Actualización en el manejo odontológico del paciente con patología hepática

1. Daniel Ortega Concepción ¹
2. Juan Francisco Peña Cardelles
3. Jorge A. Cano Durán
4. Mario Santos Mansilla Romaní
5. Lorenzo Arriba de la Fuente
6. Luis Miguel Sáez Alcaide
7. Gonzalo Hernández Vallejo ²

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Abstract

Liver disease or dysfunction may be due to numerous causes such as acquired infections, congenital diseases or drug abuse. When this dysfunction and liver damage are prolonged overtime, it can lead to hepatic cirrhosis, an irreversible condition and serious repercussions for the patient. The two most frequent liver diseases and the major causes of cirrhosis are hepatitis or hepatic inflammation, which may be due to numerous factors, being the most frequent virus infections, and alcoholic liver disease, caused by alcohol abuse continued during a long period of time. The dental management of a patient with liver disorders is a real challenge, since the liver plays a vital role in many metabolic functions, such as the bile secretion or excretion of bilirubin from hemoglobin metabolism. A failure in the liver function can lead to alterations in the metabolism of amino acids, ammonia, proteins, carbohydrates and triglycerides. A patient with liver disease will have an altered metabolism of numerous drugs commonly used by the dentist, will have a greater risk of hemorrhage due to abnormalities in the synthesis of different coagulation factors, being also a patient with a higher risk of infections. The great repercussion of the liver disease, as well as the remarkable lack of knowledge of many dental professionals in its management, justify this article where it is detailed both the most important generalities of this entity and its main oral manifestations and considerations in dental management.

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