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血糖控制质量是否应指导糖尿病患者的牙种植治疗?关注:种植体周围疾病。

Should Quality of Glycemic Control Guide Dental Implant Therapy in Patients with Diabetes? Focus on: Peri-Implant Diseases.

作者信息

Aldahlawi Salwa, Nourah Dalia, Andreana Sebastiano

机构信息

Department of Basic and Clinical Oral Sciences, Faculty of Dentistry, Umm Al-Qura University, Makkah, Saudi Arabia.

School of Dental Medicine, University at Buffalo, Buffalo, NY, USA.

出版信息

Clin Cosmet Investig Dent. 2021 Apr 21;13:149-154. doi: 10.2147/CCIDE.S297467. eCollection 2021.

Abstract

BACKGROUND AND AIM

Traditionally patients with metabolic conditions such as diabetes mellitus are considered not suitable candidates for dental implant therapy due to increased risk of infection, impaired bone healing or the potential for vascular complications. Peri-implantitis as the more progressive form of peri-implant disease involves bone loss and estimated to occur in nearly half of all implant cases long-term. Despite extensive research on association of hyperglycemia with dental implants in preclinical and animal models, translational effort to clinical practice is hampered by discrepancies in reported outcome indicators for peri-implantitis in patients with a spectrum of glycemic profiles. This review aims to evaluate clinical evidence for peri-implant disease in metabolically compromised patients and in particular in patients with poorly-controlled diabetes in order to inform clinical management of peri-implant disease.

MATERIALS AND METHODS

A comprehensive literature review was performed utilizing PubMed database and using the key word 'diabetes' combined with "dental implant" or "Periimplantitis" or/and "Preimplant disease".

RESULTS

Clinical studies with follow up more than 1year, systematic review and meta-analysis that evaluated peri-implant disease in diabetic patients in relation to glycemic control were taken into consideration in this review.

CONCLUSION

Studies reported conflicting results regarding the long-term effect of diabetes on peri-implant health regardless of the level glycemic control. Therefore, interpretation of finding and relevance to clinical practise should be considered on individual bases.

摘要

背景与目的

传统上,患有糖尿病等代谢性疾病的患者被认为不适合接受牙种植治疗,因为感染风险增加、骨愈合受损或存在血管并发症的可能性。种植体周围炎作为种植体周围疾病更进展的形式,涉及骨质流失,据估计在所有长期种植病例中近一半会发生。尽管在临床前和动物模型中对高血糖与牙种植体的关联进行了广泛研究,但血糖谱范围不同的患者种植体周围炎报告结果指标的差异阻碍了向临床实践的转化。本综述旨在评估代谢受损患者,特别是糖尿病控制不佳患者种植体周围疾病的临床证据,以便为种植体周围疾病的临床管理提供参考。

材料与方法

利用PubMed数据库进行全面的文献综述,使用关键词“糖尿病”与“牙种植体”或“种植体周围炎”或/和“种植前疾病”相结合。

结果

本综述考虑了随访时间超过1年的临床研究、评估糖尿病患者种植体周围疾病与血糖控制关系的系统评价和荟萃分析。

结论

无论血糖控制水平如何,关于糖尿病对种植体周围健康的长期影响,研究报告的结果相互矛盾。因此,应根据个体情况考虑研究结果的解读及其与临床实践的相关性。

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