EFFICACY OF IMPLANT SUPPORTED DENTURES IN DIABETICS

本研究的主要目的是确定叠加是否 骨结合牙种植体支持的下颌义齿是一种 传统全口义齿的有效替代治疗方法 糖尿病患者，其代谢生化控制主要是 要么通过饮食治疗，要么通过口服降糖药补充 药物或胰岛素。这两种假牙的效果 基于义齿舒适度、咀嚼效率、食物 选择、饮食摄入、生活质量、患者满意度和成本 初始和维护护理。 108例老年男性糖尿病患者， 代谢控制将被随机分配到四个组， 对照组，一组接受24次胰岛素治疗（IT），另一组接受24次 非胰岛素治疗（NIT）的患者和两个实验组，一个有30 另一组为30例NIT患者。对照组患者将 接受一套新的上颌和下颌义齿， 实验组：一个新的上颌义齿和一个覆盖下颌 由两个骨结合种植体支撑的义齿。 他们将在糖尿病诊所接受季度随访， 糖化血红蛋白浓度和在牙科诊所 观察和口腔卫生指导。此外，他们还将在 指导他们监测空腹血糖水平至少三次， 周一系列的临床评估和主观和客观的 将在进入研究后立即进行测量， 6-在安装新义齿后的1个月和36个月的时间间隔。三 多组问卷（食物偏好、患者治疗评价和 患者满意度），以确定感知的变化 在咀嚼、言语、气味、义齿卫生、舒适度、安全性和 心理健康客观测量将包括唾液 分泌率，触觉辨别阈值，最大咬 压力、口腔清除率测试和咀嚼性能测试， 肌电图活动和下颌运动记录。为期一周的 将保存饮食记录，以确定食物消费模式的变化 在咀嚼食物的困难程度方面。 两个治疗组之间的比较将在 基于预先规定的治疗失败百分比的差异 标准以及每个标准的平均得分差异 主观和客观变量。

The primary purpose of this study will be to determine whether an overlay mandibular denture supported by osseointegrated dental implants is an effective treatment alternative to a conventional complete denture in diabetic patients whose metabolic biochemical control is achieved primarily either by dietary therapy, which may be supplemented by oral hypoglycemic agents, or by insulin. The effectiveness of the two types of dentures would be based upon improvements in denture comfort, masticatory efficiency, food selection, dietary intake, quality of life, patient satisfaction and cost of initial and maintenance care. One hundred and eight elderly male diabetic patients with acceptable metabolic control will be randomly assigned to four groups providing two control groups, one with 24 insulin treated (IT) and the other with 24 non-insulin treated (NIT) patients and two experimental groups, one with 30 IT and the other with 30 NIT patients. Patients in the control groups will receive a new set of maxillary and mandibular dentures and in the experimental groups a new maxillary denture and an overlay mandibular denture supported by two osseointegrated implants. They will be followed in the Diabetic Clinic on a quarterly basis for glycosylated hemoglobin concentrations and in the Dental Clinic for observation and oral hygiene instructions. In addition, they will be instructed to monitor their fasting glucose levels at least three times a week. A series of clinical evaluations and subjective and objective measurements will be made immediately after entry into the study and at 6-month and 36-month intervals after the insertion of new dentures. Three sets of questionnaires (food preference, patient treatment evaluation and patient satisfaction) will be administered to determine perceived changes in mastication, speech, odor, denture hygiene, comfort, security and psychological well-being. The objective measurements will include salivary secretion rates, tactile discrimination thresholds, maximal biting pressures, oral clearance tests, and masticatory performance tests, electromyographic activity and mandibular movement recordings. A one-week dietary log will be kept to determine changes in food consumption patterns in terms of the degree of difficulty to chew foods. Comparisons between the two treatment groups will be made on the differences in percentages of treatment failures based on prespecified criteria as well as differences in the mean scores for each of the subjective and objective variables.