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1.
糖尿病合并牙周炎患者的手指末梢血(FSB)血糖与龈沟血(GCB)血糖浓度高度一致,GCB和FSB中的糖化血红蛋白(GHbA1c)水平高度一致。在牙周病患者人群中,糖尿病的发病率约占其总数的2/3。即有大量的牙周病患者未被临床诊断出糖尿病,这些患者会定期地进行口腔疾病治疗,因此口腔医院是一个筛查糖尿病的重要场所。口腔医生在对牙周病患者进行牙周维护期诊疗的同时筛查其糖尿病,有助于患者糖尿病的早期诊断,早期干预,阻止其并发症发展;有助其制定诊疗方案,优化治疗效果。牙周探诊是牙周病特别是牙周炎诊断中最常用最重要的检查方法,利用探诊过程中的GCB来分析患者的血糖和GHbA1c水平,微创、简便、准确、省时和安全,可避免用FSB检测血糖水平时针刺取血操作烦琐、患者恐惧和疼痛显著的缺陷。  相似文献   

2.
目的:检测牙周健康者、慢性龈炎和慢性牙周炎患牙龈沟液中瘦素水平,为牙周炎的早期诊断提供客观指标。方法:选择牙周健康者、慢性龈炎和慢性牙周炎患者3组,治疗前记录牙周各项临床指标,并用Whatman 1号滤纸收集颊侧近远中牙周袋内GCF采用ELISA检测瘦素含量;同时收集血清进行瘦素水平的检测。结果:3组中慢性牙周炎组龈沟液中瘦素水平与牙周健康者龈沟液中瘦素水平比较有显著差异(P<0.05),慢性牙周炎组龈沟液中瘦素水平与慢性龈炎龈沟液中瘦素水平及慢性龈炎组龈沟液中瘦素水平与牙周健康者龈沟液中瘦素水平比较均无显著差异;牙周健康者、慢性龈炎和慢性牙周炎患者血液中瘦素水平比较均有显著差异(P<0.05)。血中的瘦素与临床指标PLI (P<0.01,r=0.593)、PD(P<0.05,r=0.920)、BI(P<0.05,r=0.862)、AL(P<0.05,r=0.846)均相关;龈沟液中的瘦素与临床指标PLI(P<0.01,r=0.813)、PD(P<0.05,r=0.962))、BI(P<0.05,r=0.720、AL(P<0.05,r=0.946)均相关。结论:龈沟液中瘦素水平可能是反映牙周组织状况的一项较为客观的指标。  相似文献   

3.
目的 探讨牙周基础治疗对伴 2型糖尿病的中、重度牙周炎患者牙周炎症控制、血清炎症指标以及糖代谢水平的影响。方法 将前期临床试验人群中的 56例中、重度牙周炎患者(平均临床附着水平> 3 mm)纳入本研究进行亚组分析,采用重复测量的方差分析比较治疗组和对照组牙周指数(包括平均探诊深度、临床附着水平和探诊出血指数)、超敏 C反应蛋白( hsCRP)、糖化血红蛋白( HbA1c)、空腹血糖在基线、 1.5个月、 3个月、 6个月连续 4次的变化。结果 伴2型糖尿病的中、重度牙周炎患者在牙周治疗后平均探诊深度( F=62.898,P=0.000)、临床附着水平( F=51.263,P=0.000)和探诊出血指数( F=75.164,P=0.000)在治疗后逐渐改善,其中平均探诊深度(t=-2.050,P=0.045)和探诊出血指数( t=-4.538,P=0.000)显著优于对照组;治疗后 hsCRP(F=6.391,P=0.010)、 HbA1c(F=4.536,P=0.011)、空腹血糖( F=3.073,P=0.031)降低,其中 hsCRP显著低于对照组( t=-2.261,P=0.028)。结论 牙周基础治疗有助于改善伴 2型糖尿病的中、重度牙周炎患者的牙周炎症和血清炎症指标以及糖代谢水平。  相似文献   

4.
目的探讨口腔卫生指导对2型糖尿病伴慢性牙周炎患者牙周状况和血糖水平的影响。方法 31例2型糖尿病伴慢性牙周炎患者,接受口腔卫生指导后,分别在基线、6周、3个月、6个月、12个月和18个月检测牙周临床指标和血糖代谢指标。牙周临床指标包括:探诊深度、附着丧失、探诊出血、菌斑指数;血糖代谢指标包括:空腹血糖、糖化血红蛋白。结果 31例患者基线、6周、3个月、6个月、12个月和18个月6个时间点的附着丧失量(P=0.003)和探诊出血阳性率(P=0.022)差异有统计学意义;其它指标如探诊深度(P=0.203)、菌斑指数(P=0.087)、空腹血糖(P=0.352)和糖化血红蛋白(P=0.071)的变化没有统计学意义。结论口腔卫生指导可以短期改善2型糖尿病伴慢性牙周炎患者的牙周炎症,但对牙周组织退缩没有更大的帮助,尚不能认为口腔卫生指导对血糖代谢有显著影响。  相似文献   

5.
糖尿病患者牙周非手术治疗对血糖水平的影响   总被引:25,自引:1,他引:24  
目的 探讨牙周非手术治疗对糖尿病患者牙周炎症控制及血糖水平的影响。方法 从83例胰岛素非依赖性糖尿病牙周炎患者中选出代谢控制不良的 31例 ,行牙周非手术治疗 ,测量并比较术前、术后 4、8周的探诊出血、探诊深度及糖化血红蛋白水平。结果 所有患者治疗后探诊出血、探诊深度明显减少。重度牙周炎患者糖化血红蛋白从 ( 9 86± 2 1 0 ) %降低为 ( 8 77± 1 62 ) % ,差异有显著性 (P <0 0 1 ) ;中轻度牙周炎患者糖化血红蛋白的变化差异无显著性 (P >0 0 5)。结论 糖尿病患者牙周炎症控制能在一定程度上改善代谢水平 ,但改善的效果可能与治疗前血糖水平和牙周状况有关  相似文献   

6.
目的探讨牙周基础治疗对2型糖尿病(T2DM)伴慢性牙周炎患者血清炎性细胞因子及糖化血红蛋白(HbAlc)含量的影响。方法选择2012年3月至2013年9月就诊于沈阳市口腔医院牙周科患者135例,其中T2DM伴慢性牙周炎患者63例(T2DM组),单纯慢性牙周炎患者72例(CP组);另从沈阳市口腔医院体检中心选择牙周健康正常人50名,作为正常对照组。于牙周基础治疗前及治疗后3个月,检查各组的牙周状况以及检测血清炎性细胞因子和HbAlc含量,并对检测结果进行比较分析。结果牙周基础治疗能改善慢性牙周炎患者的牙周健康状况,降低炎性细胞因子水平。牙周基础治疗前T2DM组和CP组的C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)及白细胞介素-6(IL-6)含量均高于正常对照组,差异有统计学意义(均P〈0.05)。与牙周基础治疗前比较,T2DM组和CP组的CRP、TNF-α及IL-6含量在牙周基础治疗后3个月均明显下降,差异有统计学意义(均P〈0.05)。牙周基础治疗前,T2DM组的HbAlc含量明显高于CP组和正常对照组;牙周基础治疗后3个月,T2DM组的HbAlc含量显著下降,且其治疗前后差异有统计学意义(P〈0.05)。结论 T2DM伴慢性牙周炎患者进行牙周基础治疗,可改善患者的牙周状况和全身健康状况,从而减少糖尿病及其并发症的发生和发展。  相似文献   

7.
目的:研究糖尿病前期患者其糖代谢水平与牙周炎症的相关性。方法:对171名糖尿病前期患者(30~65岁)进行牙周检查,根据探诊出血结果分为高探诊出血(H-BOP)和低探诊出血(L-BOP)比例组,检测2组糖代谢指标(空腹血糖、糖耐量、胰岛素抵抗及糖化血红蛋白)及牙周检查指标(菌斑指数、牙周袋深度、附着丧失、探诊出血比例),对混杂因素(年龄、性别等)等校正后用多因素回归分析方法研究糖代谢指标与牙周探诊出血的相关性。结果:与L-BOP组相比,H-BOP组患者的牙周袋深度、附着丧失水平、空腹血糖水平及糖耐量水平均明显增加(P<0.05);进行多因素回归分析后,随着空腹血糖水平、糖耐量水平的升高,患者为H-BOP的几率显著增加(OR=1.33,1.45),随着胰岛素抵抗水平(HOMA-IR)升高时,患者为H-BOP的几率也有增加(OR=1.20)。而糖化血红蛋白与空腹胰岛素升高时,患者为H-BOP的几率有减小,但相关差异无显著性。结论:糖尿病前期患者其糖代谢水平与牙周炎症有相关性。  相似文献   

8.
目的:探讨Ⅱ型糖尿病对牙周炎病人龈沟液白介素-1β(IL-1β)、前列腺素E2(PGE2)水平的影响及其与糖脂代谢情况的关系。方法:选择Ⅱ型糖尿病伴发牙周炎病人18例(DM组)、单纯牙周炎病人18例(PD组)和全身、牙周健康者18例(H组)为研究对象。分别测定各组糖化血红蛋白(HbA1C)、血脂水平以及龈沟液(gingival cervicular fluid GCF)中IL-1β、PGE2水平,并同时测定牙周龈沟出血指数、探诊深度、附着丧失等指标。结果:DM、PD组龈沟出血指数(SBI)、探诊深度(PD)、附着丧失(AL)、龈沟液PGE2水平明显高于H组(P〈0.05),DM与PD组无明显差异;DM组病人糖化血红蛋白、龈沟液IL-1B指标均明显高于PD、H组(P〈0.05);龈沟液IL-1β水平与HbA1C含量正相关。结论:糖尿病伴发牙周炎病人龈沟液IL-1β水平升高可能受全身因素影响,进一步促进牙周病变发展。  相似文献   

9.
目的探讨牙周非手术治疗对2型糖尿病伴慢性牙周炎患者牙周状况和血糖代谢水平的影响。方法 2型糖尿病伴慢性牙周炎患者135例,糖化血红蛋白(glycosylated hemoglobin,HbA1c)平均值(7.33±1.42)%,随机分为治疗组和对照组。治疗组接受牙周非手术治疗,对照组暂不接受治疗,只接受口腔卫生宣教。观察2组干预前及干预后3个月、干预后6个月的牙周临床指标,包括探诊深度(probing depth,PD)、菌斑指数(plaque index,PLI)、探诊出血(bleeding on probing,BOP)和血糖代谢指标,包括空腹血糖(fasting plasma glucose,FPG)、HbA1c的变化情况。结果同治疗前相比,治疗组全口平均PD(F=89.956,P=0.000)、PLI(F=82.399,P=0.000)、BOP(F=169.535,P=0.000)随时间推移下降,差异有统计学意义。对照组全口平均PD随时间推移差异无统计学意义(F=3.002,P=0.076);PLI(F=11.443,P=0.001)、BOP(F=6.537,P=0.008)下降有统计学意义。干预后6个月,组间比较PD(t=-3.318,P=0.001)、PLI(t=-4.354,P=0.000)、BOP(t=-5.868,P=0.000)差异有统计学意义。治疗组FPG(F=4.325,P=0.015)和HbA1c(F=6.654,P=0.003)随时间推移下降,差异有统计学意义;对照组FPG(F=0.215,P=0.756)和HbA1c(F=1.767,P=0.184)随时间推移变化无统计学意义;干预后6个月,两组间FPG(t=-1.386,P=0.171)和HbA1c(t=-1.065,P=0.289)差异无统计学意义。结论牙周非手术治疗能有效控制2型糖尿病伴牙周炎患者的牙周炎症;尚不能认为牙周非手术治疗可以改善糖尿病患者的血糖代谢。  相似文献   

10.
目的:分析糖尿病伴牙周炎的老年患者牙周炎症程度与糖尿病糖脂代谢紊乱之间的相关性。方法:151例糖尿病伴牙周炎患者,根据牙周炎症程度分为轻度和中重度牙周炎组,采用Logistic二元回归进行多因素分析患者空腹血糖、糖化血红蛋白、甘油三酯、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇的含量与牙周炎症程度的相关性。结果:血液中高含量的空腹血糖 OR=3.344(1.015-11.024)、糖化血红蛋白 OR=2.948(1.049-8.288)、甘油三酯OR=2.829(1.074-7.453)和低密度脂蛋白胆固醇OR=1.656(1.017-2.696)是构成老年糖尿病伴牙周炎患者病变加重的危险因素。结论:老年人糖尿病糖脂代谢紊乱与牙周炎炎症程度有明显相关性。  相似文献   

11.
Background: This pilot study examines whether a novel diabetes screening approach using gingival crevicular blood (GCB) could be used to test for hemoglobin A1c (HbA1c) during periodontal visits. Methods: Finger‐stick blood (FSB) samples from 120 patients and GCB samples from those patients with adequate bleeding on probing (BOP) were collected on special blood collection cards and analyzed for HbA1c levels in a laboratory. The Pearson correlation coefficient was used to measure correlation between FSB and GCB HbA1c values for 75 paired FSB and GCB samples. A receiver–operator characteristic curve (ROC) analysis was performed to determine an optimal GCB HbA1c criterion value for a positive diabetes screen. Results: For the 75 paired samples, the Pearson correlation coefficient was 0.842. The ROC analysis identified a criterion value of 6.3% for the GCB HbA1c test with high sensitivity (0.933) and high specificity (0.900), corresponding to FSB HbA1c values ≥6.5% (in the diabetes range). Using this GCB HbA1c criterion value for 27 additional paired samples, in which there was an unidentified component observed to coelute within the elution window of GCB HbA1c in the laboratory, there was agreement between FSB and GCB values for 24 of the pairs according to whether both were within or outside of the diabetes range. Conclusion: Using a criterion value of 6.3%, GCB samples are acceptable for HbA1c testing to screen for diabetes in most persons with BOP at the GCB collection site.  相似文献   

12.
To cite this article:
Int J Dent Hygiene 10 , 2012; 250–258
DOI: 10.1111/j.1601‐5037.2011.00542.x Rosedale MT, Strauss SM. Diabetes screening at the periodontal visit: patient and provider experiences with two screening approaches. Abstract: Objectives: This study examined patient and dental provider experiences during the periodontal visit of diabetes screening approaches involving the collection of gingival crevicular blood (GCB) and finger stick blood (FSB) for haemoglobin A1c (HbA1c) testing. Methods: At a large, urban, US periodontics and implant clinic, FSB samples from 120 patients and GCB samples from 102 of these patients were collected on special blood collection cards and sent to a laboratory for HbA1c testing, with test results sent to the patients from the laboratory. Quantitative and qualitative data from patients and qualitative data from providers were collected and analysed. Results: Quantitative and qualitative data support the feasibility and acceptability of the approaches described. Themes that arose from the interviews with providers and patients include ‘a good chance to check’, ‘patient choice’, ‘FSB versus GCB testing’ and ‘a new way of interacting and viewing the dental visit’. Conclusions: Periodontal patients and dental providers believe that the dental visit is an opportune site for diabetes screening and generally prefer GCB to FSB collection. HbA1c testing is well tolerated, convenient and acceptable to patients, and GCB testing reduces time and liability obstacles for dental providers to conduct diabetes screening.  相似文献   

13.
OBJECTIVE: Antioxidant defence reduces in diabetes mellitus (DM) and periodontitis. This study investigates antioxidant enzyme; superoxide dismutase (SOD) activity in gingiva and blood glucose and lipid levels in type-2 DM patients and systemically healthy individuals with chronic periodontitis (CP). MATERIALS AND METHODS: Periodontal parameters, blood glycated-haemoglobin (HbA1c), glucose and lipid levels, and gingival-SOD activities (spectrophotometric assay) were measured in 17 DM patients with CP (DMCP), 17 systemically healthy CP patients, 18 periodontally healthy DM patients (DMPH), and 17 healthy controls (PH). RESULTS: Periodontal parameters were higher in periodontitis groups than the controls (p<0.05), while there was no difference between the periodontitis groups and between the control groups. HbA1c, glucose, and triglyceride levels were higher in diabetic groups than the non-diabetic groups (p<0.05). Low-density lipoprotein (LDL), very-LDL and cholesterol values of the DMCP group did not significantly differ from the CP group. No differences existed between diabetic patients with and without periodontitis in HbA1c, glucose, and lipid levels and the same was true for non-diabetic patients with and without periodontitis. Gingival-SOD activity was lower in periodontitis groups than the matched control groups (p<0.05). DMPH group had the highest and CP group had the lowest SOD levels. There were correlations between periodontal parameters, gingival-SOD activity, HbA1c, glucose and high-density lipoprotein (HDL) levels. CONCLUSION: The results suggest that gingival-SOD activity increases in diabetes and decreases in periodontitis and relations may exist between gingival-SOD activity, periodontal status, HbA1c, glucose and HDL levels. The higher gingival-SOD activity in diabetes may be attributed to an adaptive mechanism in the tissue.  相似文献   

14.
目的 检测糖尿病儿童口腔常见致病菌的含量,探讨其与血糖控制水平的相关性.方法 选取学龄期糖尿病儿童40例和同期体检健康的学龄期儿童50名,收集龈上菌斑,采用DNA聚合酶联反应法(PCR)检测牙龈卟啉单胞菌(Pg)、伴放线放线杆菌(Aa)、中间普氏菌(Pi)及福塞坦氏菌(Tf)4种主要牙周致病菌的相对含量.采用Spearman单因素相关分析4种主要牙周致病菌的相对含量与血糖控制水平的相关性.结果 糖尿病儿童空腹血糖(FPG)、餐后2h血糖(2hPG)及糖化血红蛋白(HbA1c)高于对照组(P<0.05).糖尿病儿童Pg、Pi及Tf相对表达含量高于对照组(P<0.05),2组间Aa含量比较,差异无统计学意义(P>0.05).Pg、Pi及Tf均与FPG、2 hPG和HbA1c呈正相关(P<0.05).Aa与FPG、2 hPG和HbA1c无相关性(P>0.05).结论 糖尿病儿童口腔常见致病菌的相对表达含量升高,其含量与血糖控制水平相关.  相似文献   

15.
目的:观察牙周非手术治疗对2型糖尿病伴牙周病老年患者血糖(GLU)、糖化血红蛋白(HbA1c)水平的影响。方法:选择2型糖尿病伴牙周病老年患者107例,按糖尿病控制良好、不佳分为A、B两组,经牙周非手术治疗后随访,分析治疗前和治疗后4个月的牙周袋探诊深度(PD)、附着丧失(AL)以及GLU、HbA1c的水平。结果:A组治疗前牙周状况和B组相比,差异有显著性(P〈0.01)。两组患者治疗后牙周状况较治疗前均有改善,差异有显著性(P〈0.01),并且A组治疗效果好于B组,差异有显著性(P〈0.01)。牙周治疗后患者的GLU、HbA1c与治疗前均有改善,差异有显著性(P〈0.05)。结论:2型糖尿病伴牙周病老年患者的牙周健康状况与血糖控制状态有关。牙周非手术治疗可降低其GLU、HbA1c的水平,可以明显改善2型糖尿病伴牙周病老年患者的牙周健康状况。  相似文献   

16.
BACKGROUND: Patients with diabetes have increased incidence and severity of periodontal disease not accounted for by differences in the subgingival microbial infection. Poor glycemic control has been consistently associated with periodontal disease severity. Also, recent evidence suggests that hyperglycemia may induce inflammatory cytokine production. Few studies, however, have examined local biochemical measures of periodontal inflammation in patients with type 2 diabetes. The aim of this study was to determine whether glycemic control was related to gingival crevicular fluid (GCF) levels of interleukin-1beta (IL-1beta). METHODs: GCF samples were collected from 45 patients with type 2 diabetes and untreated chronic periodontitis. Plaque index (PI), bleeding on probing (BOP), probing depth (PD), and attachment level (AL) were recorded at six sites per tooth. IL-1beta levels were determined from individual GCF samples by enzyme-linked immunoabsorbent assay (ELISA). Individual site and mean patient values were calculated. Glycated hemoglobin (HbA1c) levels were measured from anticoagulated whole blood using an automated affinity chromatography system. Serum glucose was also determined. RESULTS: Clinical periodontal measures (PD, AL, BOP) and measures of glycemic control (HbA1c, random glucose) were significantly correlated with GCF IL-1beta. Patients with greater than 8% HbA1c had significantly higher mean GCF IL-1beta levels than patients with less than 8% HbA1c. In a multivariate model adjusting for age, gender, PD, AL, BOP, and PI, HbA1c and random glucose were independent predictors of high GCF IL-1beta. CONCLUSIONS: Poor glycemic control is associated with elevated GCF IL-1beta. These data are consistent with the hypothesis that hyperglycemia contributes to an heightened inflammatory response, and suggests a mechanism to account for the association between poor glycemic control and periodontal destruction.  相似文献   

17.
This report reviews the current understanding of the relationship between diabetes and root caries, and investigates the evidence for dental chairside testing of gingival crevicular blood (GCB) glucose levels to assess risk for type 2 diabetes mellitus. Diabetes is linked with the progression of periodontal disease and a greater number of exposed root surfaces at risk for root caries. The rapidly increasing prevalence of type 2 diabetes coupled with a general trend towards retention of teeth means that the number of patients with increased risk for root caries is expanding significantly. Many patients with diabetes or abnormal blood glucose levels are unaware of their condition or that they are at increased risk for oral disease. Systemic blood glucose concentrations are comparable to those found in GCB and therefore may be a useful adjunctive clinical aid in determining appropriate care for patients and providing timely referrals to general medical practitioners. Use of GCB testing within the dental clinic is described. It is proposed that future studies be undertaken to provide clinicians with improved risk assessment strategies and to evaluate GCB glucose screening models.  相似文献   

18.
Background:  To determine the effect of non-surgical periodontal therapy on serum TNF-α and HbA1c levels in poorly and well-controlled type 2 diabetic patients.
Methods:  In total, 45 patients were enrolled in the study; 30 patients with type 2 diabetes mellitus with periodontitis (15 with poorly controlled diabetes, HbA1c ≥ 7%, group 1A and 15 with well-controlled diabetes, HbA1c < 7%, group 1B) and 15 patients that were systemically healthy with periodontitis (group 2). The plaque index, gingival index, probing depth, clinical attachment loss, gingival bleeding index, HbA1c value, and circulating TNF-α concentration were measured at baseline and three months after the non-surgical periodontal therapy.
Results:  All periodontal parameters and serum TNF-α levels were significantly decreased three months after the non-surgical periodontal therapy compared to the baseline values in all groups. The HbA1c values were significantly decreased only in well-controlled diabetic patients. We found no significant differences in the periodontal parameters or TNF-α levels at baseline and after three months between the two groups.
Conclusions:  Although non-surgical periodontal therapy eliminates local/systemic infection and inflammation via decreases in TNF-α, it is insufficient for significantly reducing HbA1c levels without strict glycaemic control in poorly controlled diabetic patients in a short time period.  相似文献   

19.
Background: Patients with diabetes mellitus (DM) have a high prevalence of periodontitis. Periodontitis in these patients is characterized by severe inflammation and tissue breakdown, and its diagnosis is important for cures of periodontitis and DM. The purpose of this study is to investigate the levels of glycated albumin (GA), a DM marker, and calprotectin, an inflammatory marker, in gingival crevicular fluid (GCF) from patients with periodontitis and DM (DM‐P). Methods: The 78 participants in this study were patients with DM, chronic periodontitis (CP), DM‐P, and healthy individuals (H). GCF and blood were collected, and GA and calprotectin in GCF were analyzed using Western blotting and enzyme‐linked immunosorbent assay. Levels were compared among H, DM, CP, and DM‐P groups. Blood GA and glycated hemoglobin (HbA1c) were measured, and the correlation among GCF GA and blood HbA1c or GA levels was investigated. Receiver operating characteristic (ROC) analysis for GCF GA to predict DM was performed. Results: GA was identified in GCF, and its amount/concentration in GCF samples from DM and DM‐P were significantly higher than those of non‐DM groups (H and CP). Calprotectin amounts in GCF from CP and DM‐P were significantly higher than in H and DM groups. GCF GA level was positively correlated with blood HbA1c and GA level. ROC analysis of GCF GA showed an optimal cutoff value to predict DM. Conclusions: GA showed a high level in GCF from patients with DM. Examination of GA and calprotectin in GCF may be useful for predicting DM‐P.  相似文献   

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