Dental markers of endogenous intoxication in patients with non-alcoholic fatty liver disease

Abstract

Objective — to determine some dental markers of endogenous intoxication in the treatment of patients with non‑alcoholic fatty liver disease (NAFLD).
 Materials and methods. Examinations involved 44 patients with verified NAFLD diagnosis (the main group). The control group consisted of 20 somatically healthy subjects, representative in terms of gender and age. Clinical dental examinations were carried out twice, before and after the treatment, with an interval of 10 days. A questionnaire survey was conducted to assess the discipline of oral hygiene care. The level of oral hygiene was studied using the Greene–Vermillion index. The level of endotoxin in venous blood and oral fluid was assessed by immunoenzymatic method. The degree of endogenous intoxication was evaluated based on the structural and optical properties of a drop of oral fluid on a glass slide using an electron microscope. An analysis of correlations between non‑invasive and invasive techniques has been carried out.
 Results. More than half of the patients in the main group (61.3%) cleaned their teeth once a day. The value of the Greene–Vermillion oral hygiene index was equal to 2.3 points, which indicated an unsatisfactory state of hygienic care. In patients of the main group, the level of endotoxemia was equal to 0.9 EU/ml, and the level of LPS in oral fluid was 33.5 U/ml, which exceeded similar parameters in the control group by 2 and 1.6 times, respectively. In the micro preparations of oral fluid facies, 71.0% of patients in the main group had markers of endogenous intoxication (EI) of 3rd grade, 20.4% — EI of 2nd grade, and only 9.0% had EI of 1st grade. After 10 days, according to the re‑questioning data, 72.7% of patients in the main group followed full hygienic care of the oral cavity, and the Greene–Vermillion index decreased to 1.6 points, which was assessed as a satisfactory condition. In the micro preparations of facies of oral fluid, markers of EI of the 2nd grade were observed in 56.8% of the main group and markers of EI of 1st grade in 22.7% of subjects. The number of patients with EI markers of the 3rd grade decreased in 3.5 times compared to the first visit.
 Conclusions. Proper hygienic care of the oral cavity of patients with NAFLD results in the reduction of endogenous intoxication degree.