糖尿病患者内牙周病变的非手术与手术治疗：一项10年回顾性队列研究
Nonsurgical vs. Surgical Treatment of Endo-Perio Lesions in Diabetic Patients: A 10-Year Retrospective Cohort Study.
作者信息
Parihar Anuj Singh, Karbhari Cauvery N, Narayani Shwetha, Sinhababu Songbit, Singh Minerva, Laddha Rashmi
机构信息
Department of Periodontology, People's Dental Academy, Bhopal, Madhya Pradesh, India.
Department of Periodontology, ESIC Dental College and Hospital, Kalaburagi, Karnataka, India.
出版信息
J Pharm Bioallied Sci. 2025 May;17(Suppl 1):S615-S617. doi: 10.4103/jpbs.jpbs_62_25. Epub 2025 May 10.
BACKGROUND
Endo-perio lesions are challenging to manage in diabetic patients due to impaired healing and infection risk. This study compared long-term outcomes of nonsurgical and surgical treatments for these lesions.
METHODS
We analyzed 187 diabetic patients with endo-perio lesions. 92 received nonsurgical treatment (root canal treatment ± scaling and root planing) and 95 underwent surgery (apicoectomy ± guided tissue regeneration). The primary outcome was tooth retention (Kaplan-Meier analysis). Secondary outcomes included lesion resolution, probing depth reduction, clinical attachment level gain, and patient-reported pain/discomfort.
RESULTS
At 10 years, tooth retention was 82% (nonsurgical) and 75% (surgical) ( = 0.32). Both groups improved significantly ( < 0.05), but surgery yielded greater probing depth reduction and clinical attachment gain ( < 0.01). Surgical patients initially reported more discomfort, but pain levels were similar at 6 and 12 months.
CONCLUSIONS
Both approaches showed comparable long-term tooth retention. Surgical treatment enhanced periodontal healing but caused more initial discomfort.
背景
由于愈合受损和感染风险，糖尿病患者的牙髓-牙周联合病变难以处理。本研究比较了这些病变的非手术和手术治疗的长期效果。
方法
我们分析了187例患有牙髓-牙周联合病变的糖尿病患者。92例接受非手术治疗（根管治疗±龈下刮治和根面平整），95例接受手术治疗（根尖切除术±引导组织再生）。主要结局是牙齿保留情况（Kaplan-Meier分析）。次要结局包括病变消退、探诊深度降低、临床附着水平增加以及患者报告的疼痛/不适。
结果
10年后，牙齿保留率非手术组为82%，手术组为75%（P = 0.32）。两组均有显著改善（P < 0.05），但手术组探诊深度降低和临床附着增加更明显（P < 0.01）。手术患者最初报告的不适更多，但6个月和12个月时疼痛程度相似。
结论
两种方法的长期牙齿保留情况相当。手术治疗促进了牙周愈合，但最初引起的不适更多。
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