Miralles Lucia, Silvestre F Javier, Hernández-Mijares Antonio, Bautista Daniel, Llambes Fernando, Grau Diana
University of Valencia, Spain.
Med Oral Patol Oral Cir Bucal. 2006 May 1;11(3):E256-60.
Diabetes mellitus is one of the most common chronic diseases in the general population. A study is made of the presence of caries in type 1 diabetic patients. The specific aim was to determine whether such patients present a greater incidence of dental caries than non-diabetic individuals. An evaluation was also made of the relationship of caries to salivary flow and to factors inherent to the disease such as the degree of metabolic control, the duration of diabetes, and the existence of chronic complications.
The study comprised 90 type 1 diabetics between 18 and 50 years of age, and a group of non-diabetic controls matched for age and sex. Visual and tactile exploration of the dentition was carried out in all cases. Oral hygiene was rated based on the O'Leary plaque index, and basal (unstimulated) and stimulated salivary flow were evaluated in both groups. In the diabetic group, correlations were established with disease control based on the mean glycosylated hemoglobin (HbA1c) value corresponding to the two years prior to examination; evolution of the disease in years; and the existence of complications such as diabetic neuropathy or retinopathy.
Under similar conditions of oral hygiene and salivary flow, the diabetic group showed a higher incidence of caries than the control group (p<0.05). Likewise, on specifically analyzing the diabetic group, metabolic control of the disease, the duration of diabetes, and the existence of complications of the disease exerted an influence upon the development of dental caries.
Qualitative salivary studies are advised to better account for this increased incidence of caries in the diabetic population.
糖尿病是普通人群中最常见的慢性病之一。本研究针对1型糖尿病患者的龋齿情况展开。具体目标是确定此类患者的龋齿发病率是否高于非糖尿病个体。同时还评估了龋齿与唾液流量以及该疾病固有因素（如代谢控制程度、糖尿病病程和慢性并发症的存在）之间的关系。
该研究纳入了90名年龄在18至50岁之间的1型糖尿病患者，以及一组年龄和性别相匹配的非糖尿病对照组。所有病例均进行了牙列的视诊和触诊检查。根据奥利里菌斑指数对口腔卫生进行评分，并评估两组的基础（非刺激性）和刺激性唾液流量。在糖尿病组中，根据检查前两年的平均糖化血红蛋白（HbA1c）值与疾病控制情况建立相关性；记录疾病的病程年限；以及是否存在糖尿病神经病变或视网膜病变等并发症。
在口腔卫生和唾液流量相似的条件下，糖尿病组的龋齿发病率高于对照组（p<0.05）。同样，在对糖尿病组进行具体分析时发现，疾病的代谢控制、糖尿病病程以及疾病并发症的存在对龋齿的发生发展产生了影响。
建议进行唾液定性研究，以便更好地解释糖尿病患者中龋齿发病率增加的情况。
