糖尿病患者种植义齿周围软硬组织变化的相关研究

发布时间：2018-03-26 03:20

  本文选题：糖尿病　切入点：种植义齿　出处：《华北理工大学》2017年硕士论文

【摘要】：目的以糖化血红蛋白(Hb A1c)的高低值为分组标准,通过对比三组不同范围Hb A1c的糖尿病患者种植体周围软硬组织的变化情况以及种植体周围组织病的发生率和种植体的成功率,来研究Hb A1c水平高低对种植体周围软硬组织的影响,从而为糖尿病(DM)种植患者后期的种植体维护和血糖的控制范围提供理论依据和数据支持。方法实验对象的选择:根据病例纳入和排除标准,选取我院口腔科2014年1月至2016年7月以来期望进行口腔种植的患者,其中2型DM患者48例,健康者36例。对患者术前1个月,术后3、6、9、12个月的Hb A1c水平进行监测,排除Hb A1c波动水平较大者(即CV%10%),然后将Hb A1c平均值作为分组依据将DM患者分为B组(6Hb A1c≤8.0)30例,C组(8.0Hb A1c10.0)18例,健康组为A组(Hb A1c≤6.0)36例。实验方法:记录患者年龄和性别,手术当天测空腹血糖,要求控制在6.7~12.2mmol/L以内。在手术后4个月左右进行冠修复,要求患者按时随访复诊,测量并记录三组种植体修复时、修复后半年和一年,三次复查时的种植体的改良龈沟出血指数(ms BI)、探诊深度(PD)和边缘骨水平(MBL)的变化值,并评估种植体周围组织病的发生率和种植成功率。统计学方法:PD及MBL变化值的组间比较采用单因素方差分析,率的比较采用卡方检验,ms BI计分数的组间比较采用秩和检验,统计学软件采用SPSS19.0。结果1三组性别、年龄比较无差异(P均0.05);2对种植体修复时、修复后半年和修复后一年时PD的变化值进行A、B、C三组间的比较,方差分析结果显示组间差异无统计学意义(P0.05);3对A、B、C三组种植体修复时、修复后半年和修复后一年时MBL的变化值进行组间比较,两两比较的方差分析结果显示C组MBL的变化值均高于A、B两组(半年时P_A=0.041,P_B=0.035;一年时P_A=0.021,P_B=0.032),差异均具有统计学意义,而A、B两组间比较无统计学差异,而修复后半年和修复后一年时MBL的变化值组间比较差异无统计学意义;4对A、B、C三组种植体在修复时的ms BI计分数进行比较,秩和检验结果显示组间差异无统计学意义(P0.05),在对种植修复后半年和一年的ms BI计分数进行比较时,C组的ms BI计分数均要高于A、B两组(半年时P_A=0.016,P_B=0.028;一年时P_A=0.034,P_B=0.031),差异均具有统计学意义,而A、B两组间比较无统计学差异;5种植体修复一年后发现,三组间周围组织病发生率比较有统计学差异(P=0.048);6种植体修复一年后发现,三组间种植成功率的比较无统计学差异(P0.05)。结论1种植义齿骨结合成功率较高,但高HbA1c水平会增加骨的吸收;2Hb A1c水平升高,会增加种植体周围探诊出血的可能性;3 DM患者种植的成功率在短期内(一年内)较高,远期效果如何需长期随访观察;4 Hb A1c的升高会增加种植体周围组织病的发生率,2型DM患者的牙周组织变化与血糖控制有关。
[Abstract]:With the purpose of glycosylated hemoglobin (Hb A1c) the level of value for patients with diabetes by grouping criteria, compared three groups of different Hb A1c planting changes of body hard and soft tissue and peri implant tissue disease incidence rate and the success rate of implant, to study effects of Hb A1c on the level of peri implant soft tissue diabetes mellitus (DM), so as to provide a theoretical basis and data support the control range of implants with the late implant maintenance and blood glucose. Methods the choice: according to the inclusion and exclusion criteria, since January 2014 to July 2016 in our hospital department of Stomatology expectations for oral implant patients, including 48 cases of type 2 DM patients, 36 cases healthy subjects. In 1 patients before operation, monitoring the level of A1c Hb 3,6,9,12 months after operation, Hb A1c excluded larger fluctuation level (CV%10%), and then Hb A1c as average packet On the basis of the DM patients were divided into B group (6Hb A1c 8) 30 cases, group C (8.0Hb A1c10.0) 18 cases, healthy group and A group (Hb A1c 6) in 36 cases. Methods: records of patients age and gender, the day of surgery fasting blood glucose control, within 6.7~12.2mmol/L after the operation. About 4 months of crown repair, requiring patients to follow-up on time, measure and record the three groups of implant restoration, repair after half a year and one year, modified sulcus implant three review the bleeding index (MS BI), probing depth (PD) and the marginal bone level (MBL) changes the value and evaluation of peri implant disease incidence rate and success rate of planting. Statistical methods: PD and MBL values were compared by single factor variance analysis, were compared using the chi square test, MS BI scores between groups using the Wilcoxon rank sum test, using statistical software SPSS19.0. 1 results in three groups there is no gender, age 宸�寮�(P鍧，

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