2型糖尿病患者血糖控制对种植体龈沟牙周致病菌的影响

摘要

Objective:To investigate the effect of glycemic control on the quantity and presence rate of implant bone binding and gingival pathogens in patients with type 2 diabetes mellitus. Methods:A to-tal of 106 patients with type 2 diabetes and periodontitis were collected and divided into glycated hemoglo-bin(HbA1c) <8% group(48 cases) and HbA1c≥8% group(58 cases) according to HbA1c value.The age of two groups of patients,HbA1c,plaque index and depth of periodontal detection were recorded.The subgingival plaque of the selected teeth was collected and the distribution and detection of 6 suspicious pathogenic bacteria were detected by polymerase chain reaction(PCR). Results:Compared with HbA1c<8% group,sulcus bleeding index and probing depth in HbA1c≥8% group were significantly higher (P<0.05).The bacterial quantity and the detection rate of periodontal pathogens[Tannerella forsythia (Tf),Prevotella intermedia(Pi) and Fusobacterium nucleatum(Fn)] in HbA1c≥8% group were signifi-cantly higher than those in HbA1c<8% group(P<0.05). Porphyromonas gingivalis(Pg), Tf and Fn were positively correlated with HbA1c (P <0.05),but the level of Pi was negatively correlated with HbA1c(P<0.05). Conclusion:HbA1c of diabetic patients is correlated with the reproduction of sub-gingival periodontal pathogens and it may be implicated good and stable glycemic control should be bene-ficial to long-term stability of implant.%目的:观察2型糖尿病患者的血糖控制对种植体龈沟牙周致病菌的影响.方法:收集接受种植牙手术的106例2型糖尿病伴牙周炎的患者,按糖化血红蛋白(HbA1c)值分为HbA1c<8%组(48例)和HbA1c≥8%组(58例).比较两组患者的年龄、HbA1c比例、菌斑指数、牙周探诊深度.采集入选牙位的龈下菌斑,采用聚合酶链式反应(PCR)检测6种可疑牙周致病菌数量并统计检出率;分析龈下病菌感染与HbA1c的相关性.结果:HbA1c≥8%组患者龈沟出血指数、探诊深度、福塞坦氏菌、中间普氏菌和具核梭杆菌数量和检出率均明显高于HbA1c<8%组(P均<0.05);牙龈卟啉单胞菌、福塞坦氏菌和具核梭杆菌与患者 HbA1c呈正相关(P<0.05),中间普氏菌与HbA1c呈负相关(P<0.05).结论:糖尿病患者的血糖水平与种植体龈下牙周致病菌菌群的繁殖有相关性.