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

Abstract

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.