两种刮治方案对糖尿病伴有牙周炎患者的临床疗效评价

The effect of full-mouth debridement versus quadrant scaling and root planning on the improvement of periodontal index and glycemic control in patients with type 2 diabetes mellitus

目的评估全口一次性刮治和常规分区段法刮治两种刮治方案对糖尿病伴有牙周炎患者牙周健康和代谢水平的影响。方法选取30例2型糖尿病伴有慢性牙周炎患者,随机分2组,每组15例。A组为接受全口一次性刮治,B组为接受常规分区段法刮治。于基线和治疗后3个月记录牙周健康情况和代谢水平。牙周参数记录包括菌斑指数、出血指数、牙周袋深度、附着水平。代谢参数包括糖化血红蛋白。结果 A组和B组所有牙周参数和代谢参数均有明显改善,但两组之间差异无统计学意义,糖化血红蛋白水平改善与出血指数变化相关。结论牙周基础治疗可以改善糖尿病伴有牙周炎患者的牙周健康状况以及糖代谢水平,且两种刮治方案同样有效。

Objective to investigate the effect of full-mouth debridement versus quadrant scaling and root planning on periodontal index and glycemic control in type 2 diabetes mellitus （type 2 DM） patients who have chronic periodontitis. Methods Thirty type 2 DM patients with chronic periodontitis were randomly assigned to two different treatment proto-cols： a single session of full-mouth subgingival instrumentation using a EMS ultrasonic device with water coolant （ A group）, quadrant scaling/root planning with Gracey hand instruments （B group）. The periodontal parameters recorded in-cluded plaque index（PLI）, bleeding index（BI）, probing pocket depth（PD）, and clinical attachment level（AL）. The follow-ing metabolic parameter was recorded： glycated hemoglobin （HbAlc）. These were recorded at baseline and at the end of 3 months. Results A statistically significant effect could be demonstrated for periodontal parameters for both group A and group B （treatment groups）. Glycated hemoglobin values showed statistically significant decrease in both groups, but there was no difference between group A and group B. Conclusion For type 2 DM patients with chronic periodontitis, full-mouth ultrasonic debridement could achieve a comparable clinical effcacy and improvement of glycemic control to conventional quadrant scaling and root planning.