口腔扁平苔藓与肝病关系的病例对照研究

目的：探讨口腔扁平苔藓与慢性肝病的关系。方法：回顾性分析４７６例口腔扁平苔藓的肝病、肝功能异常发生情况，并与年龄、性别配对的４７６例其它口腔粘膜病及１７１１名健康人比较。结果：口腔扁平苔藓患者慢性肝病发生率６５％，１项肝功能异常发生率为２３．９％，二项或二项以上为５．３％。上述指标均较疾病对照组和正常对照组为高（Ｐ＜０．０１），其中尤以反映间质反应的指标如血清蛋白、ＴＴＴ、ＺｎＴＴ的异常改变较为明显。结论：口腔扁平苔藓与肝病有一定的关系，其所伴发的肝病以慢性肝病疾患为主。     

Relationship between periodontal disease and cirrhosis of the liver in humans

Abstract The periodontal condition of a well-described group of cirrhotic patients was compared with that of a control group, matched forage, sex ratio and socio-economic background, expressed as years of education. The test group comprised 30 cirrhotic patients, 35–64 years of age. The diagnosis cirrhosis of the liver was confirmed histologically, and no other systemic diseases were present. The material was grouped according to age, 35–44, 45–54 and 55–64 years of age. The examination included determination of tooth loss, a plaque index, a gingival index, retentive calculus, retentive decay and fillings, and loss of attachment. The amount of plaque was equal in test and control groups, whereas the cirrhotics had a higher degree of severity of gingival inflammation as well as a greater amount of subgingival calculus than the controls. Test and control groups exhibited no significant difference as regards loss of attachment and tooth loss, and similar correlations between loss of-attachment and age were demonstrated in the two groups. Patients suffering from cirrhosis for more than 3 years showed significantly greater loss, of attachment, as well as more plaque and calculus compared with those with a disease duration of less than 3 years. It is suggested that this aggravation of the periodontal condition is related to increasing neglect of the teeth, as the cirrhotic condition aggravates.     

甲基丙烯酸甲酯单体对小鼠肝、肺、肾功能的影响

目的:研究口腔义齿修复常用材料甲基丙烯酸甲酯单体对小鼠肺、肝、肾组织的影响.方法:雄鼠50只分成2组,实验组和对照组.实验组小鼠强迫吸入挥发的甲基丙烯酸甲酯单体,对照组吸入空气,分别活体眼球后取血,血清检测ALP、GPT、GOT反映对肝功影响.颈椎脱臼处死法处死后取肝、肺、肾组织,包埋切片,观察其病理改变.结果:经统计学分析,血清中碱性磷酸酶、谷丙转氨酶、谷草转氨酶的含量实验组与对照组比较,有显著性差异(P<0.05);组织病理切片可直接观察到:实验组小鼠肺组织出现炎细胞浸润、纤维样变、肺泡破裂的现象.肾组织中肾小球萎缩、玻璃样变,及肾小囊、肾小管内纤维素样渗出.结论:甲基丙烯酸甲酯引起了小鼠肝功的变化及肺肾组织的病理学改变,提示甲基丙烯酸甲酯对小鼠肝、肺、肾都有毒性作用.     

Assessment and management of oral health in liver transplant candidates

Liver transplantation has become a standard treatment for end-stage liver disease and the number of recipients has grown rapidly in the last few years. Dental care during pre-transplant workup is important to reduce potential sources of infection in the drug-induced immunosuppression phase of liver transplantation.

Objectives

The objectives of this study were to document the prevalence of oral abnormalities in patients on a liver transplant waiting list presenting to an urban dental school clinic, discuss the appropriate dental treatment according their systemic conditions and compare their oral manifestations with those of healthy individuals.

Material and Methods

A pilot study was conducted involving 16 end-stage liver disease individuals (study group- SG) attending the Special Care Dentistry Center of the University of São Paulo and 16 control individuals (control group- CG) with no liver diseases, receiving dental care at the Dental School of the University of São Paulo. These individuals were assessed for their dental status (presence of oral disease or abnormalities), coagulation status, and dental treatment indications.

Results

The patients from SG exhibited a greater incidence of oral manifestations compared with CG (p=0.0327) and were diagnosed with at least one oral disease or condition that required treatment. Coagulation abnormalities reflecting an increased risk of bleeding were found in 93.75% of the patients. However, no bleeding complications occurred after dental treatment.

Conclusions

The patients with chronic liver diseases evaluated in this study exhibited a higher incidence of oral manifestations compared with the control group and had at least one oral disease or abnormality which required dental treatment prior to liver transplantation. Careful oral examination and evaluation of the patient, including laboratory tests, will ensure correct oral preparation and control of oral disease prior to liver transplantation.     

槟榔碱对口腔癌患者及小鼠肝脏功能影响的初步研究

目的:通过比较有、无槟榔咀嚼史的口腔癌患者肝功能指标变化,并与槟榔碱诱导小鼠口腔黏膜下纤维化模型的肝脏损伤比较,探讨槟榔碱对肝脏功能的影响。方法:比较有、无咀嚼槟榔史各50名口腔癌男性患者谷丙转氨酶(ALT)、谷草转氨酶(AST)、碱性磷酸酶(ALP)、总胆红素(TBIL)肝功能指标差异;将45只小鼠,随机分成对照组、停药组、不停药组,每组15只。配制1000mg/L槟榔碱溶液分别持续自由喂养停药组、不停药组2周后,停药组改用实验室灭菌水自由喂养2周,不停药组继续槟榔碱溶液喂养2周;对照组用实验室灭菌水自由喂养4周。检测各组小鼠不同时间段上述肝功能指标变化情况,并采用苏木素-伊红(HE)染色观察小鼠肝脏组织学改变。结果:与无咀嚼槟榔史患者相比,咀嚼槟榔的肝功能指标AST、TBIL显著升高(P<0.05),ALT、ALP无明显变化;与对照组小鼠相比,停药组和不停组随用药时间增长,ALT、AST、ALP显著升高(P<0.05),而停药组停药2周后ALT、AST、ALP显著下降(P<0.05),TBIL无统计学差异;HE染色显示肝脏均出现损伤,但不停药组小鼠损伤更为明显。结论:槟榔的成分对肝脏有损伤,其作用的有效成分可能是槟榔碱。     

MicroRNA expression profiling of the developing murine molar tooth germ and the developing murine submandibular salivary gland

Using microarrays, miRNA expression profiles have been established at selected times during development (E15.5, P0 and P5) of the murine first molar mandibular tooth germ and the right submandibular salivary gland (E15.5, P0, P5 and P25). Microarray data was validated using real-time PCR, also facilitating RT-PCR profiling of nine selected miRNAs. In general, good agreement between microarray data and real-time PCR data was found. Further, miRNA expression profiles of foetal and adult liver were also investigated, and found to agree with published data. In tooth germ and salivary gland up to 88 different miRNAs were detected. In all tissues examined miRNA expression was highly dynamic; miRNA profiles changing extensively with time of development. Additionally, the expression of some miRNAs was tissue-specific. Bioinformatic analysis of clusters of miRNAs was attempted using the miRGate software, the results suggesting miRNAs to be involved in the regulation of essential developmental processes, e.g., epithelical cell proliferation, mesodermal cell fate determination and salivary gland morphogenesis.     

肝移植术后口腔粘膜病变的诊治

目的：探讨肝移植术后口腔粘膜病变的诊治。方法：通过所经治的１０例临床活体肝部分移植术患儿，报告了口腔粘膜病变的特点。结果：有４例患儿出现了口腔粘膜病变，分别为单纯疱疹１例，口腔真菌感染１例，原因不清的复合性病变２例，全部病例都经治而愈。结论：肝移植术后口腔粘膜病变主要由病毒、真菌、药物或营养失衡所致，其诊治各有特点，需区别对待     

口腔粘膜扁平苔藓患者丙型肝炎病毒感染的初步研究

目的：了解ＯＬＰ患者ＨＣＶ感染情况,探讨ＨＣＶ感染与ＯＬＰ之间的关系。方法：用全自动生化检测仪,酶联免疫测定及ＰＣＲ法分别测定４１名ＯＬＰ患者和３８名对照者外周血ＳＧＰＴ、ＳＧＯＴ、抗－ＨＣＶ和ＨＣＶ－ＲＮＡ。结果：４１名ＯＬＰ患者中,１５人（３６．６％）有肝酶异常升高、１２人（２９．３％）抗－ＨＣＶ阳性,１０人（２４．４％）ＨＣＶ－ＲＮＡ阳性;而３８名对照组中,６人（１５．８％）有肝酶异常升高,３人（７．９％）抗－ＨＣＶ阳性,３人（７．９％）ＨＣＶ－ＲＮＡ阳性,ＯＬＰ组的上述三项指标均较对照组为高（Ｐ＜０．０５、Ｐ＜０．０１、Ｐ＜０．０５）,两组存在明显的差异。结论：国人ＯＬＰ患者存在较高的ＨＣＶ感染率,表明有相当部份的ＯＬＰ患者体内有ＨＣＶ存在与复制,ＯＬＰ的发病可能与此有一定的关系。     

Decrease of Pericytes is Associated With Liver Disease Caused by Ligature‐Induced Periodontitis in Rats

Background: Damage caused by periodontitis not only affects periodontal tissues, but also increases the severity of various illnesses such as rheumatoid arthritis, diabetes, and liver diseases. The aim of this study is to investigate the association between induced periodontitis and damage caused through its systemic effects on the liver. Methods: Twenty rats were divided into two groups: control and periodontitis. The following parameters were evaluated: gingival bleeding index (GBI), probing depth (PD), myeloperoxidase (MPO) activity, alveolar bone loss (ABL) for periodontal tissues; histopathologic examination of gingival and liver tissues; immunohistochemistry to cells positive for neural/glial antigen 2 (NG2) expressed in hepatic pericytes, glutathione (GSH), and malondialdehyde (MDA) concentrations in liver; and serum levels of alanine aminotransferase and aspartate aminotransferase. Results: GBI, PD, MPO, ABL, and histopathologic examinations demonstrated the development of periodontitis. There was a significant increase in microvesicular steatosis accompanied by a marked reduction in NG2+ pericytes in the periodontitis group compared with the control group. The periodontitis group had significantly lower GSH and higher MDA concentration in the liver compared with the control group. Conclusions: The present study results link the systemic effects of induced periodontitis with changes in hepatic tissues such as microvesicular steatosis, likely caused by an increase in oxidative stress and lipid peroxidation. The findings from the present study implicate an association between a decrease of pericytes and liver disease caused by ligature‐induced periodontitis in rats.     

Risk of bleeding during oral surgery in patients with liver cirrhosis: A systematic review

BackgroundThe liver is responsible for the production of almost all coagulation factors, but does this indicate a risk of developing unusual bleeding in patients with liver cirrhosis during dental surgery?Types of Studies ReviewedIn this systemic review, the authors followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist and performed a search of PubMed, Latin American and Caribbean Health Sciences Literature, Web of Science, Scopus, and Cochrane databases.ResultsSeven studies met the inclusion criteria. The sample sizes ranged from 23 through 318 participants, number of extracted teeth ranged from 62 through 1,183, platelet count ranged from 16,000 through 216,000 per cubic milimeter, and the international normalized ratio was less than 4. The prevalence of hemorrhagic events in the studies ranged from 0% through 8.9%, and almost all were controlled with local hemostatic measures.Conclusions and Practical ImplicationsDuring dental treatment, patients with liver cirrhosis have a low bleeding risk in spite of the decreased number of platelets and increased international normalized ratio.