Presence and consequence of tooth periapical radiolucency in patients with cirrhosis

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DOI

  • Lea Ladegaard Grønkjær
  • Palle Holmstrup
  • Søren Schou, Section for Oral and Maxillofacial Surgery, Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen., Kristoffer Schwartz, Department of Oral and Maxillofacial Surgery, Aalborg Hospital, Johanne Kongstad, Section of Periodontology, Microbiology, and Community Dentistry, Department of Odontology, Faculty of Health and Medical Sciences.,
  • Peter Jepsen
  • Hendrik Vilstrup

BACKGROUND: Periapical radiolucency is the radiographic sign of inflammatory bone lesions around the apex of the tooth. We determined the prevalence and predictors of periapical radiolucency in patients with cirrhosis and the association with systemic inflammation status and cirrhosis-related complications.

METHODS: A total of 110 cirrhosis patients were consecutively enrolled. Periapical radiolucency was defined as the presence of radiolucency or widening of the periapical periodontal ligament space to more than twice the normal width. Predictors of periapical radiolucency and the association with systemic inflammation markers and cirrhosis-related complications were explored by univariable and multivariable logistic regression analyses.

RESULTS: Periapical radiolucency was present in one or more teeth in 46% of the patients. Strong predictors were gross caries (odds ratio [OR] 3.12, 95% confidence interval [CI] 1.43-6.79) and severe periodontitis (OR 3.98, 95% CI 1.04-15.20). Also old age (OR 1.10, 95% CI 1.01-1.19) and smoking (OR 3.24, 95% CI 1.02-17.62) were predictors. However, cirrhosis etiology (alcoholic vs nonalcoholic) or severity (Model of End-Stage Liver Disease score) were not predictors. The patients with periapical radiolucency had higher C-reactive protein (15.8 mg/L vs 8.1 mg/L, P=0.02) and lower albumin contents (25 g/L vs 28 g/L, P=0.04) than those without. Furthermore, the patients with periapical radiolucency had a higher prevalence of cirrhosis-related complications such as ascites, hepatic encephalopathy, and/or variceal bleeding (46% vs 27%, P=0.05).

CONCLUSION: Periapical radiolucency is often present as an element of poor oral health status and likely has an adverse clinical significance, which should motivate diagnostic and clinical attention to the findings.

Original languageEnglish
JournalHepatic Medicine: Evidence and Research
Volume8
Pages (from-to)97-103
Number of pages7
DOIs
StatePublished - 2016

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