Seshima Fumi, Nishina Makiko, Namba Takashi, Saito Atsushi
Department of Periodontology, Tokyo Dental College.
Bull Tokyo Dent Coll. 2016;57(2):97-104. doi: 10.2209/tdcpublication.2015-0041.
We report a case of generalized chronic periodontitis and type 2 diabetes mellitus requiring periodontal treatment including regenerative therapy. The patient was a 66-year-old man who presented with the chief complaint of gingival inflammation and mobile teeth in the molar region. He had been being treated for type 2 diabetes mellitus since 1999. His glycated hemoglobin (HbA1c) level was 7.8%. An initial examination revealed sites with a probing depth of ≥7 mm in the molar region, and radiography revealed angular bone defects in this area. Based on a clinical diagnosis of generalized chronic periodontitis, the patient underwent initial periodontal therapy. An improvement was observed in periodontal conditions on reevaluation, and his HbA1c level showed a reduction to 6.9%. Periodontal regenerative therapy with enamel matrix derivative was then performed on #16, 26, and 27. Following another reevaluation, a removable partial denture was fabricated for #47 and the patient placed on supportive periodontal therapy (SPT). To date, periodontal conditions have remained stable and the patient's HbA1c level has increased to 7.5% during SPT. The results show the importance of collaboration between dentist and physician in managing periodontal and diabetic conditions in such patients.
我们报告一例需要包括再生治疗在内的牙周治疗的广泛性慢性牙周炎和2型糖尿病患者。患者为一名66岁男性，主要诉求为磨牙区牙龈炎症和牙齿松动。自1999年以来，他一直在接受2型糖尿病治疗。他的糖化血红蛋白（HbA1c）水平为7.8%。初步检查发现磨牙区探诊深度≥7mm的部位，影像学检查显示该区域有角形骨缺损。基于广泛性慢性牙周炎的临床诊断，患者接受了初步牙周治疗。复查时观察到牙周状况有所改善，他的HbA1c水平降至6.9%。然后对16、26和27号牙进行了釉基质衍生物牙周再生治疗。再次复查后，为47号牙制作了可摘局部义齿，并让患者接受支持性牙周治疗（SPT）。迄今为止，牙周状况保持稳定，患者在接受SPT期间HbA1c水平升至7.5%。结果表明，在管理此类患者的牙周和糖尿病状况时，牙医和医生之间合作的重要性。
