牙周疾病是一種牙齒周圍組織慢性發炎的疾病，而肝膿瘍是因細菌感染進而在肝臟中形成濃液。目前鮮少有學者做這兩者疾病相關風險之研究。因此本研究係使用台灣健康保險研究的數據，應用全國人口病例對照研究來分析牙周疾病（PD），洗牙（DS）和化膿性肝膿瘍（PLA）之間的關係。本研究篩選辨識了691名肝膿瘍患者，並按年齡和性別配對了2,764名沒有肝膿瘍的人作為對照組。並利用logistic回歸評估在牙周疾病風險暴露下是否會與肝膿瘍相關。研究結果顯示，牙周疾病是20-40歲肝膿瘍患者的危險因子，風險值為正常人的2.31倍（aOR = 2.31，95％信賴區間= 1.37-3.90，p = 0.0018）。進一步研究分析，平均一年洗一次牙患肝膿瘍風險是沒有洗牙族群的0.76倍（aOR = 0.76，95％信賴區間= 0.59-0.96）；一年內多於一次洗牙患肝膿瘍的風險值有顯著下降（aOR = 0.61，95％信賴區間= 0.39-0.95）。綜合本研究結果，小於50歲的成人牙周疾病患者比對照表組更容易患肝膿瘍，尤其是在一年內沒有洗牙的情況之下。此外，至少每年接受2次洗牙治療的非牙周疾病患者患肝膿瘍的風險相對低於對照組。
The purpose of this study was to investigate the relationship between Periodontitis (PD), dental scaling (DS), and pyogenic liver abscesses (PLAs). A nationwide population-based case–control study was applied using data from the National Health Insurance Research Database in Taiwan. We identified and enrolled 691 PLA patients, who were individually matched by age and sex to 2,764 controls. Conditional logistic regression was applied to estimate adjusted odds ratios (aORs) in patients with exposure to PD and DS before PLA. After adjusting for other confounding factors, PD remained a risk factor for PLA among patients aged 20–40 years, with an aOR of 2.31 (95% confidence interval [CI] = 1.37–3.90, p = 0.0018). In addition, the average aOR for PLA was significantly lower among patients with one DS (aOR = 0.76, 95% CI = 0.59–0.96) and more than one DS (aOR = 0.61, 95% CI = 0.39–0.95) within 1 year before the index date. According to these results, we concluded that adult periodontitis patients’ < 50 year-old are more at risk for PLA than control, especially when they have no DS. Moreover, from 20 years non-periodontal patients subjected to 2 DS at least per year are less at risk of PLA than control.
