Departments of Public HealthCommunity MedicineFamily Medicine, Jordan University of Science and Technology, Irbid, Jordan.
J Periodontal Res. 2010 Dec;45(6):741-7. doi: 10.1111/j.1600-0765.2010.01294.x.
Several studies have shown that periodontitis can complicate the severity of diabetes by worsening the degree of glycemic control. The purpose of this study was to determine the effect of full-mouth tooth extraction on glycemic control among type 2 diabetic patients.
A total of 58 patients with type 2 diabetes mellitus and advanced periodontitis who were requiring extraction of all remaining teeth were randomized consecutively into treatment (full-mouth tooth extraction) and control groups (no treatment). Eight patients were lost to follow-up or reported use of antibiotics, leaving 50 patients to be included in the analysis. All patients had all their remaining teeth in a hopeless condition. Relevant data were collected, and glycosylated hemoglobin (HbA(1c) ) and fasting blood glucose levels were measured at baseline and at follow-up times of 3 and 6 mo.
At baseline, the mean (SD) HbA(1c) level was 8.6% (1.24) in the treatment group and 7.7% (0.87) in the control group. In the treatment group, the mean HbA(1c) level decreased significantly from 8.6% at baseline to 7.4% after 3 mo of denture treatment, and continued to decrease to 7.3% after 6 mo. In the control group, the mean HbA(1c) decreased from 7.7% at baseline to 7.5% after 3 mo, and remained almost the same after 6 mo. After adjusting for the baseline HbA(1c) , the mean reduction in HbA(1c) after 3 mo in the treatment group [1.23% (0.79)] was significantly higher than the mean reduction in the control group [0.28% (0.87)].
Full-mouth tooth extraction resulted in an improvement in glycemic control among diabetic patients. Large-scale multicentre clinical trials are needed to confirm the current evidence.
多项研究表明，牙周炎可通过加重血糖控制程度使糖尿病恶化，从而使糖尿病的严重程度复杂化。本研究旨在确定全口拔牙对 2 型糖尿病患者血糖控制的影响。
连续随机将 58 例 2 型糖尿病伴重度牙周炎且需全口拔牙的患者分为治疗组（全口拔牙）和对照组（不治疗）。8 例患者失访或报告使用抗生素，50 例患者纳入分析。所有患者均存在所有余留牙无可救药的情况。收集相关数据，分别于基线和拔牙后 3 个月及 6 个月测量糖化血红蛋白（HbA1c）和空腹血糖水平。
基线时，治疗组的平均（标准差）HbA1c 水平为 8.6%（1.24），对照组为 7.7%（0.87）。治疗组的平均 HbA1c 水平从基线时的 8.6%显著下降至戴义齿 3 个月后的 7.4%，戴义齿 6 个月后继续下降至 7.3%。对照组的平均 HbA1c 从基线时的 7.7%下降至戴义齿 3 个月后的 7.5%，戴义齿 6 个月后基本保持不变。校正基线 HbA1c 后，治疗组戴义齿 3 个月时 HbA1c 的平均降低幅度[1.23%（0.79）]显著高于对照组[0.28%（0.87）]。
全口拔牙可改善糖尿病患者的血糖控制。需要开展大规模多中心临床试验来证实目前的证据。
