Diabetes: Implant Integration, Success, and Benefit

描述（由申请人提供）：糖尿病的一个比较微妙的并发症是由于牙齿脱落和功能受损而导致患者生活质量下降。虽然种植体治疗在治疗良好的糖尿病患者中显示出希望，但这种全身疾病对种植体治疗的影响仍然存在问题。事实上，可能是那些血糖控制不佳的患者通过植入治疗改善饮食控制获得的益处最大。目的：我们的长期目标是为糖尿病患者种植护理的患者特异性治疗方案的发展提供科学依据。本研究旨在解决以下目的：1)确定2型糖尿病和血糖控制对牙种植体整合、并发症和功能负荷前后成功的影响。2)确定2型糖尿病和血糖控制对下颌全口义齿添加种植支持相关的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体整合、成功、并发症、口腔健康相关生活质量和满意度，并在将义齿转换为双种植体支持的下颌覆盖义齿后1至3.5年。患者将从控制良好（HbA1c<8.0%）或控制不良（HbA1c 8.1-12%）的2型糖尿病患者和非糖尿病健康对照组中招募（45例/组）。所有患者（n=135）将从圣安东尼奥/南德克萨斯地区招募。这项研究希望利用糖尿病的高患病率。在这个地区。结果：评估包括种植体失败（移除或未修复）、临床并发症、共振频率分析（RFA）作为种植体整合的衡量标准、口腔健康相关生活质量、满意度和饮食。意义：本研究通过研究血糖控制与种植体治疗之间的具体关系，挑战了现有的关于糖尿病患者使用种植体治疗血糖控制不良的范式。它探索了植入治疗的潜力，为血糖控制较差的糖尿病患者提供重要的功能、营养和生活质量方面的益处。最终，这些信息将有助于建立以证据为基础的糖尿病患者种植牙治疗评估和应用指南。

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.