牙周病与糖尿病关系的研究进展

牙周病主要包括牙龈炎和牙周炎,是人类最常见的感染病之一,严重的牙周炎有可能增加心血管病、糖尿病、早产及肺部感染等系统性疾病的易感性。近年来,牙周病与全身性疾病的关系不仅引起国内外口腔医学界学者的关注,同时也受到其他医学界的重视。其中牙周病与糖尿病关系的研究更是倍受瞩目。目前,牙周病与糖尿病之间的关系虽已基本确立,但两者相互作用的内在机制尚未完全明确。本文总结有关牙周病与糖尿病关系方面的资料,对牙周病感染增加糖尿病易感性作综合阐述。     

老年人牙周病的治疗与糖尿病的关系

随着年龄的增大,老年人牙周病的患病率和严重程度均增加,同时患糖尿病等全身性疾病的几率也增高。本文总结有关老年人牙周病与糖尿病的相互关系。     

武汉市公务员糖尿病与牙周炎相关性调查研究

目的：对武汉市国家公务员的牙周状况及血糖情况进行调查,探讨糖尿病与牙周炎的相关性。方法：2004.11～12月,对武汉市国家公务员以工作单位为抽样框进行随机整群抽样,对493人进行了血糖及牙周状况的横断面调查,其中458人符合纳入标准作为研究对象,再把研究对象分为中青年年龄段（30～59岁）与老年年龄段（60岁以上）分别进行研究。最终资料通过χ2检验及Logistic多因素回归分析进行统计学分析。结果：在单因素分析中,糖尿病与牙周炎具有相关性;在整个人群的多因素分析中,以年龄在30～39岁这一组作为对照时,年龄在40～49岁组,50～59岁、70岁以上组与之相比没有显著差异（P〉0.05）,而60～69岁组与之相比有统计学差异（P〈0.05）.说明在60～69岁这一年龄段患牙周炎的风险增加。老年组人群（60岁以上）血糖值与牙周炎在统计学上呈正相关。提示血糖超过7.0mmol/L（OR=6.906,CI1.274～37.424）是牙周炎的危险因素。结论：糖尿病为牙周炎患病的危险因素,对牙周炎患病的影响主要在老年阶段（60岁以上）。     

肾病患者牙周病流行病学调查报告

肾病患者牙周病流行病学调查报告赵广军①夏镇斌①程玉华①夏缨①吕晓光②①天津市解放军２５４医院（３００１４２）②秦皇岛市第二八一医院肾病中心（０６６１０５）牙周病是口腔科罹患率最高的多发病、常见病之一。其病因复杂，并且许多种疾病如糖尿病、甲状腺功能亢进...     

粤西北连南瑶族成人牙周病流行病学调查

目的：调查粤西北连南瑶族成人牙周病流行情况,为开展瑶族人牙周病防治措施提供依据。方法：采用多阶段分层等容量随机抽样方法,抽取连南县城和各乡镇的720名瑶族成人,进行牙周病流行病学调查。结果：连南瑶族成人牙周病检出率91．81％,晚期牙周病检出率50．84％,牙周病检出率随着年龄的增长而增高,且乡镇明显高于县城（χ2＝28．08,P＜0．01）,男性明显高于女性（χ2＝8．15,P＜0．01）。牙石检出率乡镇明显高于县城（χ2＝19．89,P＜0．01）,男性明显高于女性（χ2＝8．17,P＜0．01）。牙龈出血检出率乡镇明显高于县城（χ2＝11．39,P＜0．01）,男性明显低于女性（χ2＝85．77,P＜0．01）。结论：连南瑶族成人牙周病的流行情况较严重,且城乡、男女性别差异明显,预防工作应以乡镇和男性瑶族人为重点,进行口腔卫生宣教和戒烟宣传,加强对牙周病系统治疗、洁牙和及时镶牙的宣传,提高瑶族人牙周病就诊率和治疗率,从而降低牙周病患病率。     

132例老年人糖尿病与牙周病相互关系的临床观察

糖尿病与牙周炎密切相关,具有双向相互作用,有共同的发病基础。近些年学者提出将牙周炎列为糖尿病的第六并发症,患有糖尿病的牙周炎患者,如血糖未能被很好的控制,牙周病变的发展有其特殊性。糖尿病患者的血糖控制情况、患病的年限与牙周病牙槽骨吸收破坏程度的比例关系,本研究旨在观察。     

糖尿病患者口腔疾病的流行病学调查

目的对糖尿患者群所患口腔疾病进行流行病学调查并研究其防治对策。方法根据WHO《口腔健康调查方法》,参照“全国第二次口腔流行病学调查方法”,糖尿病按WHO诊断标准,对大庆市中直企业32677人进行健康体检。诊断糖尿病患者432例,并随机抽取无系统性疾病健康者432例作为对照组。两组人群均由经过统一培训医生进行口腔检查。结果在糖尿病患者432例中,有376例(87.37%)患有各种口腔疾病,其中牙周病360例(83.33%)。对照组432例中,208例(48.15%)患有各种口腔疾病,其中牙周病168人(38.89%)。两组差异有显著性(P<0.05)。结论糖尿病患者口腔疾病发生率高,其中以牙周病为多。     

牙周病就诊原因流行病学调查

目的调查研究牙周病就诊原因流行病学的状况。方法对我院2008年1月1日—12月31日983例牙周科就诊患者的就诊原因进行回顾性分析,了解其流行病学情况。结果就诊原因最主要的症状中排在前3位的依次是牙龈出血、牙齿松动、牙周脓肿。结论加强口腔卫生宣教是预防和治疗牙周病的一个重要内容。     

孕妇牙周病与胎膜早破的相关性研究

目的:本研究通过检查比较胎膜早破孕妇与正常孕妇牙周健康状况,分析牙周健康状况与胎膜早破的关系,为胎膜早破的病因提供一定的临床依据。方法:选择早产胎膜早破(PPROM)孕妇18例、足月胎膜早破(PROM)孕妇20例作为实验组,足月正常孕妇(Non-PROM)28例作为对照组。检查牙周状况记录菌斑指数(PLI)、探诊深度(PD)和龈沟出血指数(SBI)。结果:胎膜早破组牙龈炎症明显,牙周状况差,PLI、SBI均高于正常对照组,差异有统计学意义(P<0.05)。各组间探诊深度无明显差别,无统计学意义。结论:牙周病可能是导致胎膜早破的原因之一。孕期及孕前的口腔保健及口腔健康教育,是预防和减少不良妊娠结局发生的有效措施。     

Ⅱ型糖尿病患者的牙周病治疗及影响疗效的相关因素分析

目的探索治疗Ⅱ型糖尿病患者牙周炎的方法与影响疗效的相关因素。方法经临床确诊为Ⅱ型糖尿病伴牙周炎的患者91例,根据牙周炎严重程度设计出不同的个体化治疗方案,经多次治疗,2年随访,分析并介绍了对此类患者治疗的方法与经验。结果血糖控制组和术后口腔卫生状况保持良好组的牙周病患者其治疗疗效显著高于血糖未控制组和术后口腔卫生状况保持较差组(P<0.005)。结论血糖的合理控制、牙周局部治疗及术后口腔卫生保健是糖尿病合并牙周病治疗成功的保障。     

糖尿病和牙周病临床相互关系的初步研究

目的通过临床问卷调查,初步探讨牙周病与胰岛素非依赖性糖尿病的相互关系,并探讨通过牙周非手术治疗对胰岛素非依赖性糖尿病患者牙周病变控制及血糖水平的影响。方法选取齐鲁医院内科住院患者120例,分为胰岛素非依赖性糖尿病组63例、对照组57例。两组均设计相同问卷进行临床调查,比较两组牙周患病率及牙周健康状况(牙龈出血、牙齿松动、牙齿缺失、牙龈萎缩)的差异。并对63例胰岛素非依赖性糖尿病患者中的26例行牙周非手术治疗,测量并比较患者术前及术后4、8周的牙龈出血、牙周袋深度及糖化血红蛋白的水平。结果胰岛素非依赖性糖尿病组的牙周病患病率(50.05%)高于对照组(33.25%),胰岛素非依赖性糖尿病组牙周健康状况差于对照组,统计学检验两组差异有显著性(P<0.01)。胰岛素非依赖性糖尿病患者牙周非手术治疗后,牙龈出血减轻或消失、牙周袋变浅、重型牙周炎患者糖化血红蛋白降低。结论牙周病与胰岛素非依赖性糖尿病之间存在一定的相关性,胰岛素非依赖性糖尿病患者牙周炎症的控制能在一定程度上改善代谢水平及治疗效果。     

2型糖尿病患者牙周指标与糖化血红蛋白关系的研究

目的 :研究 2型糖尿病患者牙周指标与糖化血红蛋白间的相关关系。方法 :随机选择 3 0例 2型糖尿病伴牙周炎患者于牙周基础治疗前检测其体重 ,菌斑指数 ,牙龈指数 ,探诊出血指数 ,探诊深度 ,附着丧失 ,糖化血红蛋白值。结果 :糖化血红蛋白与附着丧失、年龄的密切相关。结论 :糖化血红蛋白是影响牙周破坏的重要指标。     

慢性牙周炎与2型糖尿病的关系研究进展

慢性牙周炎（chronic periodontitis,CP）与糖尿病（diabetes mellitus,DM）关系密切,其相互影响是近年来牙周医学研究的热点。DM是CP的危险因素之一,可通过多种机制促进CP发生发展,同时CP也是DM的第6大并发症,可影响DM病程进展,约90%以上的DM为2型糖尿病（type 2 diabetes mellitus,T2DM）,本文就CP和T2DM相互影响的特点及机制等方面的研究进展作一综述。     

糖尿病与牙周炎的相互关系

探讨牙周炎与糖尿病之间的双向关系。一些研究表明，糖尿病的表征可以表现为牙周炎，同时也可能成为糖尿病的危险因素，两者相互影响，互为因果。本文就两者相互作用的病理基础、临床表现及治疗特点进行综述，以期对今后的治疗有所裨益。     

The relationship between periodontal diseases and diabetes: an overview

Diabetes mellitus, caused by the malfunction of insulin-dependent glucose and lipid metabolism, presents with the classical triad of symptoms: polydypsia, polyuria, and polyphagia which are often accompanied by chronic fatigue and loss of weight. Complications of diabetes mellitus include retinopathy, nephropathy, neuropathy, and cardiovascular disease. Periodontal diseases are infections affecting the periodontium and resulting in the loss of tooth support. The association between diabetes mellitus and periodontitis has long been discussed with conflicting conclusions. Both of these diseases have a relatively high incidence in the general population (diabetes 1% to 6% and periodontitis 14%) as well as a number of common pathways in their pathogenesis (both diseases are polygenic disorders with some degree of immunoregulatory dysfunction). On the one hand, numerous reports indicate a higher incidence of periodontitis in diabetics compared to healthy controls, while other reports fail to show such a relationship. Clarification of this dilemma is occurring as the diagnostic criteria for periodontitis and diabetes mellitus improve, controlled studies with increased sample sizes are carried out, and the studies take into account major confounding variables that impact on the pathogenesis of both diseases. Current studies tend to support a higher incidence and severity of periodontitis in patients with diabetes mellitus. The overview looks at the bidirectional relationship between periodontitis and diabetes. An analysis of the National Health and Nutrition Examination Survey (NHANES) III data set confirms the previously reported significantly higher prevalence of periodontitis in diabetics than in non-diabetics (17.3% versus 9%). The analysis of the data also shows that the prevalence of diabetes in patients with periodontitis is double that seen in the non-periodontitis patients (12.5% versus 6.3%) and that this difference is also statistically significant. The pathogenesis of the 2 diseases is reviewed with an emphasis on common genetic and immune mechanisms. On the basis of the overview, 2 hypotheses for testing the relationship between periodontitis and diabetes are discussed. The first proposes a direct causal or modifying relationship in which the hyperglycemia and hyperlipidemia of diabetes result in metabolic alterations that may then exacerbate bacteria-induced inflammatory periodontitis. The second hypothesis proposes that a fortuitous combination of genes (gene sets) could result in a host who, under the influence of a variety of environmental stressors, could develop either periodontitis or diabetes or both.     

牙周病与妊娠期糖尿病关系的临床研究

目的 研究牙周病与妊娠期糖尿病的相关性,探讨牙周炎对妊娠期糖尿病血清C-反应蛋白的影响.方法 选择24～28周孕妇中,患有妊娠期糖尿病孕妇100例纳入试验组,身体健康孕妇100例作为对照组,检查其牙周健康指数,其中包括牙龈指数、龈沟出血指数、附着丧失水平、牙周袋探诊深度,统计分析两组差别.同时在试验组孕妇中选取伴牙周炎和牙周健康的孕妇各30例,检测其血清C-反应蛋白的含量,进行统计学分析.结果 除牙周探诊深度外,两组孕妇的其他牙周健康指数均的差异有统计学意义(P＜0.05),试验组牙周炎孕妇的血清C-反应蛋白水平显著高于同组牙周健康的孕妇(P＜0.05).结论 牙周病与妊娠期糖尿病具有相关性,牙周炎症可能是妊娠期糖尿病的危险因素之一.     

Oral manifestations of previously undiagnosed non-insulin dependent diabetes mellitus

The oral manifestations are described of 43 patients with previously undiagnosed non-insulin dependent diabetes mellitus (NIDD) who presented to an Oral Medicine Unit in a 24-month period. The diagnosis of diabetes mellitus was confirmed by measurement of fasting blood glucose and where necessary by a glucose tolerance test. Sixteen patients had burning mouth syndrome, ten patients had unusually prolonged fungal and/or bacterial infections, nine patients had a nonspecific condition such as altered taste, six patients had an oral mucosal lesion such as erosive lichen planus, one patient had sialosis and one patient complained of sialorrhoea. The frequency of undiagnosed NIDD was twice that expected among the general population. Treatment directed at improving glycemic control also produced resolution of the patients' oral symptoms in most cases.     

Relationship between markers of metabolic control and inflammation on severity of periodontal disease in patients with diabetes mellitus

AIM: The aim of this study was to investigate the relationship between markers of metabolic control and inflammation and periodontal disease parameters in patients with diabetes. MATERIAL & METHODS: One hundred and eighty one adult patients with diabetes attending treatment at two diabetes centres were invited to participate in the study. Periodontal examination included full-mouth assessment for probing depths and bleeding on probing (BOP). Blood analyses were carried out for glycated haemoglobin, (HbA1c), high-sensitivity C reactive protein, (hsCRP) and lipid profile comprising total cholesterol, low-density lipoprotein cholesterol (LDL chol), high-density lipoprotein cholesterol (HDL chol) and triglycerides. RESULTS: Upon multivariate analysis, periodontal disease severity in terms of increased percentage of BOP and mean percentage of sites with probing depths > or = 5 mm were found to be associated with inadequate glycaemic control as measured by HbA1c (p<0.01). HsCRP was also found to be a significant predictor for mean percentage of sites with probing depths > or = 5 mm (p<0.05). After controlling for age, gender, smoking habits and number of teeth, positive correlations were found between HbA1c and percentage sites with probing depths > or = 5 mm, percentage sites BOP, total cholesterol, LDL chol and triglycerides (p<0.05). Using the adjusted differences, subjects with acceptable glycaemic control (HbA1c < 8%) showed a lower percentage of sites with BOP and probing depths > or = 5 mm (p<0.05) when compared with those having inadequate glycaemic control. There was also a trend towards lower blood cholesterol in the well-controlled group. CONCLUSION: The level of glycaemic control as measured by HbA1c emerged as the most consistent risk factor associated with the extent and severity of periodontal disease in this study cohort.     

2型糖尿病患者罹患口腔假丝酵母菌感染危险因素的Logistic回归分析

目的通过多因素分析,筛选出与2型糖尿病患者伴发口腔假丝酵母菌感染密切相关的指标,建立预测方程,分析2型糖尿病患者口腔假丝酵母菌感染的危险因素。方法选择140例2型糖尿病患者,记录性别,年龄,病程,吸烟史,空腹血糖值及系统并发症（包括肾病、神经病变和高血压）;并对患者进行口腔检查,记录口腔卫生状况、口腔黏膜情况及义齿修复情况。运用标准含漱浓缩法检测患者口腔假丝酵母菌的检出率和负载量,并采用CHROM agar显色培养基进行初步生物分型。应用Logistic回归分析方法研究2型糖尿病患者口腔假丝酵母菌感染与上述11项临床指标之间的关系。结果140例2型糖尿病患者中有69例检出口腔假丝酵母菌,检出率为49.3%,检出的假丝酵母菌菌种以白假丝酵母菌为主。以上述11项临床指标作为自变量,口腔假丝酵母菌感染发生与否作为因变量,进行Logistic回归分析,建立Logistic回归方程,方程的总判断率为82.1%。经回归分析,空腹血糖值、口腔卫生状况和黏膜干燥是2型糖尿病患者伴发口腔假丝酵母菌感染的危险因素。结论空腹血糖值、口腔卫生状况、黏膜干燥是2型糖尿病患者伴发口腔假丝酵母菌感染的危险因素;通过回归方程得出的概率值可为2型糖尿病患者口腔假丝酵母菌感染的预测及口腔护理保健提供参考。     

Relation between periodontal disease and diabetes mellitus

A study is made of a group of 67 persons with diabetes mellitus, over 15 years of age, in order to know the presence and severity of periodontal disease, in relation with degree of oral hygiene, age, duration of the course and degree of metabolic control of diabetes. It was shown that 85.1% of the cases had some form of the periodontal disease, the most frequent of which being advanced periodontitis (34.3%). 100% of the patients had an inadequate oral hygiene. Lack of metabolic control, age and degree of oral hygiene correlated positively with the severity of periodontal disease.