糖尿病患者口腔种植治疗研究现状

2017年全世界有4.51亿(年龄18～99岁)糖尿病患者,预测至2035年这个数字将达5.92亿人,而糖尿病患者的一系列并发症常会导致其口腔相关的血管与骨组织病变,因此口腔种植科医生亟需了解糖尿病患者的临床特点以为其提供最佳的治疗方式。对于口腔种植医生而言,对血糖控制不良的糖尿病患者进行口腔种植治疗目前仍存在以下几项难题:①糖尿病患者拔牙后牙槽窝愈合缓慢,常需辅以引导骨再生术,从而延长治疗周期,增加患者痛苦;②糖尿病患者牙槽植骨后新骨生成率低;③糖尿病患者牙种植体取得有效骨结合所需时间长,效果差;④糖尿病患者牙种植体周围组织健康受血糖水平影响,维护不易。目前的研究认为,糖尿病患者当血糖水平得到很好控制时(HbA1c≤6%),种植体的远期成功率是可预期的。本文将对糖尿病患者口腔种植治疗的研究现状进行述评,以期为临床提供参考。

Current status of dental implantation therapy for diabetic patients

In 2017,there were 451 million people(ages 18 to 99)with diabetes worldwide,and this number is ex-pected to grow to 592 million by 2035.A series of complications in diabetic patients often leads to oral vascular and bone lesions.Therefore,dental implant doctors urgently need to understand the clinical characteristics of diabetes melli-tus patients to provide the best treatment.For dental implant doctors,the following problems still exist in the treatment of diabetic patients with poor blood sugar control:①alveolar fossa healing in diabetic patients is slow after extraction,and bone regeneration is often needed,which prolongs the treatment cycle and increases the pain of patients;②the rate of new bone formation in diabetic patients after alveolar bone grafting is slow;③it takes a long time for the body to achieve effective bone bonding after dental implantation in diabetic patients,and the outcomes are poor;④the health of the tissue around dental implants is affected by blood sugar level,which is difficult to maintain in diabetic patients.Current studies suggest that the long-term success rate of implants is predictable in diabetic patients when blood sugar levels are well controlled(HbA1c<6%).This article will review the current research status of dental implantation thera-py for diabetic patients to provide a reference for clinical practice.