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2型糖尿病患者的根尖周炎与血糖控制:横断面研究

Apical periodontitis and glycemic control in type 2 diabetic patients: Cross-sectional study.

作者信息

Pérez-Losada Flor de Liz, López-López José, Martín-González Jenifer, Jané-Salas Enric, Segura-Egea Juan J, Estrugo-Devesa Albert

机构信息

DDS, Doctoral fellow, Department of Odontostomatology, Faculty of Medicine and Health Sciences, University of Barcelona. L'Hospitalet de Llobregat, Barcelona, Spain.

MD, DDS, PhD, Professor, Department of Odontostomatology, Faculty of Medicine and Health Sciences, University of Barcelona- Dental Hospital, University of Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain.

出版信息

J Clin Exp Dent. 2020 Oct 1;12(10):e964-e971. doi: 10.4317/jced.57191. eCollection 2020 Oct.

Abstract

BACKGROUND

The objective of this study was to analyze the possible relationship between the glycemic control and the prevalence of apical periodontitis in type 2 diabetic patients. The null hypothesis was that apical periodontitis is not associated with glycemic control.

MATERIAL AND METHODS

In a cross-sectional design, the radiographic records of 216 type 2 diabetic patients (65.0 ± 10.7 years), 117 men (54.2%) and women (45.8%), were examined. Glycated hemoglobin (HbA1c) was used to assess glycemic control, considering an HbA1c level < 6.5% as well-controlled diabetes. Apical periodontitis was diagnosed as radiolucent periapical lesions using the periapical index score. The Student t test, chi-square test, and logistic regression analysis were used in the statistical analysis.

RESULTS

The average HbA1c value was 7.0 ± 2.2%. Forty seven (21.8%) had HbA1c levels under 6.5% (mean ± SD = 6.0 ± 2.2%), being considered well-controlled patients, and 169 (78.2%) had an HbA1c level ≥ 6.5% (mean ± SD = 7.8 ± 2.24%), being considered poor controlled patients. Forty four per cent of diabetics had apical periodontitis, 12.5% had root-filled teeth, and 52.3% had root filled teeth with radiolucent periapical lesions. No significant differences were observed in any of these three variables between patients with good or poor glycemic control. In the multivariate logistic regression analysis the presence of radiolucent periapical lesions in at least one tooth did not correlate significantly with HbA1c levels (OR = 1.4; 95% C.I. = 0.70 - 3.09; = 0.31).

CONCLUSIONS

The results reveal no association of glycemic control with the prevalence of apical periodontitis or root canal treatment in diabetic patients. Apical periodontitis, diabetes mellitus, endodontic medicine, glycated haemoglobin.

摘要

背景

本研究的目的是分析2型糖尿病患者血糖控制与根尖周炎患病率之间的可能关系。无效假设是根尖周炎与血糖控制无关。

材料与方法

采用横断面设计,检查了216例2型糖尿病患者(65.0±10.7岁)的影像学记录,其中男性117例(54.2%),女性99例(45.8%)。糖化血红蛋白(HbA1c)用于评估血糖控制情况,将HbA1c水平<6.5%视为糖尿病控制良好。根尖周炎通过根尖指数评分诊断为根尖周透射性病变。统计分析采用Student t检验、卡方检验和逻辑回归分析。

结果

平均HbA1c值为7.0±2.2%。47例(21.8%)患者的HbA1c水平低于6.5%(平均值±标准差=6.0±2.2%),被视为血糖控制良好的患者;169例(78.2%)患者的HbA1c水平≥6.5%(平均值±标准差=7.8±2.24%),被视为血糖控制不佳的患者。44%的糖尿病患者患有根尖周炎,12.5%的患者有根管充填牙,52.3%的患者有根尖周透射性病变的根管充填牙。血糖控制良好或不佳的患者在这三个变量中的任何一个上均未观察到显著差异。在多因素逻辑回归分析中,至少一颗牙齿存在根尖周透射性病变与HbA1c水平无显著相关性(比值比=1.4;95%置信区间=0.70 - 3.09;P=0.31)。

结论

结果显示糖尿病患者的血糖控制与根尖周炎患病率或根管治疗之间无关联。根尖周炎、糖尿病、牙髓病学、糖化血红蛋白。

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