2型糖尿病患者磨牙拔除后牙槽嵴三维方向参数变化趋势对种植体植入时机的参考  

Implant inserting opportunity affected by aveolar ridge change post-extraction in molar region for type 2 diabetic patients

作　　者：王舒妍 丁锋 赵国强 赵文爽 杨瑞 刘向东 陈旭涛 张思佳 宋应亮 WANG Shuryan;DING Feng;ZHAO Guoqiang;ZHAO Wenshuang;YANG Rui;LIU Xiangdong;CHEN Xutao;ZHANG Sija;SONG Yingliang(State Key Laboratory of Miliary Stomatology&National Clinical Research Center for Oral Diseases&Shaanxi Engineering Research Center for Dental Materials and Advanced Manufacture,Department of Implant Dentistry,Xi'an 710032;Department of Oral Disease,School of Stomatolo-gy,The Fourth Military Medical University,China.)

机构地区：[1]军事口腔医学国家重点实验室,国家口腔疾病临床医学研究中心,陕西省口腔疾病临床医学研究中心,第四军医大学口腔医院黏膜病科,西安710032 [2]军事口腔医学国家重点实验室,国家口腔疾病临床医学研究中心,陕西省口腔疾病临床医学研究中心,第四军医大学口腔医院种植科,西安710032

出　　处：《实用口腔医学杂志》2020年第4期591-595,共5页Journal of Practical Stomatology

基　　金：国家自然科学基金(编号:81771107)。

摘　　要：目的:通过临床回顾性队列研究,分析2型糖尿病患者(T2DM)磨牙拔除后牙槽嵴三维方向参数变化趋势对种植体植入时机的影响。方法:选取病史>3年且血糖水平得到控制的T2DM患者作为研究对象,按配比法与非糖尿病患者(对照)配对共75对。CBCT测量记录拔牙前后牙槽嵴高度(ARH)与宽度(ARW)在三维方向上的变化。结果:拔牙前2组患者在3~24月的4个时间分组中ARW和ARH均无统计学差异(P>0.05)。拔牙后糖尿病组(DM)的牙槽嵴高度变化值大于对照组(P<0.05);DM组在拔牙后3个月ARW先变宽,再逐渐变窄,ARH则持续减小;对照组在拔牙后ARW和ARH均减小。结论:对于T2DM磨牙拔除患者,拔牙后3个月时ARW最宽,为植入种植体的最佳时机。针对拔牙后牙槽窝未完全形成骨愈合的患者,建议种植体植入时并行骨增量术。Objective: To identify the implant inserting opportunity affected by aveolar ridge dimensional change post-extraction in type 2 diabetic patients. Methods: Pre-and post-extraction CBCT images of type 2 diabetes(T2 DM) patients and age and sex matched non-diabetic controls(control;n=75) were analysed for the investigation of post-extraction ridge dimensional changes. Post-extraction follow-up time ranged from 3 to 24 months. Ridge dimensions alveolar ridge width(ARW) and alveolar ridge height(ARH) were compared between the groups using CBCT images. Results: No significant differences between the groups were observed in pre-extraction socket dimensions(ARW and ARH). Post-extraction ARH decreased more in DM group than in control group in all point groups(3, 4-6, 7-12 and 13-24 months). Differences in ARW between the control and DM group at all the post-extraction time points were not statistically significant. Conclusion: ARW is widest at 3 months post-extraction in T2 DM patients, it might be the best time point for implant surgery. For the sockets do with uncomplet heal, guided bone regeneration should be considered.

关 键 词：2型糖尿病 拔牙 牙槽窝 牙种植 

分 类 号：R782.1[医药卫生—口腔医学] R783.6[医药卫生—临床医学]