M Jegan, Ahamed A Saneem, Lakshmi G Vijaya
Dentistry, Priyadarshini Dental College and Hospital, Chennai, IND.
Oral and Maxillofacial Surgery, Priyadarshini Dental College and Hospital, Chennai, IND.
Cureus. 2024 Oct 7;16(10):e70998. doi: 10.7759/cureus.70998. eCollection 2024 Oct.
Background Diabetes mellitus hinders wound healing after tooth extractions due to hyperglycemia, causing complications like infections and delayed recovery. The precise role of glycemic control in healing remains uncertain. This study aims to clarify it by comparing outcomes in patients with well-controlled and poorly controlled blood sugar levels. Material and methods This prospective observational study at Priyadarshini Dental College and Hospital (October-November 2023) involved 100 insulin-dependent diabetic patients (n = 100) requiring dental extractions, divided into group A with random blood sugar (RBS) ≤150 mg/dL (n = 50) and group B with RBS between 151 and 240 mg/dL (n = 50). Inclusion criteria included fully erupted teeth in patients aged 18 or older, while exclusion criteria comprised those on antibiotics, with systemic immunodeficiency, undergoing chemotherapy, or with active infections. Preoperative RBS and post-extraction wound dimensions were recorded, and clinical outcomes, such as pain, bleeding, infection, dry socket, and tissue color changes, were assessed on days 1, 7, and 14. Ethical approval was obtained from the Institutional Ethical Committee (IEC-PDCH5/4-2023) and the Indian Council of Medical Research (ICMR Reference ID: 2023-14931). Data were analyzed using chi-square and independent sample t-tests. Results The findings suggest that higher glycemic levels (151-240 mg/dL) are associated with increased pain and complications but do not significantly affect healing outcomes compared to levels ≤150 mg/dL. Group A shows better healing status, while group B has a higher incidence of moderate pain and bleeding. Conclusion This study indicates that glycemic levels between 151 and 240 mg/dL have no significant impact on post-extraction healing compared to levels ≤150 mg/dL in diabetic patients. Elevated blood sugar within this range may not increase the risk of delayed healing or complications. However, managing blood sugar levels is still critical, as uncontrolled diabetes can lead to adverse outcomes. Further research is required to determine the ideal glycemic range for optimal healing in diabetic patients.
糖尿病因高血糖会阻碍拔牙后的伤口愈合，引发感染和恢复延迟等并发症。血糖控制在愈合过程中的具体作用仍不明确。本研究旨在通过比较血糖控制良好和控制不佳患者的治疗结果来阐明这一问题。
这项在普里亚达尔希尼牙科学院和医院进行的前瞻性观察研究（2023年10月至11月）纳入了100例需要拔牙的胰岛素依赖型糖尿病患者（n = 100），分为A组（随机血糖[RBS]≤150 mg/dL，n = 50）和B组（RBS在151至240 mg/dL之间，n = 50）。纳入标准包括年龄在18岁及以上患者的完全萌出牙齿，排除标准包括正在使用抗生素、有全身免疫缺陷、正在接受化疗或有活动性感染的患者。记录术前RBS和拔牙后伤口尺寸，并在第1天、第7天和第14天评估疼痛、出血、感染、干槽症和组织颜色变化等临床结果。获得了机构伦理委员会（IEC-PDCH5/4-2023）和印度医学研究理事会（ICMR参考编号：2023-14931）的伦理批准。数据采用卡方检验和独立样本t检验进行分析。
研究结果表明，较高的血糖水平（151-240 mg/dL）与疼痛和并发症增加相关，但与≤150 mg/dL的水平相比，对愈合结果没有显著影响。A组愈合状况更好，而B组中度疼痛和出血的发生率更高。
本研究表明，与糖尿病患者≤150 mg/dL的血糖水平相比，151至240 mg/dL的血糖水平对拔牙后愈合没有显著影响。在此范围内血糖升高可能不会增加延迟愈合或并发症的风险。然而，控制血糖水平仍然至关重要，因为糖尿病控制不佳会导致不良后果。需要进一步研究以确定糖尿病患者实现最佳愈合的理想血糖范围。
