Grossi S G, Skrepcinski F B, DeCaro T, Zambon J J, Cummins D, Genco R J
Department of Oral Biology, School of Dental Medicine, State University of New York, Buffalo, USA.
J Periodontol. 1996 Oct;67(10 Suppl):1094-102. doi: 10.1902/jop.1996.67.10s.1094.
Diabetics and smokers are two patient groups at high risk for periodontal disease who also exhibit impaired wound healing and, therefore, constitute two different groups in whom the relationship between host-parasite interaction, outcome of periodontal therapy, and systemic factors is best represented. The results of two independent clinical trials involving treatment of periodontal disease in diabetics and smokers are presented. A new treatment regimen for the management of periodontal disease associated with diabetes mellitus is proposed. This treatment approach incorporates both antimicrobial agents and pharmacological modulation of the host response. Elimination of periodontal infection and reduction of periodontal inflammation in diabetic patients resulted in a significant short-term reduction in the concentration of glycosylated hemoglobin (HbA1c). Control of chronic infections and modulation of the host response offer a new therapeutic approach in the management of patients with both diabetes and periodontal disease. The effect of smoking on periodontal healing is also discussed. The clinical and microbiological response of smokers to non-surgical periodontal therapy is compared to non-smokers. In addition, possible mechanisms whereby diabetes mellitus and cigarette smoking increase the severity of periodontal disease are discussed.
糖尿病患者和吸烟者是患牙周病的两个高危患者群体，他们的伤口愈合也受到损害，因此，这两个不同的群体最能体现宿主与寄生虫相互作用、牙周治疗结果和全身因素之间的关系。本文展示了两项关于糖尿病患者和吸烟者牙周病治疗的独立临床试验结果。提出了一种治疗与糖尿病相关牙周病的新方案。这种治疗方法既包括抗菌药物，也包括对宿主反应的药理学调节。消除糖尿病患者的牙周感染和减轻牙周炎症，可使糖化血红蛋白（HbA1c）浓度在短期内显著降低。控制慢性感染和调节宿主反应为糖尿病和牙周病患者的管理提供了一种新的治疗方法。本文还讨论了吸烟对牙周愈合的影响。将吸烟者与非吸烟者对非手术牙周治疗的临床和微生物学反应进行了比较。此外，还讨论了糖尿病和吸烟加重牙周病严重程度的可能机制。
