Periodontal status and microbial profiles across the clinical spectrum of liver cirrhosis.

OBJECTIVES

Periodontitis is common in patients with cirrhosis, but this association remains underexplored. This cross-sectional study aimed to assess periodontal conditions and characterize periodontal biofilm composition in individuals with liver cirrhosis.

METHODS

Adults with liver cirrhosis were enrolled. Periodontal parameters were recorded, and supragingival and subgingival biofilm samples were collected. Forty bacterial species were quantified using checkerboard DNA-DNA hybridization. Findings were stratified by Child-Pugh class and MELD score.

RESULTS

Forty-five patients were included; 88.9% exhibited periodontal disease (57.8% gingivitis on a reduced periodontium, 31.1% periodontitis), and 11.1% were periodontally healthy. Periodontal diagnosis was not associated with liver-disease severity (p > 0.05). Gingivitis showed the highest supragingival bacterial load, with enrichment of orange- and red-complex pathogens, particularly Tannerella forsythia. Patients with compensated liver disease (Child-Pugh A; MELD < 15) showed higher counts of Aggregatibacter actinomycetemcomitans and Fusobacterium nucleatum ssp. nucleatum (p < 0.05). Among patients with periodontitis, higher subgingival proportions of red-complex pathogens were observed in those with MELD < 15.

CONCLUSIONS

Periodontal disease was highly prevalent in patients with cirrhosis. Although periodontal diagnosis was not associated with liver-disease severity, distinct microbiological patterns were observed. These findings highlight the potential relevance of periodontal monitoring in patients with cirrhosis and warrant further investigation in larger, longitudinal studies.