Department of Dentistry, Jawaharlal Institute of Post Graduate Medical Education and Research (JIPMER), 74, 4th Cross, Thanthai Periyar Nagar, Pondicherry, 605005, India.
Dept of Internal Medicine, Jawaharlal Institute of Post Graduate Medical Education and Research (JIPMER), Pondicherry, 605005, India.
Clin Oral Investig. 2021 Jan;25(1):179-185. doi: 10.1007/s00784-020-03349-7. Epub 2020 May 29.
Many dental surgeons consider a type 2 diabetic patient to be at higher risk for wound healing complications following exodontia. Random blood glucose (RBG) and glycosylated hemoglobin (HbA1C) values help the surgeon determine the glycemic control and assess if the patient can undergo the surgical procedure.
The purpose of this study was to analyze if preoperative HbA1C and RBG testing could predict the risk of wound healing and infectious complications in type 2 DM patients undergoing exodontia in an office setting.
This prospective observational study included 133 type 2 diabetic patients and age- and gender-matched non-diabetic patients undergoing exodontia. Preoperative HbA1C values and random blood glucose levels were obtained for patients in both groups. Wound healing and infectious complications and additional interventions performed were recorded.
Duration of diabetes ranged from 1 to 25 years. 80.5% of diabetics were treated with oral hypoglycemics. A vast majority of patients in both groups underwent extraction of only a single tooth. There was no significant difference in non-infectious complications between the two groups. The absolute risk of infectious complications in diabetics was 10.5% compared to a 6.8% risk among the control group. Age, RBG values, HbA1C, duration of DM, and number and nature of exodontia performed did not show any statistical significance.
This study observed a slight, but not statistically significant increase in the risk of infectious complications in type 2 DM patients undergoing exodontia. Surgical site infections were amenable to surgical drainage with or without oral antibiotics on an outpatient basis with favorable healing outcomes.
The RBG and HbA1C values were not significantly associated with risk of infectious complications. Resorting to prophylactic antibiotics and warning about possible adverse healing for routine exodontia in type 2 DM patients is unnecessary.
许多牙医认为 2 型糖尿病患者在拔牙后伤口愈合并发症的风险更高。随机血糖（RBG）和糖化血红蛋白（HbA1C）值有助于外科医生确定血糖控制情况，并评估患者是否可以接受手术。
本研究旨在分析术前 HbA1C 和 RBG 检测是否可以预测在办公室环境中接受拔牙的 2 型糖尿病患者的伤口愈合和感染并发症风险。
这项前瞻性观察研究包括 133 名 2 型糖尿病患者和年龄及性别匹配的非糖尿病患者，他们都接受了拔牙手术。记录两组患者的术前 HbA1C 值和随机血糖水平。记录伤口愈合和感染并发症以及进行的其他干预措施。
糖尿病病程从 1 年到 25 年不等。80.5%的糖尿病患者接受了口服降糖药治疗。两组中绝大多数患者仅拔除了一颗牙齿。两组之间在非感染性并发症方面没有显著差异。糖尿病患者的感染性并发症的绝对风险为 10.5%，而对照组的风险为 6.8%。年龄、RBG 值、HbA1C、糖尿病病程以及拔牙的数量和性质均与统计意义无关。
本研究观察到 2 型糖尿病患者拔牙后感染性并发症的风险略有增加，但无统计学意义。手术部位感染可通过手术引流解决，无论是否口服抗生素，都可在门诊进行，愈合效果良好。
RBG 和 HbA1C 值与感染性并发症的风险无显著相关性。对于 2 型糖尿病患者常规拔牙，无需预防性使用抗生素和告知可能出现不良愈合的风险。
