伴2型糖尿病牙周炎患者种植修复机械并发症与口腔菌群变化的相关性分析  

Correlation analysis between mechanical complications of implant restoration and changes of oral flora in periodontitis patients with type 2 diabetes mellitus

作　　者：王颖 陈冠君 阙文力 吴芳娇[1] WANG Ying;CHEN Guan-jun;QUE Wen-li;WU Fang-jiao(Hainan Provincial Hospital of Traditional Chinese Medicine,Hainan Haikou 570203,China)

机构地区：[1]海南省中医院,海南海口570203

出　　处：《临床口腔医学杂志》2023年第8期486-490,共5页Journal of Clinical Stomatology

摘　　要：目的:分析伴2型糖尿病(type 2 diabetes mellitus,T2DM)牙周炎患者种植修复机械并发症与口腔菌群变化的关系。方法:选取2018年1月~2021年1月我院收治的进行种植修复治疗的伴T2DM牙周炎患者175例(植体数277枚),随访12个月记录机械并发症情况。根据是否发生机械并发症分为发生组(21例/34枚植体)和未发生组(154例/243枚植体),记录两组患者人口学信息、种植修复前牙周学指标、种植修复后菌群分布等资料,采用Logistic回归分析法明确伴T2DM牙周炎患者种植修复发生机械并发症的影响因素,并分析机械并发症与口腔菌群变化的相关性。结果:两组患者种植修复治疗后口腔牙髓卟啉单胞菌、具核梭杆菌、中间普雷沃菌、伴放线放线杆菌均有所增长(P<0.05),且发生组种植修复后菌群水平显著高于未发生组(P<0.05)。单因素分析结果显示,发生组中性别、牙位、不良咬合习惯及菌落分布与未发生组有显著差异(P<0.05);多因素分析结果显示性别、牙位、不良咬合习惯、牙髓卟啉单胞菌、具核梭杆菌菌落数是种植修复机械并发症的独立影响因素(P<0.05)。结论:口腔中牙髓卟啉单胞菌、具核梭杆菌的增长与T2DM合并牙周炎患者种植修复机械并发症存在相关性,且男性、后牙、上颌牙位、不良咬合习惯是T2DM合并牙周炎患者种植修复机械并发症的危险因素。Objective:To analyze the relationship between mechanical complications of implant repair and oral microflora in patients with type 2 diabetes mellitus(T2DM)periodontitis.Methods:A total of 175 patients(277 implants)with T2DM periodontitis who received implant repair treatment in our hospital from Jan 2018 to Jan 2021 were selected and followed up for 12 months to record the mechanical complications.The patients were divided into the occurrence group(21 cases/34 implants)and the non-occurrence group(154 cases/243 implants)according to the occurrence of mechanical complications.The demographic information,periodontal indicators before implantation and repair,and the distribution of microflora after implantation and repair were recorded.The influencing factors of mechanical complications of implantation and repair in patients with type 2 diabetes periodontitis were determined by Logistic regression analysis.The correlation between mechanical complications and oral microflora was analyzed.Results:The levels of Porphyromonas gingivalis(PG),Fusobacterium nucleatum(FN),Prevotella intermedia(PI) and Actinobacillus actinomycetemcomitans(AA) increased in both groups after implant restoration(P<0.05),and the level of flora after implant restoration in the occurrence group was significantly higher than that in the non-occurrence group(P<0.05).Single factor analysis showed that there were significant differences in gender,tooth position,bad occlusion habit and colony distribution between the two groups(P<0.05).Multivariate analysis showed that gender,tooth position,bad occlusal habits,colony number of PG and FN were independent influencing factors of mechanical complications of implant restoration(P<0.05).Conclusion:The growth of Porphyromonas gingivalis and Fusobacterium nucleatum in the oral cavity is related to the mechanical complications of implant restoration in patients with T2DM and periodontitis,and male,posterior teeth,maxillary teeth and bad occlusal habits are the risk factors for mechanical complications of impla

关 键 词：2型糖尿病 牙周炎 牙种植 机械并发症 口腔菌群 

分 类 号：R781.4[医药卫生—口腔医学] R782.1[医药卫生—临床医学]