Clinical and radiographic variables related to implants with simultaneous grafts among type 2 diabetic patients treated with different hypoglycemic medications: a retrospective study.
Clinical and radiographic variables related to implants with simultaneous grafts among type 2 diabetic patients treated with different hypoglycemic medications: a retrospective study.
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使用不同降糖药物治疗的 2 型糖尿病患者中与种植体同步移植相关的临床和影像学变量：一项回顾性研究
DOI：
10.1186/s12903-021-01583-3
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发表时间：
2021-04-27
期刊：
影响因子：
2.9
通讯作者：
Song Y
中科院分区：
文献类型：
--
作者：
Shi S;Ding F;Liu X;Wang L;Wang X;Zhang S;Zhao G;Song Y
不同降糖药物对2型糖尿病患者种植体周围相关指标的影响仍不明确。因此，本研究旨在评估使用不同降糖药物的患者种植体周围的影像学边缘骨丧失以及临床参数。
在这项回顾性队列研究中，收集了符合纳入标准的2型糖尿病患者的牙种植记录。仅使用以下单一药物的患者：胰岛素、二甲双胍或胰高糖素样肽 - 1（GLP - 1）类药物，根据其用药情况进行分组。这些患者在初始状态相同的情况下接受种植体植入，并且所有的修复体均为粘固的陶瓷冠。在种植体植入后即刻以及随访1年和2年时，通过根尖片评估种植体周围边缘骨水平。对各组间的基线特征进行比较。使用Kruskal - Wallis检验初步比较种植体周围影像学边缘骨丧失和临床参数，然后通过协方差分析控制协变量。对多重比较进行Bonferroni事后调整检验。
在查阅了7000多份病历后，对随访1年的150名患者的308颗种植体进行了评估。GLP - 1药物组的种植体周围边缘骨丧失明显小于胰岛素组和二甲双胍组（P < 0.01）。二甲双胍组的影像学骨丧失高于胰岛素组（P < 0.05）。其中一些纳入研究的患者失访。只有74名患者的129颗种植体完成了2年随访。二甲双胍组的影像学骨丧失仍然高于胰岛素组（P < 0.05）和GLP - 1组（P < 0.01）。各组间的探诊出血（BOP）阳性率和平均牙周袋深度（PD）无显著差异（P > 0.05）。
在1年和2年随访时，使用不同降糖药物的患者的影像学指标并不完全相同。在确保基线特征一致后，GLP - 1药物对种植体周围骨改建的积极作用可能不低于胰岛素或二甲双胍。需要更多的研究来验证这些药物对种植体周围骨的直接作用。
临床试验注册号ChiCTR2000034211（回顾性注册）
BackgroundThe influence of different hypoglycemic agents on peri-implant variables among type 2 diabetes mellitus patients is still unclear. Therefore, the aim of this study was to assess the radiographic marginal bone loss and clinical parameters around implants in patients using different hypoglycemic agents.MethodsIn this retrospective cohort study, the dental implant records of type 2 diabetes mellitus patients who met the inclusion criteria were collected. The patients using only single medication as follows: insulin, metformin, or glucagon-like peptide-1 (GLP-1) drugs, were grouped according to their medication. These patients received implant placement with the same initial status, and all the prosthesis restorations were cement-retained ceramic crowns. The peri-implant marginal bone levels were evaluated by periapical radiographs immediately after implant placement and at 1 and 2-year follow-up visits. The baseline characteristics were compared among groups. The peri-implant radiographic marginal bone loss and clinical parameters were preliminarily compared using the Kruskal–Wallis test, and then the covariates were controlled by covariance analysis. Bonferroni post hoc adjustment test was performed for the multiple comparisons.ResultsAfter a review of more than 7000 medical records, a total of 150 patients with 308 implants at 1-year follow-up were assessed. The peri-implant marginal bone loss in the GLP-1 drug group was significantly smaller than the insulin group and metformin group (P< 0.01). The radiographic bone loss in the metformin group was higher than the insulin group (P< 0.05). Some of these included patients were lost to follow-up. Only 74 patients with 129 implants completed the 2-year follow-up. The radiographic bone loss in the metformin group was still higher than the insulin group (P< 0.05) and GLP-1 group (P< 0.01). There was no significant difference in the BOP (+) and the mean PD among groups (P> 0.05).ConclusionsThe radiographic variables were not exactly the same among the patients with different hypoglycemic agents at both the 1 and 2-year follow-ups. After ensuring consistency in baseline characteristics, the positive effect of GLP-1 drugs on peri-implant bone remodeling may be no less than insulin or metformin. More studies are needed to verify the direct effect of these drugs on peri-implant bone.Clinical trial registration numberChiCTR2000034211 (retrospectively registered).
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