Diabetes: Implant Integration, Success, and Benefit

描述(申请人提供)：糖尿病较为微妙的并发症之一是患者因牙齿脱落和功能受损而导致的生活质量下降。虽然种植体治疗在管理良好的糖尿病患者中显示出了希望，但这种全身性疾病对牙科种植治疗的影响仍然存在问题。事实上，通过植入性治疗改善饮食控制，可能是那些血糖控制不足的患者获得的最大好处。目的：我们的长期目标是为糖尿病患者的植入物护理开发针对患者的治疗方案提供科学依据。本研究旨在解决以下目标：1)确定2型糖尿病和血糖控制在功能负荷前后对种植体整合性、并发症和成功率的影响。2)确定与下颌全口义齿种植支持相关的2型糖尿病和血糖控制对口腔健康相关生活质量的影响。方法：一项平行设计的前瞻性研究将评估使用传统义齿的无牙患者的种植整合率、成功率、并发症、口腔健康相关的生活质量和满意度，以及在将义齿转换为双种植体支持的下颌覆盖义齿后的1到3.5年内。患者将从控制良好(HbA1c和Lt；8.0%)或控制较差(HbA1c 8.1-12%)的2型糖尿病患者中招募(45名受试者/组)，以及非糖尿病健康对照组受试者。所有患者(n=135)将从圣安东尼奥/德克萨斯州南部地区招募。这项研究旨在利用糖尿病的高患病率。在这片区域。结果：评估包括种植体失败(取出或未修复)、临床并发症、作为衡量种植体完整性的共振频率分析(RFA)、与口腔健康相关的生活质量、满意度和饮食。影响：这项建议通过检查血糖控制和种植治疗之间的特定关系，挑战了现有的用于缺乏良好血糖控制的糖尿病患者的牙科种植治疗的范例。它探索了植入治疗为血糖控制较差的糖尿病患者提供重要的功能、营养和生活质量好处的潜力。最终，这些信息将有助于建立以证据为基础的指南，用于评估和应用糖尿病患者的牙科种植治疗。

DESCRIPTION (provided by applicant): One of the more subtle complications of diabetes mellitus is a decrease in the patient's quality of life due to tooth loss and compromised function. While implant therapy has shown promise in patients with well- managed diabetes, questions remain as to the influence of this systemic condition on dental implant therapy. In fact, it may be those patients with inadequate glycemic control that have the most to gain by improvements in dietary control through implant therapy. Purpose: Our long-term goal is to develop the scientific rationale for the development of patient-specific, therapeutic protocols for implant care in diabetic patients. This study seeks to address the following aims: 1) Determine the impact of type 2 diabetes and glycemic control on dental implant integration, complications, and success both before and after functional loading. 2) Identify the impact of type 2 diabetes and glycemic control on oral health-related quality of life associated with the addition of implant-support to mandibular complete dentures. Methods: A parallel design, prospective study will assess dental implant integration, success, complications, oral health-related quality of life and satisfaction for edentulous patients with conventional dentures, and through 1 to 3.5 years after converting the denture to a 2-implant supported mandibular overdenture. Patients will be recruited (45 subjects/group) from well-controlled (HbA1c<8.0%) or poorly-controlled (HbA1c 8.1-12%) type 2 diabetic patients, and non-diabetic, healthy control subjects. All patients (n=135) will be recruited from the San Antonio/south Texas area. This study looks to capitalize on the high prevalence of diabetes. in this area. Outcomes: Assessments include implant failures (removal or non-restored), clinical complications, resonance frequency analysis (RFA) as a measure of implant integration, oral health-related quality of life, satisfaction, and diet. Implications: This proposal challenges existing paradigms regarding the utilization of dental implant therapy for diabetic patients lacking good glycemic control by examining the specific relationship between glycemic control and implant therapy. It explores the potential for implant therapy to provide important functional, nutritional, and quality of life benefits to diabetes patients with poorer glycemic control. Ultimately, this information will contribute to the establishment of evidence-based guidelines for the assessment and application of dental implant therapy for patients with diabetes.