Schmalz Gerhard, Schiffers Nora, Schwabe Sandra, Vasko Radovan, Müller Gerhard A, Haak Rainer, Mausberg Rainer F, Ziebolz Dirk
Department of Cariology, Endodontology, and Periodontology, University of Leipzig, Leipzig, Germany.
Department of Preventive Dentistry, Periodontology, and Cariology, University Medical Center Goettingen, Goettingen, Germany.
Int Dent J. 2017 Jun;67(3):186-193. doi: 10.1111/idj.12282. Epub 2017 Feb 2.
The aim of this cross-sectional study was to evaluate the dental and periodontal health, as well as the microbiological and salivary conditions, of patients with and without diabetes mellitus (DM) who are receiving haemodialysis.
One-hundred and fifty-nine haemodialysis patients were included and divided into groups according to the pre-existing diabetes status: DM or no DM. The oral examination included dental findings and assessment of the periodontal situation. The periodontal condition was classified as healthy/mild, moderate or severe periodontitis. Subgingival biofilm samples were analysed using the polymerase chain reaction. The salivary diagnostics included measurement of unstimulated and stimulated salivary flow, pH and buffer capacity. Statistical analyses used Fisher's test, the t-test and the Mann-Whitney U-test (α = 5%).
The dental findings showed no significant difference between patients with and without DM (P = 0.44). The prevalence of periodontitis was high (96% in patients with DM and 97% in patients who did not have DM) and there was no significant difference between the groups (P = 0.71). There was a higher prevalence of Porphyromonas gingivalis, Parvimonas micros, Eubacterium nucleatum and Capnocytophaga spp. in patients without DM (P < 0.05). The salivary pH was significantly higher in patients without DM (P < 0.01).
While differences in the prevalence of periodontal pathogenic bacteria and in the salivary pH were detected between the groups, the dental and periodontal status was comparable between patients with and without DM. Accordingly, DM appears to have no decisive influence on the oral health in patients treated with haemodialysis who have well-controlled diabetes.
本横断面研究旨在评估接受血液透析的糖尿病患者与非糖尿病患者的牙齿和牙周健康状况，以及微生物和唾液状况。
纳入159例血液透析患者，根据既往糖尿病状况分为糖尿病组和非糖尿病组。口腔检查包括牙齿检查和牙周状况评估。牙周状况分为健康/轻度、中度或重度牙周炎。使用聚合酶链反应分析龈下生物膜样本。唾液诊断包括测量非刺激性和刺激性唾液流量、pH值和缓冲能力。统计分析采用Fisher检验、t检验和Mann-Whitney U检验（α = 5%）。
牙齿检查结果显示糖尿病患者与非糖尿病患者之间无显著差异（P = 0.44）。牙周炎患病率较高（糖尿病患者为96%，非糖尿病患者为97%），两组之间无显著差异（P = 0.71）。非糖尿病患者牙龈卟啉单胞菌、微小单胞菌、具核梭杆菌和二氧化碳嗜纤维菌属的患病率较高（P < 0.05）。非糖尿病患者的唾液pH值显著更高（P < 0.01）。
虽然两组之间在牙周病原菌患病率和唾液pH值方面存在差异，但糖尿病患者与非糖尿病患者的牙齿和牙周状况相当。因此，对于糖尿病得到良好控制的接受血液透析的患者，糖尿病似乎对口腔健康没有决定性影响。
