Avaliação da saúde bucal de pacientes cirróticos em fila de transplante hepático

  1. Karina Pidhorodeckyj 1
  2. Jefferson da Rocha Tenório 2
  3. Nathália Tuany Duarte 2
  4. Bruna Di Profio 1
  5. Letícia Bezinelli 1
  6. Claudio Pannuti 3
  7. Karem L Ortega 3
  1. 1 Universidade de São Paulo Faculdade de Odontologia
  2. 2 Universidade de São Paulo Faculdade de Odontologia Doutorado em Ciências Odontológicas (Patologia Oral e Maxilofacial e Pacientes Especiais)
  3. 3 Universidade de São Paulo Faculdade de Odontologia Departamento de Estomatologia
Revista:
Revista Estomatológica Herediana

ISSN: 2225-7616

Ano de publicación: 2018

Volume: 28

Número: 4

Páxinas: 237-244

Tipo: Artigo

DOI: 10.20453/REH.V28I4.3426 DIALNET GOOGLE SCHOLAR lock_openAcceso aberto editor

Outras publicacións en: Revista Estomatológica Herediana

Resumo

Objectives: To assess the oral health of patients waiting for a liver transplantation. Material and Methods: A total of 103 cirrhotic patients were evaluated for socio-demographic characteristics and medical history of liver cirrhosis (etiology, time of inclusion in the transplant list, MELD - Model for End Liver Disease - value, complications of cirrhosis and routine medications in use). In addition, simplified oral hygiene index (IHO-S), dental caries index (DMFT) and sialometry were performed to verify oral health. After tabulation of the data, descriptive analyzes were performed. Results: The mean age was 54 years, the male gender was the most prevalent and the elementary school was completed by only 44% of the studied population. Hepatitis C and alcoholic cirrhosis were the etiologies that, more frequently, led the patients to indication for liver transplantation. Esophageal varices, ascites and portal hypertension were the complications of cirrhosis most observed. The mean DMFT of the studied population was considered high (23.3 ). Conclusions: The oral health of cirrhotic patients in the waiting list for transplantation is not satisfactory. Longitudinal studies are needed to investigate the relationship between foci of oral infections and the occurrence of infections post-transplant liver.

Referencias bibliográficas

  • Albillos, A,Lario, M,Álvarez-Mon, M. (2014). Cirrhosis-associated immune dysfunction: distinctie features and clinical relevance. J Hepatol. 61. 1385-1396
  • Guggenheimer, J,Eghtesad, B,Close, JM,Shay, C,Fung, JJ. (2007). Dental health status of liver transplant candidates. Liver Transpl. 13. 280-286
  • Oettinger-Barak, O,Barak, S,Machtei, EE,Ardekian, L,Baruch, Y,Peled, M. (2001). Periodontal changes in liver cirrhosis and post-transplantation patients: I:clinical findings. J Periodontol. 72. 1236-1240
  • Oettinger-Barak, O,Machtei, EE,Barak, S,Baruch, Y,Ardekian, L,Peled, M. (2002). Periodontal changes in liver cirrhosis and post-transplantation patients: II:radiographic findings. J Periodontol. 73. 313-316
  • Silva-Santos, PS,Fernandes, KS,Gallottini, MH. (2012). Assessment and management of oral health in liver transplant candidates. J Appl Oral Sci. 20. 241-245
  • Pizzo, G,Guiglia, R,Lo-Russo, L,Campisi, G. (2010). Dentistry and internal medicine: from the focal infection theory to the periodontal medicine concept. Eur J Intern Med. 21. 496-502
  • Vasanthan, A,Dallal, N. (2007). Periodontal treatment considerations for cell transplant and organ transplant patients. Periodontol. 2000. 44. 82-102
  • Tinoco-Araujo, JE,Orti-Raduan, ES,Santos, D. (2015). Oral health-related quality of life before hematopoietic stem cell transplantation. Clin Oral Investig. 19. 2345-2349
  • Palmer, SC,Ruospo, M,Wong, G. (2015). Dental health and mortality in people with end-stage kidney disease treated with hemodialysis: A multinational cohort study. Am J Kidney Dis. 66. 666-676
  • Ruospo, M,Palmer, SC,Craig, JC. (2014). Prevalence and severity of oral disease in adults with chronic kidney disease: a systematic review of observational studies. Nephrol Dial Transplant. 29. 364-375
  • Marcinkowski, A,Ziebolz, D,Kleibrink, BE. (2018). Deficits in oral health behavior and oral health status in patients after lung transplantation. Clin Respir J. 12. 721-730
  • Zwiech, R,Bruzda-Zwiech, A. (2013). Does oral health contribute to post-transplant complications in kidney allograft recipients. Acta Odontol Scand. 71. 756-763
  • Kim, SI,Kim, YJ,Jun, YH. (2009). Epidemiology and risk factors for bacteremia in 144 consecutive living-donor liver transplant recipients. Yonsei Med J. 50. 112-121
  • Jalan, R,Fernandez, J,Wiest, R. (2014). Bacterial infections in cirrhosis: a positionstatement based on the EASL Special Conference 2013. J Hepatol. 60. 1310-1324
  • Gallili, D. (1982). A modern approach to prevention and treatment of oral bleeding in patients with hepatocellular disease. Oral Surg. 54. 277-280
  • Morrissey, PE,Madras, PN,Monaco, AP. (2001). Clinical management of the transplant patient. Arnold. London.
  • Tilney, NL. (2000). Transplantation and its biology: from fantasy to routine. J Appl Physiol. 89. 1681-1689
  • Glassman, P,Wong, C,Gish, R. (1993). A review of liver transplantation for the dentist and guidelines for dental management. Spec Care Dent. 13. 74-80
  • (2016). Associação Brasileira de Transplante de Órgãos Registro Brasileiro de Transplantes. RBT. 22. 0-0
  • Wilson, RL,Martinez-Tirado, J,Whelchel, J,Lordon, RE. (1982). Occult dental infection in renal transplant patients. Am J Kidney Dis. 2. 354-356
  • Reyna, J,Richardson, JM,Mattox, DE,Banowsky, LH,Nicastro-Lutton, JJ. (1982). Head and neck infection after renal transplantation. JAMA. 247. 3337-3339
  • Aberg, F,Helenius-Hietala, J,Meurman, J,Isoniemi, H. (2014). Association between dental infections and the clinical course of chronic liver disease. Hepatol Res. 44. 349
  • Helenius-Hietala, J,Meurman, JH,Höckerstedt, K,Lindqvist, C,Isoniemi, H. (2012). Effect of the aetiology and severity of liver disease on oral health and dental treatment prior to transplantation. Transpl Int. 25. 158
  • Greene, JC,Vermillion, JR. (1964). The simplified oral hygiene index. J Am Dent Assoc. 68. 7-13
  • (2013). World Health Organization Oral health surveys: basic methods. WHO. Geneva.
  • Kim, WR,Smith, JM,Skeans, MA. (2014). OPTN/SRTR 2012 Annual Data Report: Liver. Am J Transplant. 1. 69-96
  • (2014). Brasil Ministério da SaúdeSecretaria de Atenção à SaúdeDepartamento de atenção básica Projeto SBBrasil 2010: Pesquisa Nacional de Saúde Bucal - Resultados Principais. Ministério da Saúde. Brasília.
  • Tanasiewicz, M,Hildebrandt, T,Obersztyn, I. (2016). Xerostomia of various etiologies: A review of the literature. Adv Clin Exp Med. 25. 199-206
  • Nonzee, V,Manopatanakul, S,Khovidhunkit, SO. (2012). Xerostomia, hyposalivation and oral microbiota in patients using antihypertensive medications. J Med Assoc Thai. 95. 96-104
  • Guggenheimer, J,Mayher, D,Eghtesad, B. (2005). A survey of dental care protocols among US organ transplant centers. Clin Transplant. 19. 15-18