Periodontal disease related to diabetic status - A pilot study of the response to periodontal therapy in type 1 diabetes
Periodontal disease related to diabetic status - A pilot study of the response to periodontal therapy in type 1 diabetes
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DOI：
10.1111/j.1600-051x.1997.tb00219.x
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发表时间：
1997-07-01
影响因子：
6.7
通讯作者：
Karjalainen, K
中科院分区：
文献类型：
--
作者：
Tervonen, T;Karjalainen, K
对36例1型糖尿病（DM）患者和10例非糖尿病对照者的牙周健康状况以及对口腔卫生教育、洁治和根面平整术的反应进行了研究。受试者的年龄范围为24-36岁。根据3年期间的糖化血红蛋白（HbA 1c）水平和糖尿病并发症的存在，将糖尿病组分为3个亚组，如下所示：（D1）代谢控制良好且无并发症的受试者（n=13），（D2）代谢控制不同且伴/不伴视网膜病变的受试者（n=15）和（D3）重度糖尿病受试者，即，长期控制不良和/或多种并发症（n=8）。在基线和牙周治疗后4周、6个月和12个月进行临床测量（菌斑、龈下结石、探诊袋深度、探诊后出血和临床附着水平）。使用Student t检验和ANOVA进行组间比较。根据牙菌斑评分，在整个研究期间，所有组的口腔卫生状况相似。在任何检查中，糖尿病组与非糖尿病对照组之间的牙周健康状况均无显著性差异。控制良好且无并发症的糖尿病患者（D1）和中度控制伴/不伴视网膜病变的糖尿病患者（D2）的牙周健康水平与非糖尿病对照组相同。我们的研究结果表明，在代谢控制不良和/或多种并发症（D3）的糖尿病受试者中，基线时al大于或等于2 mm的程度显著更高，并且在纵向研究期间pd大于或等于4 mm的快速复发表明，这些受试者中作为糖尿病并发症的牙周破裂增加。为了能够评估牙周预后和牙周治疗的需要，在个人的基础上，临床医生应该很好地了解他/她的病人的糖尿病状态。
Variation in the periodontal health status and the response to oral hygiene education, scaling and root planing were studied in 36 subjects with type-1 diabetes mellitus (DM) and in 10 non-diabetic control subjects. The age range of the subjects was 24-36 years. The diabetic group was divided into 3 subgroups based on the levels of glycosylated hemoglobin (HbA1c) over a 3 year period and the presence of diabetic complications as follows: (D1) subjects with good metabolic control and no complications (n=13), (D2) subjects with varying metabolic control with/without retinopathy (n=15) and (D3) subjects with severe diabetes, i.e., with poor long-term control and/or multiple complications (n=8). Clinical measurements (plaque, subgingival calculus, probing pocket depth, bleeding after probing and clinical attachment level) were performed at the baseline and 4 weeks and 6 and 12 months after periodontal therapy. The between-group comparisons were made using the Student t-test and ANOVA. Based on the plaque scores, the oral hygiene status was similar in all groups during the whole study. No statistically-significant differences in the periodontal health status could be found between the diabetic group as a whole and the non-diabetic controls at any examination. The level of periodontal health of the diabetics with good control and no complications (D1) and those with moderate control with/without retinopathy (D2) was on the same level with that seen in the non-diabetic controls. Our findings of the significantly higher extent of al greater than or equal to 2 mm at the baseline and the fast recurrence of pd greater than or equal to 4 mm during the longitudinal study in diabetic subjects with poor metabolic control and/or multiple complications (D3) indicate increased periodontal breakdown as a complication of DM in these subjects. To be able to assess the periodontal prognosis and the need for periodontal therapy on an individual basis,the clinical practitioner should be well aware of the diabetic status of his/her patients.