两种龈下刮治和根面平整术对2型糖尿病伴慢性牙周炎疗效的比较

Type 2 diabetes with chronic periodontitis: Comparison of efficacy of subgingival scaling and root planing

目的:比较一次法龈下刮治和根面平整术(FM-SRP)和常规的四分法龈下刮治和根面平整术(Q-SRP)治疗2型糖尿病伴慢性牙周炎的临床疗效,并观察慢性牙周炎治疗对2型糖尿病患者血糖控制的影响。方法:将48例2型糖尿病伴慢性牙周炎患者随机分为2组:FM-SRP组在l天内完成全口所有象限的刮治和根面平整,Q-SRP组每周进行1个象限的刮治,连续4周完成全口治疗。于治疗前、治疗3个月和6个月时,检测菌斑指数(PLI)、牙周探诊深度(PD)、临床附着水平(CAL)、探诊出血(BOP)及空腹血糖(FPG)与糖化血红蛋白(HbAlc)的变化。结果:有3例患者被剔除。与治疗前相比,2种治疗方式在3个月和6个月时的PLI、PD、CAL和BOP均有显著改善(P<0.05),FPG和HbAlc无显著性改变(P>0.05)。但各项指标的变化在2组间均无显著性差异(P>0.05)。结论:本组资料,FM-SRP和Q-SRP两种方法治疗2型糖尿病伴慢性牙周炎均可达到相同的临床效果,但对2型糖尿病患者血糖控制无明显影响。

Objective： To evaluate the clinical effects of full-mouth scaling plus root planning （FMSRP） and quartering subgingival scaling plus root planing （Q-SRP）, and to observe the effect of treatment of chronic periodontitis on blood glucose control of type 2 diabetes. Methods： Forty-eight patients with type 2 diabetes and chronic periodontitis were randomly divided into 2 groups. The FMSRP group received full-mouth scaling and root planning completed within 1 day, while the Q-SRP group received quadrant scaling and root planning once a week for 4 weeks. Plaque index （PLI）, probing depth （PD）, clinical attachment level （CAL）, bleeding on probing （BOP）, FPG and HbAlc were collected at baseline, 3 and 6 months after treatment. Results： 3 cases were rejected from the study. Compared with the baseline, both therapies resulted in significant improvements in PLI, PD, CAL and BOP （P〈0.01）, without changes in the HbA1c levels after therapy （P〉0.05）. No significant differences were observed between groups for all parameters at any time （P〉 0.05）. Conclusions： FMSRP and PMSRP were equally effective in treating chronic periodontitis in subjects with type 2 diabetes, without significant improvements in the glycemic control at 3 and 6 months.