糖尿病合并慢性牙周炎牙种植预后及其高风险因素分析

Prognosis of dental implants with diabetes and chronic periodontitis and analysis of its high risk factors

目的:分析2型糖尿病(T2DM)合并慢性牙周炎(CP)牙种植预后及其高风险因素。方法:选取2012年4月~2016年11月成都市龙泉驿区第一人民医院口腔科收治的55例T2DM合并CP患者(观察组),另选取50例单纯CP患者(对照组)及50例牙周健康牙列缺损患者(牙周健康组),分析种植牙预后及其高风险因素。结果:牙周指标方面,对照组、观察组分别于完成牙种植修复后6个月、3个月开始,PD、mSBI、mPLI、MBL水平显著升高,差异有统计学意义(P<0.05);牙周健康组各指标均无明显变化(P>0.05)。龈沟液方面,对照组与观察组完成牙种植修复后3月开始,TNF-α、IL-1β、IL-6水平明显升高(P<0.05),且观察组修复后3、6个月各炎症指标水平高于对照组(P<0.05),牙种植后2年开始观察组种植牙成功率低于对照组、牙周健康组(P<0.05),对照组与牙周健康组种植牙成功率比较差异无统计学意义(P>0.05);年龄、吸烟、合并骨质疏松症、牙槽骨骨质量、血糖控制情况、口腔卫生习惯是影响T2DM合并CP牙种植预后的独立危险因素(P<0.05)。结论:T2DM合并CP牙种植患者应着重防治吸烟、骨质疏松症、血糖控制及口腔卫生习惯等高风险因素,改善牙种植预后。

Objective:To analyze the prognosis and high risk factors of dental implants in patients with type 2 diabetes mellitus(T2DM)complicated with chronic periodontitis(CP).Methods:The clinical data of 55 dental implant patients with type 2 diabetes and chronic periodontitis admitted to our hospital from April 2012 to November 2016 were selected.In addition,50 patients with simple chronic periodontitis and dental implants were selected as the control group,and 50patients with periodontal healthy dentition defects were selected as the periodontal healthy group.Analyze the prognosis of dental implants and their high-risk factors.Results:In terms of periodontal indicators,the levels of PD,mSBI,mPLI,and MBL in the control group and the observation group were significantly increased at 6 months and 3 months after the completion of dental implant restoration,and the difference was statistically significant(P<0.05).There was no significant change in each index in the periodontal healthy group(P>0.05).In terms of gingival crevicular fluid,the levels of TNF-α,IL-1βand IL-6 in the control group and the observation group were significantly increased from 3 months after the restoration of dental implants(P<0.05),and the observation group was 3 and 6 months after the restoration.The level of each inflammatory index was higher than that in the control group(P<0.05).The success rate of dental implantation in the observation group was lower than that in the control group and the periodontal healthy group 2 years after dental implantation(P<0.05).There was no significant difference in the success rate(P>0.05);age,smoking,combined osteoporosis,alveolar bone quality,blood sugar control,and oral hygiene were the independent risk factors for the prognosis of T2DM complicated with CP implantation(P>0.05).Conclusion:Patients with dental implants with diabetes and chronic periodontitis should focus on the prevention and treatment of high-risk factors such as smoking,osteoporosis,blood sugar control and oral hygiene habits,and improve the prognosis of dental implants.