High incidence of periodontitis in patients with ascitic decompensated cirrhosis.

Background: Periodontitis has been associated with various liver diseases. However, the relevance of periodontitis in the progression of decompensated cirrhosis remains inconclusive. In particular, it is unclear whether the common periodontitis pathogens, () and (), can be detected not only in the oral mucosa but also in ascites and stool.

Aim: To investigate the significance of periodontitis, , and in cirrhosis patients with ascitic decompensation.

Methods: This prospective study was conducted at the University Hospital Hamburg-Eppendorf, a tertiary center in Northern Germany. A cohort of 27 patients with ascitic decompensated liver cirrhosis underwent dental examinations to assess the association between periodontitis and various clinical parameters of cirrhosis, as well as patient outcomes. PCR was used to test gingival samples, ascites, and stool for the presence of and . Gingival samples were collected by probing the deepest gum pocket of a sextant and wiping them on a cotton swab.

Results: Periodontitis was diagnosed in 22 out of 27 (82%) ascite patients, which is significantly more common than in a control cohort of 100 unselected patients (59%, = 0.04). was detected in the gingiva of six patients, and one of them also had in their stool. However, was not found in the ascites of any patient. Five out of six patients with had periodontitis (83%). was not detected in any sample. Patients without periodontitis had a significantly higher mortality rate compared to those with periodontitis, and survival (Kaplan-Meier analysis) was longer in patients with periodontitis ( = 0.02). Transplant-free survival was also more common in patients with periodontitis compared to those without (63% 0%, = 0.02).

Conclusion: Decompensated cirrhotic patients frequently suffer from periodontitis. However, there was no evidence of the translocation of or into ascites. The survival of cirrhotic patients with periodontitis was not reduced.