periodic maintenance in patients with viral liver disease. J Adv Prosthodont 2016; 8:321-8. [PMID: 27555902 PMCID: PMC4993846 DOI: 10.4047/jap.2016.8.4.321] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2016] [Revised: 07/22/2016] [Accepted: 08/08/2016] [Indexed: 01/30/2023] Open
Abstract
PURPOSE This study was designed to investigate the maintenance of teeth and implants in patients with viral liver disease. MATERIALS AND METHODS 316 patients without any significant systemic disease were selected as a control group. Liver disease group was consisted of 230 patients. Necessary data were collected using clinical records and panoramic radiographs. Then, the patients were subdivided into 2 groups based on the type of active dental therapy received before maintenance period (Pre-Tx). Analysis for finding statistically significant difference was performed based on the need for re-treatment of active dental therapy (Re-Tx) and change in the number of teeth (N-teeth) and implants (N-implants). RESULTS Comparing to control group, the patients with liver disease showed higher value on N-teeth, N-implants, and Re-Tx. Statistically significant differences were found on N-teeth (P=.000) and Re-Tx (P=.000) in patients with non-surgical Pre-Tx. Analysis based on severity of liver disease showed that N-teeth and Re-Tx were directly related to severity of liver disease regardless of received type of Pre-Tx. Significant differences were found on N-teeth (P=.003) and Re-Tx (P=.044) in patients with non-surgical Pre-Tx. CONCLUSION In this study, it was concluded that liver disease might influence the loss of teeth and cause the relapse of dental disease during maintenance period in patients. A significant positive relationship between tooth and implant loss and severity of liver disease seems to exist.
Collapse
Affiliation(s)
- Da-Le Yoon
- Department of Periodontology, School of Dentistry, Kyungpook National University, Daegu, Republic of Korea
| | - Yong-Gun Kim
- Department of Periodontology, School of Dentistry, Kyungpook National University, Daegu, Republic of Korea
| | - Jin-Hyun Cho
- Department of Prosthodontics, School of Dentistry, Kyungpook National University, Daegu, Republic of Korea
| | - Sang-Kyu Lee
- College of Pharmacy and Research Institute of Pharmaceutical Sciences, Kyungpook National University, Daegu, Republic of Korea
| | - Jae-Mok Lee
- Department of Periodontology, School of Dentistry, Kyungpook National University, Daegu, Republic of Korea
| |
Collapse
|
|
21
|
Ham SY, Kim J, Oh YJ, Lee B, Shin YS, Na S. Risk factors for peri-anaesthetic dental injury. Anaesthesia 2016; 71:1070-6. [DOI: 10.1111/anae.13560] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/13/2016] [Indexed: 11/27/2022]
Affiliation(s)
- S. Y. Ham
- Department of Anaesthesiology and Pain Medicine; Yonsei University College of Medicine; Seoul Korea
| | - J. Kim
- Department of Anaesthesiology and Pain Medicine; Anaesthesia and Pain Research Institute; Yonsei University College of Medicine; Seoul Korea
| | - Y. J. Oh
- Department of Anaesthesiology and Pain Medicine; Anaesthesia and Pain Research Institute; Yonsei University College of Medicine; Seoul Korea
| | - B. Lee
- Department of Anaesthesiology and Pain Medicine; Yonsei University College of Medicine; Seoul Korea
| | - Y.-S. Shin
- Department of Anaesthesiology and Pain Medicine; CHA Bundang Medical Center; CHA University; Seongnam Korea
| | - S. Na
- Department of Anaesthesiology and Pain Medicine; Anaesthesia and Pain Research Institute; Yonsei University College of Medicine; Seoul Korea
| |
Collapse
|
|
22
|
Neves J, de Araújo Nobre M, Oliveira P, Martins Dos Santos J, Malo P. Risk Factors for Implant Failure and Peri-Implant Pathology in Systemic Compromised Patients. J Prosthodont 2016; 27:409-415. [PMID: 27348845 DOI: 10.1111/jopr.12508] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/28/2016] [Indexed: 11/29/2022] Open
Abstract
PURPOSE To identify the possible risk factors for implant failure and peri-implant pathology in a population of systemically compromised patients. MATERIALS AND METHODS This retrospective clinical study included a total of 721 systemically compromised patients (422 women, 299 men), with an average age of 51 years (range: 20 to 87) rehabilitated with dental implants. The average follow-up time was 7.3 years. The patients' demographic variables (age and gender) and clinical variables (implant location, type of implant surface, and systemic conditions) were recorded. Outcome measures were implant failure and peri-implant pathology. Binary logistic regression models were performed to investigate the effect of the patients' demographic and clinical characteristics on the dependent variables implant failure and peri-implant pathology. A linear regression model was performed to correlate the patient's characteristics with the number of failed implants. Odds ratios (OR) with 95% confidence intervals and corresponding levels of significance were estimated for each variable. RESULTS Multivariate logistic regression disclosed increased age (patients over 40 years of age) as a risk factor for implant failure (OR = 2.63) and hepatitis as a risk factor for peri-implant pathology (OR = 3.74). Multivariate linear regression disclosed rheumatologic and cardiac diseases to be correlated with a higher number of failed implants. CONCLUSIONS Within the limitations of this study, the results suggest no absolute contraindications for implant rehabilitation in a population of systemically compromised patients. Nevertheless, this study suggests that increasing age, rheumatological condition, cardiovascular condition, and hepatitis should be considered when performing implant-supported rehabilitations due to their negative influence on the outcome.
Collapse
Affiliation(s)
- Joana Neves
- Center for Interdisciplinary Research Egas Moniz, Campus Universitário, Caparica, Portugal.,Oral Hygiene Department, Maló Clinic, Lisbon, Portugal
| | | | - Pedro Oliveira
- Center for Interdisciplinary Research Egas Moniz, Campus Universitário, Caparica, Portugal
| | | | - Paulo Malo
- Department of Oral Surgery, Maló Clinic, Lisbon, Portugal
| |
Collapse
|
|
23
|
Austin S, Bailey D, Chandu A, Dastaran M, Judge R. Analysis of commonly reported medical conditions amongst patients receiving dental implant therapy in private practice. Aust Dent J 2016; 60:343-52. [PMID: 25330368 DOI: 10.1111/adj.12237] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/12/2014] [Indexed: 11/29/2022]
Abstract
BACKGROUND The population seeking implants in private practice is a demographically and medically unique group. Understanding their medical needs can improve treatment planning and service delivery specifically for this population. METHODS Privately practising dental clinicians from Victoria, Australia, participated in a five-year retrospective study. Data were collected from the medical histories of 4116 patients who met the inclusion criterion of at least one implant placed within the study period of 1 January 2005 to 31 December 2009. Descriptive statistics were used to describe patient demographics and commonly reported medical conditions. RESULTS The most common age group to receive implant therapy was between 51 and 60 years (30.4% of patients). The patient population reported a broad range of co-morbidities including psychiatric disorders (83 patients), cardiovascular disorders (253 patients), gastrointestinal disorders (224 patients) and respiratory disorders (502 patients). Smoking was less prevalent amongst the study population compared to the general population. CONCLUSIONS The population assessed in this study was a medically diverse group. Clinicians must be familiar with their target demographic and understand how the common co-morbidities amongst this patient group can influence clinical decision making and outcomes.
Collapse
Affiliation(s)
- S Austin
- Melbourne Dental School, The University of Melbourne, Victoria.,Victorian/Tasmanian Oral and Maxillofacial Training Programme
| | - D Bailey
- Melbourne Dental School, The University of Melbourne, Victoria.,Oral Health CRC, Carlton, Victoria.,eviDent Foundation, South Yarra, Victoria
| | - A Chandu
- Melbourne Dental School, The University of Melbourne, Victoria.,Western Hospital, Footscray, Victoria
| | - M Dastaran
- Melbourne Dental School, The University of Melbourne, Victoria.,Victorian/Tasmanian Oral and Maxillofacial Training Programme
| | - R Judge
- Melbourne Dental School, The University of Melbourne, Victoria
| |
Collapse
|
|
24
|
Grønkjær LL. Periodontal disease and liver cirrhosis: A systematic review. SAGE Open Med 2015; 3:2050312115601122. [PMID: 26770799 PMCID: PMC4679327 DOI: 10.1177/2050312115601122] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2015] [Accepted: 07/19/2015] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVES Studies suggest that periodontal disease, a source of subclinical and persistent infection, may be associated with various systemic conditions, including liver cirrhosis. The aim of this study was to examine the literature and determine the relationship between periodontal disease and liver cirrhosis and to identify opportunities and directions for future research in this area. METHODS A systematic review of English articles in the PubMed, EMBASE, and Scopus databases was conducted using search terms including 'liver cirrhosis', 'end-stage liver disease', 'liver diseases', 'oral health', 'periodontal disease', 'mouth disease', 'gingivitis', and 'periodontitis'. RESULTS Thirteen studies published between 1981 and 2014 were found to include data on oral health and periodontal disease in cirrhotic patients. Studies indicated an increased incidence of periodontal disease in patients with liver cirrhosis, measured with several different periodontal indices. The reported prevalence of periodontal disease in cirrhosis patients ranged from 25.0% to 68.75% in four studies and apical periodontitis was found in 49%-79% of the patients. One study found that mortality was lower among patients who underwent dental treatment versus non-treated patients. Another study suggested an association between periodontal disease and the progression of liver cirrhosis, but data are sparse and conflicting as to whether periodontal disease is correlated to cirrhosis aetiology and severity. CONCLUSION Despite the clinical reality of periodontal disease in liver cirrhosis patients, there are few published studies. Before clinical implications can be addressed, more data on the prevalence of and correlation between periodontal disease and liver cirrhosis aetiology, duration, and progression are needed.
Collapse
Affiliation(s)
- Lea Ladegaard Grønkjær
- Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus, Denmark
| |
Collapse
|
|
25
|
Maló P, de Araújo Nobre M, Gonçalves Y, Lopes A. Long-Term Outcome of Implant Rehabilitations in Patients with Systemic Disorders and Smoking Habits: A Retrospective Clinical Study. Clin Implant Dent Relat Res 2015; 18:649-65. [DOI: 10.1111/cid.12346] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- Paulo Maló
- Oral Surgery Department; Malo Clinic; Lisbon Portugal
| | | | | | - Armando Lopes
- Oral Surgery Department; Malo Clinic; Lisbon Portugal
| |
Collapse
|
|
26
|
Truong A, Higgs P, Cogger S, Jamieson L, Burns L, Dietze P. Oral health-related quality of life among an Australian sample of people who inject drugs. J Public Health Dent 2015; 75:218-24. [PMID: 25753928 DOI: 10.1111/jphd.12092] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2014] [Accepted: 01/26/2015] [Indexed: 01/28/2023]
Abstract
OBJECTIVES People who inject drugs (PWID) have poor oral health. However, their oral health-related quality of life (OHRQoL) is unknown. Our study was designed to measure the OHRQoL of PWID. METHODS The Oral Health Impact Profile-14 (OHIP-14) was administered to 794 PWID recruited in Australian capital cities as part of the 2013 Illicit Drug Reporting System (IDRS). Three OHIP-14 summary indicators were examined: "Prevalence" (proportion reporting ≥1 item at least "fairly often"), "severity" (mean total OHIP-14 score), and "extent" (number of impacts reported at least "fairly often"). Associations between "prevalence" and "extent" and variables drawn from the health, drug use, and social domains were investigated. RESULTS All OHIP-14 summary indicators among IDRS participants were significantly higher than in the general Australian population. In multivariate analysis, the "prevalence" indicator was significantly and positively associated with female gender [adjusted odds ratio (AOR) = 1.75, 95% CI 1.27-2.38], those born in Australia (AOR = 2, 95% CI 1.25-3.23), not completing Year 10 compared with those who had completed Year 12 or a higher qualification (AOR = 1.59, 95% CI 1.03-2.44), and methadone treatment (AOR = 1.61, 95% CI 1.14-2.29). The "extent" indicator was significantly and positively associated with female gender [adjusted incidence rate ratio (AIRR) = 1.56, 95% CI 1.19-2.08], unemployment (AIRR = 1.59, 95% CI 1.01-2.44), and having an injecting career of 10-20 years (AIRR = 1.76, 95% CI 1.03-3.01). CONCLUSIONS PWID have poorer OHRQoL than the Australian general population. Poor OHRQoL was particularly common in female PWID and those with longer injecting careers. Interventions to improve the oral health of PWID may improve their OHRQoL.
Collapse
Affiliation(s)
- Arthur Truong
- Centre for Population Health, Burnet Institute, Melbourne, VIC, Australia.,Department of Epidemiology and Preventative Medicine, Monash University, Melbourne, VIC, Australia
| | - Peter Higgs
- Centre for Population Health, Burnet Institute, Melbourne, VIC, Australia.,National Drug Research Institute, Curtin University, Fitzroy, VIC, Australia
| | - Shelley Cogger
- Centre for Population Health, Burnet Institute, Melbourne, VIC, Australia.,Department of Epidemiology and Preventative Medicine, Monash University, Melbourne, VIC, Australia
| | - Lisa Jamieson
- Australian Research Centre for Population Oral Health, University of Adelaide, Adelaide, SA, Australia
| | - Lucinda Burns
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia
| | - Paul Dietze
- Centre for Population Health, Burnet Institute, Melbourne, VIC, Australia.,Department of Epidemiology and Preventative Medicine, Monash University, Melbourne, VIC, Australia
| |
Collapse
|
|
27
|
|
|
28
|
Carrozzo M, Scally K. Oral manifestations of hepatitis C virus infection. World J Gastroenterol 2014; 20:7534-7543. [PMID: 24976694 PMCID: PMC4069285 DOI: 10.3748/wjg.v20.i24.7534] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2013] [Revised: 01/21/2014] [Accepted: 03/19/2014] [Indexed: 02/06/2023] Open
Abstract
Extrahepatic manifestations (EHMs) of hepatitis C virus (HCV) infection can affect a variety of organ systems with significant morbidity and mortality. Some of the most frequently reported EHM of HCV infection, involve the oral region predominantly or exclusively. Oral lichen planus (OLP) is a chronic inflammatory condition that is potentially malignant and represents cell-mediated reaction to a variety of extrinsic antigens, altered self-antigens, or super antigens. Robust epidemiological evidence support the link between OLP and HCV. As the virus may replicate in the oral mucosa and attract HCV-specific T lymphocytes, HCV may be implicated in OLP pathogenesis. Sjögren syndrome (SjS) is an autoimmune exocrinopathy, characterized by dryness of the mouth and eyes and a multitude of other systemic signs and symptoms. SjS patients have also an increased risk of non-Hodgkin lymphoma. Patients with chronic hepatitis C do frequently have histological signs of Sjögren-like sialadenitis with mild or even absent clinical symptoms. However, it is still unclear if HCV may cause a disease mimicking SjS or it is directly responsible for the development of SjS in a specific subset of patients. Oral squamous cell carcinoma is the most common oral malignant tumour and at least in some part of the world could be linked to HCV.
Collapse
|
|
29
|
Castellanos-Cosano L, Machuca-Portillo G, Segura-Sampedro JJ, Torres-Lagares D, López-López J, Velasco-Ortega E, Segura-Egea JJ. Prevalence of apical periodontitis and frequency of root canal treatments in liver transplant candidates. Med Oral Patol Oral Cir Bucal 2013; 18:e773-e779. [PMID: 23722148 PMCID: PMC3790651 DOI: 10.4317/medoral.19148] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2013] [Accepted: 03/27/2013] [Indexed: 12/13/2022] Open
Abstract
AIM The purpose of this study was to investigate the prevalence of apical periodontitis (AP) and endodontic treatment in liver transplant candidates and control healthy subjects. MATERIAL AND METHODS A descriptive cross-sectional study. Forty two liver transplant candidates (LTC) (study group) and 42 control subjects. Digital panoramic radiographs where used. Periapical status was scored according to the periapical index (PAI). Results were analysed statistically using the Chi-squared test and logistic regression. RESULTS Radiographic signs of AP in one or more teeth was found in 79% of patients in the study group and in 50% of control subjects (p = 0.008; OR = 3.7; C. I. 95% = 1.4 - 9.5). One or more root-filled teeth (RFT) were found in 19% and 62% of study and control subjects, respectively (p = 0.0001; OR = 0.14; 95% C. I. = 0.05 - 0.38). Among LTC patients 14.7% of the teeth had AP, whereas in the control subjects 4.2% of teeth were affected (p= 0.0002). The percentage of RFT in the study and control groups was 1.5% and 6.8%, respectively (p = 0.0002). CONCLUSIONS Liver transplant candidates have significantly higher prevalence of radiographic periapical lesions and lower frequency of RFT than controls healthy subjects.
Collapse
|
|
30
|
Alavian SM, Mahboobi N, Mahboobi N, Karayiannis P. Oral conditions associated with hepatitis C virus infection. Saudi J Gastroenterol 2013; 19:245-51. [PMID: 24195977 PMCID: PMC3958971 DOI: 10.4103/1319-3767.121032] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Hepatitis C virus (HCV) infection in more than 170 million chronically infected patients with no developed preventive vaccine is a globally important issue. In addition to expected hepatic manifestations, a number of extrahepatic manifestations, such as mixed cryoglobulinemia, glomerulonephritis, polyarteritis nodosa, rashes, renal disease, neuropathy, and lymphoma, have been reported following HCV infection, which are believed to be influenced by the virus or the host immune response. HCV combination therapy with pegylated interferon and ribavirin might be associated with side effects as well. The association of HCV with special oral conditions has also been reported recurrently; the mechanism of most of which remains unclear. This article reviews the association of HCV infection with some of the oral conditions such as oral health, Sjogren's syndrome, lichen planus and oral cancer.
Collapse
Affiliation(s)
- Seyed-Moayed Alavian
- Department of Gastroenterology and Hepatology, Baqiyatallah University of Medical Sciences, Research Center for Gastroenterology and Liver Disease, Tehran, Iran,Address for correspondence: Prof. Seyed-Moayed Alavian, Professor of Gastroenterology and Hepatology, Baqiyatallah Research Center for Gastroenterology and Liver Diseases, Ground Floor of Baqiyatallah Hospital, Mollasadra Avenue, Vanak Square, Tehran, Iran. E-mail:
| | - Nastaran Mahboobi
- Department of Neurology, Marien Hospital Euskirchen, Lehrkrankenhaus der Uni-Bonn, Germany
| | - Nima Mahboobi
- Department of Oral and Maxillofacial Surgery, Tehran University of Medical Sciences, Tehran, Iran
| | - Peter Karayiannis
- Department of Medicine, Imperial College, Variety Wing Floor D, St Mary's Campus, Norfolk Place, London, England
| |
Collapse
|
|
31
|
Nagao Y, Hashimoto K, Sata M. Candidiasis and other oral mucosal lesions during and after interferon therapy for HCV-related chronic liver diseases. BMC Gastroenterol 2012; 12:155. [PMID: 23122361 PMCID: PMC3503792 DOI: 10.1186/1471-230x-12-155] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2012] [Accepted: 10/31/2012] [Indexed: 01/05/2023] Open
Abstract
Background Oral lichen planus (OLP) is seen frequently in patients with hepatitis C virus (HCV) infection. The aim of this study was to evaluate the occurrence of oral candidiasis, other mucosal lesions, and xerostomia during interferon (IFN) therapy for HCV infection. Methods Of 124 patients with HCV-infected liver diseases treated with IFN therapy in our hospital, 14 (mean age 56.00 ± 12.94 years) who attended to receive administration of IFN once a week were identified and examined for Candida infection and other oral lesions and for the measurement of salivary flow. Serological assays also were carried out. Results Cultures of Candida from the tongue surfaces were positive in 7 (50.0%) of the 14 patients with HCV infection at least once during IFN therapy. C. albicans was the most common species isolated. The incidence of Candida during treatment with IFN did not increase above that before treatment. Additional oral mucosal lesions were observed in 50.0% (7/14) of patients: OLP in three (21.4%), angular cheilitis in three (21.4%) and recurrent aphthous stomatitis in one (7.1%). OLP occurred in one patient before treatment with IFN, in one during treatment and in one at the end of treatment. 85.7% of the oral lesions were treated with topical steroids. We compared the characteristics of the 7 patients in whom Candida was detected at least once during IFN therapy (group 1) and the 7 patients in whom Candida was not detected during IFN therapy (group 2). The prevalence of oral mucosal lesions (P=0.0075) and incidence of external use of steroids (P=0.0308) in group 1 were significantly higher than in group 2. The average body weight of group 1 decreased significantly compared to group 2 (P=0.0088). Salivary flow decreased in all subjects throughout the course of IFN treatment and returned at 6th months after the end of treatment. In group 1, the level of albumin at the beginning of the 6th month of IFN administration was lower than in group 2 (P=0.0550). According to multivariate analysis, one factor, the presence of oral mucosal lesions, was associated with the detection of Candida. The adjusted odds ratio for the factor was 36.00 (95% confidence interval 2.68-1485.94). Conclusion We should pay more attention to oral candidiasis as well as other oral mucosal lesions, in patients with weight loss during IFN treatment.
Collapse
Affiliation(s)
- Yumiko Nagao
- Department of Digestive Disease Information & Research, Kurume University School of Medicine, Kurume, Fukuoka, Japan.
| | | | | |
Collapse
|
|
32
|
Liu B, Dion MR, Jurasic MM, Gibson G, Jones JA. Xerostomia and salivary hypofunction in vulnerable elders: prevalence and etiology. Oral Surg Oral Med Oral Pathol Oral Radiol 2012; 114:52-60. [PMID: 22727092 DOI: 10.1016/j.oooo.2011.11.014] [Citation(s) in RCA: 116] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2011] [Revised: 11/09/2011] [Accepted: 11/15/2011] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The goal of this article is to review existing research on the prevalence and etiology of dry mouth in the vulnerable elders and identify knowledge gaps. STUDY DESIGN Vulnerable elders (VE) are persons aged >65 years who have any or all of the following: limited mobility, limited resources, or complex health status. A systematic search was conducted of PubMed sources from 1989 to May 2010. Evidence was evaluated on the prevalence and etiology of xerostomia and salivary gland hypofunction (SGH) in VE. RESULTS The search identified 1,422 publications. The inclusion/exclusion criteria yielded 348 articles, 80 of which are cited herein. CONCLUSIONS Research has showed a high prevalence of xerostomia and SGH in VE. Common etiologies include medications, poor general health, female gender, and age. Gaps still exist in the evaluation of dry mouth in VE. Nonetheless, oral dryness will remain an important health issue as life expectancy increases.
Collapse
Affiliation(s)
- Bing Liu
- Department of General Dentistry, Henry M. Goldman School of Dental Medicine, Boston University, Boston, Massachusetts 02118, USA.
| | | | | | | | | |
Collapse
|
|
33
|
Oral health profile of cirrhotic patients awaiting liver transplantation in the Brazilian Northeast. Transplant Proc 2011; 43:1319-21. [PMID: 21620119 DOI: 10.1016/j.transproceed.2011.03.063] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
BACKGROUND Infections are a frequent cause of morbidity and mortality among postoperative liver transplant (OLT) patients and a leading cause of decompensated chronic liver disease (CLD) among patients awaiting the procedure. Oral lesions that are frequently observed in subjects with CLD may represent foci for systemic infections before and after OLT. AIMS To evaluate the oral health profile of patients with CLD awaiting OLT. METHODS One hundred thirty one patients including 100 males of overall mean age 49.5 ± 10.8 years with CLD were listed for OLT and examined for oral health status according to a established protocol. RESULTS One hundred thirty (99%) patients were partially edentulous; 66 (51%) had chewing difficulties; and 63 (48%) experienced reduced salivary flow. With respect to periodontal disease and oral infections, 68 (25%) had periodontitis, 63 (48%) had periapical lesion, 64 (49%) had abscesses, and 59 (45%) had root fragments. Loss of follow-up was observed in 21 subjects. Among the 110 other patients, 63 (57%) underwent dental treatments with complications in only two cases. Interestingly, mortality was significantly lower among treated (31%) versus nontreated patient (79%; P<.001). CONCLUSIONS Poor oral health status observed in most CLD patients may represent a source of systemic infections before and after OLT. Treatment of such lesions was feasible in the majority of the patients and seemed to be associated with a reduction in mortality.
Collapse
|
|
34
|
Nagao Y, Sata M. Effect of oral care gel on the quality of life for oral lichen planus in patients with chronic HCV infection. Virol J 2011; 8:348. [PMID: 21749712 PMCID: PMC3149004 DOI: 10.1186/1743-422x-8-348] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2011] [Accepted: 07/12/2011] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Oral lichen planus (OLP) decreases the quality of life because it can cause spontaneous pain during eating and tooth-brushing and an uncomfortable feeling in the mouth. In addition, OLP may be associated with HCV-related liver disease.We investigated the visual analogue scale (VAS) and effects of oral care gel, REFRECARE-H®, on patients with OLP associated with HCV infection. RESULTS Nine OLP patients (mean age 67.9 ± 7.6 years) with HCV-related liver diseases were recruited and their VAS score determined along with a biochemical examination of the blood. Types of OLP included erosive (6 patients) and reticular (3). REFRECARE-H®, an oral care gel (therapeutic dentifrice) containing hinokitiol, was applied by each patient as a thin layer on the oral membrane, after each meal and at bedtime for 30 days. Application of REFRECARE-H® improved the quality of life in all terms of dry mouth, breath odor, oral freshness, oral pain during rest, oral pain at a mealtimes, taste disorder, loss of appetite, sleep disorder, depressive mood and jitteriness. VAS scores of dry mouth, breath odor, oral freshness, and sleep disorder were significantly increased 30 days after application of REFRECARE-H® (P = 0.01, P = 0.05, P = 0.03, P = 0.04). VAS scores of oral pain at a mealtimes and taste disorder were increased 30 days after application of REFRECARE-H® (P = 0.06). There was an absence of side effects. CONCLUSIONS REFRECARE-H® improved the quality of life for OLP. It is necessary for the hepatologist to educate patients regarding oral hygiene, as well as provide treatment of liver disease.
Collapse
Affiliation(s)
- Yumiko Nagao
- Department of Digestive Disease Information & Research, Kurume University School of Medicine, Kurume, Fukuoka 830-0011, Japan.
| | | |
Collapse
|
|
35
|
Nagao Y, Sata M. Dental problems delaying the initiation of interferon therapy for HCV-infected patients. Virol J 2010; 7:192. [PMID: 20712912 PMCID: PMC2933590 DOI: 10.1186/1743-422x-7-192] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2010] [Accepted: 08/17/2010] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND There has been little discussion about the importance of oral management and interferon (IFN) therapy, although management of the side effects of therapy for chronic hepatitis C has been documented. This study determined whether dental problems delayed the initiation of IFN therapy for hepatitis C virus (HCV)-infected patients. RESULTS We analyzed 570 HCV-infected patients who were admitted to our hospital from December 2003 to June 2010 for treatment consisting of pegylated IFN (Peg-IFN) monotherapy or Peg-IFN/ribavirin combination therapy. The group comprised 274 men and 296 women with a mean age 57.2 years. Of the 570 patients, six could not commence Peg-IFN therapy, despite their admission, because of dental problems such as periodontitis, pupitis, and pericoronitis. The ages of six whose dental problems delayed the initiation of Peg-IFN ranged from 25 to 67 years, with a mean age of 47.3 +/- 15.2 years. IFN therapy was deferred for 61.3 +/- 47.7 days. Among the six subjects for whom IFN treatment was delayed, only one had a salivary flow that was lower than the normal value. CONCLUSIONS Treatment of dental infections is required before IFN therapy for HCV infection can be started. To increase the depth of understanding of oral health care, it is hoped that dentists and medical specialists in all areas will hold discussions to generate cooperation.
Collapse
Affiliation(s)
- Yumiko Nagao
- Department of Digestive Disease Information & Research, Kurume University School of Medicine, Kurume, Fukuoka, 830-0011, Japan.
| | | |
Collapse
|
|
36
|
|
|
37
|
|
|
38
|
Correlation of hepatitis C antibody levels in gingival crevicular fluid and saliva of hepatitis C seropositive hemodialysis patients. Int J Dent 2009; 2009:247121. [PMID: 20309410 PMCID: PMC2837414 DOI: 10.1155/2009/247121] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2009] [Revised: 07/04/2009] [Accepted: 08/03/2009] [Indexed: 01/21/2023] Open
Abstract
Search for hepatitis C virus (HCV) in body fluids other than blood is important when assessing possible nonparenteral routes of viral transmission. However, the role of oral fluids in HCV transmission remains controversial. Our aim was to compare the prevalence of HCV antibody (HCV Ab) levels in saliva, and gingival crevicular fluid (GCF) of HCV seropositive hemodialysis patients. Serum, saliva and GCF samples were collected from thirty-nine patients. Samples were analyzed for HCV Ab using the Ortho HCV 3.0 SAVe enzyme-linked immunosorbent assay (ELISA). HCH Ab levels in saliva and GCF of all HCV-seropositive patients were statistically compared. Reported here are the results of the study designed to determine the correlation between HCV-RNA positivity in serum and the detection of antibodies in GCF and saliva. One hundred percent (100%) of the 39 patients have antibodies to HCV in their serum, 15.4% have antibodies to HCV in GCF, and saliva found out. HCV Ab seropositivity in GCF and saliva was significantly correlated (kappa = 0.462; P < .001). This study supports the concept that GCF may be a significant source of HCV in saliva.
Collapse
|
|
39
|
Kasman LM, London LL, London SD, Pilgrim MJ. A mouse model linking viral hepatitis and salivary gland dysfunction. Oral Dis 2009; 15:587-95. [PMID: 19656314 DOI: 10.1111/j.1601-0825.2009.01600.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
OBJECTIVE Viral hepatitis is known to cause xerostomia in humans, but this has not been reported in an animal model. We report a severe, acute, highly reproducible saliva deficiency occurring in BALB/c mice as a result of experimental viral hepatitis. MATERIALS AND METHODS BALB/c mice, splenectomized or carrying genetic mutations to detect immunological contributions to the saliva deficiency syndrome, were infected intraperitoneally with a non-lethal dose of murine cytomegalovirus. Pilocarpine-stimulated saliva volumes were determined between 0 and 15 days after infection. Salivary gland, liver, spleen, and sera were analyzed for the presence of virus, cytokines, inflammatory infiltrates, and tissue damage. RESULTS Saliva deficiency was detectable 2 days after cytomegalovirus infection, peaked at 88% below normal by day 7, and resolved partially in all mice by 15 days postinfection as sialoadenitis increased. Neither salivary gland viral titers, sialoadenitis, splenectomy, nor systemic inflammatory markers correlated with hyposalivation severity. Elevated liver enzymes did correlate with hyposalivation, and mice genetically resistant to murine cytomegalovirus-induced hepatitis were significantly protected. CONCLUSIONS Murine cytomegalovirus-induced salivary gland dysfunction is biphasic, with an acute hepatitis-associated phase and a later sialoadenitis-associated phase. Acute murine cytomegalovirus infection of BALB/c mice may provide a model for investigation of hepatitis-associated xerostomia.
Collapse
Affiliation(s)
- L M Kasman
- Department of Microbiology and Immunology, Medical University of South Carolina, BSB-201, PO Box 250504, 173 Ashley Ave, Charleston, SC 29403, USA.
| | | | | | | |
Collapse
|
|
40
|
Laslett AM, Dietze P, Dwyer R. The oral health of street-recruited injecting drug users: prevalence and correlates of problems. Addiction 2008; 103:1821-5. [PMID: 19032532 DOI: 10.1111/j.1360-0443.2008.02339.x] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIMS To examine the effects of a series of injecting drug users' (IDU) characteristics and drug use behaviours upon the self-reported oral health of a sample of IDU. DESIGN Cross-sectional survey. SETTING Melbourne, Australia. PARTICIPANTS A total of 285 IDU recruited through needle and syringe programmes, snowballing and outreach across six sites. MEASUREMENTS Structured survey that collected information on current drug use patterns, self-reported blood-borne virus status and general health factors, including open-ended questions on past-year dental health problems. FINDINGS Sixty-eight per cent of the sample reported dental problems that were commonly severe and caused dental pain. Despite these reported problems, almost half the sample had not visited the dentist in the 12 months prior to the survey. Participants who were older, and reported homelessness, not eating every day and more common injection of amphetamines rather than heroin in the previous month, were more likely to report having a past-year dental problem. CONCLUSIONS Dental problems in IDUs are common but few receive treatment. Further, those using amphetamines, with poor housing, hygiene and poor nutrition, are most at risk. Programmes designed to improve the oral health of IDU need to be developed and implemented in a manner amenable to the varying social circumstances of this marginalized group in the community.
Collapse
|
|
41
|
Carrozzo M. Oral diseases associated with hepatitis C virus infection. Part 2: lichen planus and other diseases. Oral Dis 2008; 14:217-28. [PMID: 18221456 DOI: 10.1111/j.1601-0825.2007.01432.x] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Some of the most frequent extrahepatic manifestations of hepatitis C virus (HCV) infection involve the oral region predominantly or exclusively. Part 2 of this review discusses the current evidences regarding the association of lichen planus (LP) and other diseases frequently involving the oral cavity with HCV. Epidemiological data suggest that LP may be significantly associated with HCV infections especially in southern Europe and Japan but not in northern Europe. These geographical differences are possibly influenced by immunogenetic factors, the duration of the HCV infection and the design of the published studies. Because of the fact that most of the studies published are retrospective, it is impossible to establish whether the HCV exposure occurred earlier to or after the onset of disease and more prospective studies are clearly warranted. As the virus may replicate in the skin and oral mucosa and HCV-specific T lymphocytes can be found in the oral mucosa of patients with chronic hepatitis C and LP, HCV may be implicated in the pathogenesis of LP. However, little attention has been paid to the variable effect of therapy with interferon-alpha (IFN-alpha), with or without ribavirin for LP. Conversely, it is unlikely that other oral diseases such as oral carcinoma, pemphigus and Behcet disease are triggered by HCV.
Collapse
Affiliation(s)
- M Carrozzo
- Department of Oral Medicine, School of Dental Sciences, University of Newcastle upon Tyne, Newcastle upon Tyne, UK.
| |
Collapse
|
|
42
|
Carrozzo M. Oral diseases associated with hepatitis C virus infection. Part 1. sialadenitis and salivary glands lymphoma. Oral Dis 2008; 14:123-30. [PMID: 18208477 DOI: 10.1111/j.1601-0825.2007.01436.x] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Morbidity associated with hepatitis C virus (HCV) infection is due not only to the sequelae of chronic liver disease, but also to a variety of extraheaptic manifestations (EHM). Some of the most frequently reported EHM of HCV infection involves the oral region predominantly or exclusively and they are the topics of this 2-part review. The current part 1 discusses the evidences on the association of salivary glands disorders with HCV. HCV- infected patients may frequently have histological signs of Sjögren-like sialadenitis with mild or even absent clinical symptoms. However, the pathogenetic role of HCV in Sjogren Syndrome (SS) development and the characteristics distinguishing classic SS from HCV-related sialadenitis are still an issue. It is unclear if the virus may cause a disease mimicking primary SS or if HCV is directly responsible for the development of SS in a specific subset of patients. Notably, some patients may present a triple association between HCV, SS-like sialadenitis and salivary gland lymphoma and the virus may be involved in the lymphomagenesis. The risk of having a salivary gland lymphoma is particularly high in patients with mixed cryoglobulinemia. Little attention has been paid to the effects of anti-HCV treatment on sialadenitis or lymphoma development.
Collapse
Affiliation(s)
- M Carrozzo
- Department of Oral Medicine, School of Dental Sciences, University of Newcastle upon Tyne, Newcastle upon Tyne, UK.
| |
Collapse
|
|
43
|
Salivary dysfunction associated with systemic diseases: systematic review and clinical management recommendations. ACTA ACUST UNITED AC 2007; 103 Suppl:S57.e1-15. [PMID: 17379156 DOI: 10.1016/j.tripleo.2006.11.010] [Citation(s) in RCA: 87] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2006] [Accepted: 11/08/2006] [Indexed: 01/29/2023]
Abstract
OBJECTIVES The objective of this study was to identify systemic diseases associated with hyposalivation and xerostomia and develop evidence-based management recommendations for hyposalivation/xerostomia. STUDY DESIGN Literature searches covered the English language medical literature from 1966 to 2005. An evidence-based review process was applied to management studies published from 2002 to 2005. RESULTS Several systemic diseases were identified. From studies published 2002 to 2005, 15 were identified as high-quality studies and were used to support management recommendations: pilocarpine and cevimeline are recommended for treating hyposalivation and xerostomia in primary and secondary Sjögren's syndrome (SS). IFN-alpha lozenges may enhance saliva flow in primary SS patients. Anti-TNF-alpha agents, such as infliximab or etanercept, are not recommended to treat hyposalivation in SS. Dehydroepiandrosterone is not recommended to relieve hyposalivation or xerostomia in primary SS. There was not enough evidence to support any recommendations for the use of local stimulants, lubricants, and protectants for hyposalivation/xerostomia. However, professional judgment and patient preferences may support the use of a specific product for an individual patient. CONCLUSIONS These evidence-based management recommendations should guide the clinician's management decisions for patients with salivary dysfunction related to systemic disease. Future treatment strategies may include new formulations of existing drugs, e.g., local application of pilocarpine. Recent discoveries on gene expression and a better understanding of the etiopathogenesis of SS may open new treatment options in the future.
Collapse
|
|
44
|
Temple-Smith M, Jenkinson K, Lavery J, Gifford SM, Morgan M. Discrimination or discretion? Exploring dentists' views on treating patients with hepatitis C. Aust Dent J 2006; 51:318-23. [PMID: 17256306 DOI: 10.1111/j.1834-7819.2006.tb00450.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND People with hepatitis C (over 259 000 Australians) experience stigma and discrimination, whether perceived or actual, in health care settings. They are less likely to access health care, presenting a major barrier to preventive care and treatment. This study aims to identify factors contributing to such discrimination, barriers to optimal care and strategies to overcome these. METHODS A purposive sample of 25 Victorian dentists took part in semi-structured interviews to investigate their experiences and attitudes in providing care to people with hepatitis C. Interviews were taped, transcribed and coded for thematic analysis. RESULTS All dentists interviewed were aware of Standard Precautions. However, there were some who changed practices when seeing a client with hepatitis C, suggesting that they lack confidence in Standard Precautions. When prompted, these dentists were concerned that patients may perceive these actions as discriminatory. All participants, including a small minority who expressed negative views about injecting drug users, felt a professional obligation to treat all patients. CONCLUSIONS Most dentists have appropriate attitudes regarding patients with blood-borne viruses. However, it is important for dentists to understand how their actions may be interpreted by those who feel sensitive about their status. Dentists need to feel genuinely confident about Standard Precautions and have a realistic view of the infection risk posed by patients with blood-borne viruses.
Collapse
Affiliation(s)
- M Temple-Smith
- Australian Research Centre in Sex, Health and Society, La Trobe University, Melbourne, Victoria.
| | | | | | | | | |
Collapse
|
|
45
|
Lins L, Almeida H, Vitvisk L, Carmo T, Paraná R, Reis MG. Detection of hepatitis C virus RNA in saliva is not related to oral health status or viral load. J Med Virol 2005; 77:216-20. [PMID: 16121379 DOI: 10.1002/jmv.20438] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Hepatitis C is a worldwide public health problem and its transmission is clearly associated with the parenteral route, however, the virus has also been isolated from other body fluids. Hepatitis C virus (HCV) RNA has been detected in saliva, yet the relationship between HCV and oral pathology is not clearly understood. Therefore, an investigation on HCV-RNA in saliva and its correlation with oral pathology was undertaken. Saliva and blood samples were collected from 50 anti-HCV positive patients and from 25 patients with non-HCV chronic liver disease. HCV-RNA was detected in all of the saliva samples from the HCV positive group. None of the saliva or serum samples from the non-HCV group were positive for HCV-RNA. The patients were examined for dental and oral health (dentate, partially dentate, edentulous, evidence of gum disease, or mucosal lesions); however, no correlation was found between HCV-RNA in saliva, oral health, and viral load. These results suggest that HCV-RNA presence in saliva is independent of the viral load and the oral pathology of HCV positive individuals.
Collapse
Affiliation(s)
- Liliane Lins
- Laboratório de Patologia e Biologia Molecular, Centro de Pesquisas Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Bahia, Brazil
| | | | | | | | | | | |
Collapse
|
|
46
|
Slade GD, Foy SP, Shugars DA, Phillips C, White RP. The impact of third molar symptoms, pain, and swelling on oral health-related quality of life. J Oral Maxillofac Surg 2004; 62:1118-24. [PMID: 15346364 DOI: 10.1016/j.joms.2003.11.014] [Citation(s) in RCA: 90] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE This study was designed to assess the impact of "pain and swelling" associated with third molars on patients' quality of life before surgery. PATIENTS AND METHODS The data for these analyses were obtained from a larger ongoing study designed to examine the surgical and medical management of problems associated with third molars. Data from 480 patients with 4 third molars scheduled for removal were used in the analysis. Questionnaires administered presurgery assessed patients' medical and dental history, their reasons for seeking third molar removal, and sociodemographic characteristics. Adverse impacts on oral health-related quality of life were measured using the 14-item Oral Health Impact Profile (OHIP) questionnaire. The primary outcome variable was the percentage of people reporting 1 or more of the 12 non-pain-specific OHIP items "fairly often" or "very often" during the 3 months before enrollment. RESULTS One third (178 of 480) of patients said they were seeking third molar surgery because of current or previous symptoms of pain/swelling, and 17% reported 1 or more of the 12 non-pain-specific OHIP items. In the multivariate logistic regression model, the odds of one or more impacts was greater for people who presented because of symptoms (odds ratio [OR], 2.9; 95% confidence interval [CI], 1.7 to 4.8), who were aged 25 years or more (OR, 1.9; 95% CI, 1.1-3.3), and who had a self-reported history of tooth loss due to pathology or trauma (OR, 2.9; 95% CI, 1.9 to 5.5). CONCLUSIONS Adverse impacts on quality of life occurred for 1 in 8 patients seeking third molar surgery, and the odds increased 3-fold for patients who had experienced pain/swelling compared with those who were asymptomatic.
Collapse
Affiliation(s)
- Gary D Slade
- Australian Research Centre for Population Oral Health, Dental School, University of Adelaide, Australia
| | | | | | | | | |
Collapse
|
|
47
|
Carrozzo M, Gandolfo S. Oral diseases possibly associated with hepatitis C virus. CRITICAL REVIEWS IN ORAL BIOLOGY AND MEDICINE : AN OFFICIAL PUBLICATION OF THE AMERICAN ASSOCIATION OF ORAL BIOLOGISTS 2003; 14:115-27. [PMID: 12764074 DOI: 10.1177/154411130301400205] [Citation(s) in RCA: 60] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Morbidity associated with hepatitis C virus (HCV) infection can involve a variety of extrahepatic conditions, including lichen planus (LP) and sialadenitis, predominantly or exclusively involving the oral region, conditions which have been largely neglected in reviews. The literature suggests that HCV-infected patients may frequently have Sjögren-like sialadenitis with mild clinical symptoms, whereas oral LP may be significantly associated with HCV infections in Southern Europe and Japan but not in Northern Europe. These geographical differences could be related to immunogenetic factors such as the HLA-DR6 allele, significantly expressed in Italian patients with OLP and HCV. Analysis of experimental data suggests that HCV could be involved in the pathogenesis of both these diseases. Moreover, parotid lymphoma may arise in patients with sialadenitis, mainly with type II cryoglobulinemia. Little attention has been paid to oral health needs in HCV-infected patients and the variable effect of interferon-alpha therapy on oral tissues. Further research is needed, because of the potentially great influence of oral diseases possibly linked to HCV on the quality of life of millions of patients.
Collapse
Affiliation(s)
- M Carrozzo
- Department of Biomedical Sciences and Human Oncology, Oral Medicine Section, C. so Dogliotti 14, University of Turin, I-10126 Torino, Italy.
| | | |
Collapse
|
|
48
|
Abstract
The widespread incidence of hepatitis C (HCV) infection throughout the community is of concern. Although many of those infected will not suffer significantly from their infection, up to one-third will have liver disease, fatigue and oral health problems. General dental practitioners need to be aware of the precautions necessary in treating people with severe liver disease. This paper discusses the issues associated with treating patients who have HCV infection including the importance of preventive programs to reduce dental pathology and maximise oral health.
Collapse
Affiliation(s)
- E A Coates
- South Australian Dental Service, Adelaide Dental Hospital
| | | | | |
Collapse
|