Oliver Richard C, Tervonen Tellervo
Clinical Research Center for Periodontal Disease, University of Minnesota, Minneapolis, MN.
University of Oulu, Oulu, Finland.
J Periodontol. 1994 May;65 Suppl 5S:530-538. doi: 10.1902/jop.1994.65.5s.530.
With the increasing number of diabetics in an aging population and controversial research reports on the relationship of diabetes to periodontitis, clarification of diabetes as a risk factor for periodontitis would be helpful. This review notes variations in type, metabolic control, and duration of diabetes and highlights the results of studies that have considered these variations. Diabetics who maintained reasonably good metabolic control had not lost more teeth or experienced more periodontal attachment loss than non-diabetics, although they had more periodontal pockets. Poorly-controlled diabetics with extensive calculus on their teeth had more periodontitis and tooth loss than well-controlled diabetics or non-diabetics. Long-duration diabetics were also at greater risk for periodontitis. Mechanisms by which diabetes may contribute to periodontitis include vascular changes, neutrophil dysfunction, altered collagen synthesis, and genetic predisposition. Minimizing plaque and calculus in the oral cavity through careful self-care and regular professional care is important to reduce the risk of periodontitis in diabetics. J Periodontol 1994; 65:530-538.
随着老龄化人口中糖尿病患者数量的增加，以及关于糖尿病与牙周炎关系的研究报告存在争议，明确糖尿病作为牙周炎的一个风险因素将有所帮助。本综述指出了糖尿病类型、代谢控制情况及病程的差异，并着重介绍了考虑这些差异的研究结果。代谢控制相对良好的糖尿病患者，尽管牙周袋更多，但牙齿脱落数量并不比非糖尿病患者多，牙周附着丧失情况也不比非糖尿病患者严重。牙齿上有大量牙石且血糖控制不佳的糖尿病患者，比血糖控制良好的糖尿病患者或非糖尿病患者患牙周炎和牙齿脱落的情况更严重。糖尿病病程长的患者患牙周炎的风险也更高。糖尿病可能导致牙周炎的机制包括血管变化、中性粒细胞功能障碍、胶原合成改变以及遗传易感性。通过认真的自我护理和定期的专业护理来尽量减少口腔中的菌斑和牙石，对于降低糖尿病患者患牙周炎的风险非常重要。《牙周病学杂志》1994年；65:530 - 538。
