牙列缺损合并糖尿病患者固定义齿修复后血糖波动对留存状况的影响

Influence of blood glucose fluctuation on retention after fixed denture repair in patients with dentition defect and diabetes

目的探讨牙列缺损合并糖尿病患者固定义齿修复后血糖波动对留存状况的影响,为糖尿病患者固定义齿的维护提供依据。方法病例对照研究,收集开封市中心医院于2019年1月至2022年1月收治的30例牙列缺损合并糖尿病患者固定义齿修复后1年内未留存患者的临床资料,作为未留存组;另收集医院同期30例牙列缺损合并糖尿病患者固定义齿修复后1年内留存患者的临床资料,纳入留存组。所有患者均接受固定义齿修复治疗。通过查阅病历,收集并对比患者年龄、体重、性别等基线资料;收集固定义齿修复后第7 d,每位患者体内糖化血红蛋白水平、三餐前0.5 h、餐后2 h及睡前血糖水平,计算餐后血糖波动值、一日内最大血糖波动值,分析血糖波动对牙列缺损合并糖尿病患者固定义齿修复后留存状况的影响。结果未留存组餐后血糖波动值、最大血糖波动值、糖化血红蛋白值高于留存组,差异有统计学意义(P<0.05);对比两组其他基线资料,差异无统计学意义(P>0.05);经logistic回归分析显示,餐后血糖波动值、最大血糖波动值、糖化血红蛋白值是牙列缺损合并糖尿病患者固定义齿修复后留存状况的危险因素(OR>1,P<0.05)。结论血糖波动会对牙列缺损合并糖尿病患者固定义齿修复后留存状况产生影响,其值越大,义齿留存率越低。

Objective To investigate the influence of blood glucose fluctuation on the retention of fixed dentures in patients with dentition defect and diabetes after restoration,and to provide basis for the maintenance of fixed dentures in patients with diabetes.Methods A case-control study was conducted to collect the clinical data of 30 patients with dentition defect complicated with diabetes who were admitted to Kaifeng Central Hospital from January 2019 to January 2022 and who were not retained within one year after the fixed denture repair,as the non retained group.In addition,clinical data of 30 patients with dentition defect and diabetes who were retained within one year after fixed denture repair in the same period were collected and included in the retention group.All patients received fixed denture repair.By consulting medical records,collecting and comparing baseline data such as age,weight and gender of patients;the levels of glycosylated hemoglobin,0.5 h before meals,2 h after meals and before bedtime blood glucose of each patient were collected on the 7th day after fixed denture restoration.The postprandial blood glucose fluctuation value and the maximum blood glucose fluctuation value within a day were calculated to analyze the effect of blood glucose fluctuation on the retention status of patients with dentition defect and diabetes after fixed denture repair.Results The postprandial blood glucose fluctuation value,the maximum blood glucose fluctuation value,and the glycosylated hemoglobin value in the non retained group were higher than those of the retained group,with a statistical significant difference(P<0.05).There was no statistical significant difference in other baseline data between the two groups(P>0.05).logistic regression analysis showed that postprandial blood glucose fluctuation value,maximum blood glucose fluctuation value and glycosylated hemoglobin value were the risk factors for the retention of fixed dentures in patients with dentition defect and diabetes(OR>1,P<0.05).Conclusion Blood glucose fluctuation will affect the retention of fixed dentures in patients with dentition defect and diabetes.The higher the blood glucose fluctuation,the lower the retention rate of dentures.