修复材料对合并2型糖尿病老年上颌前磨牙楔状缺损患者牙龈的影响  

Efficacy of Different Restorative Materials on Periodontal Tissues in Elderly Patients with Subgingival Wedge-Shaped Defects of Maxillary Premolar Teeth Combined with Type 2 Diabetes Mellitus

作　　者：陈慧 贺飞 代喆颖 Chen Hui;He Fei;Dai Zheying(Department of Stomatology,Wuhan Third Hospital,Wuhan 430060,China)

机构地区：[1]武汉市第三医院口腔科,武汉430060

出　　处：《成都医学院学报》2025年第2期321-326,共6页Journal of Chengdu Medical College

基　　金：武汉市卫生和计划生育委员会科研项目(No:WX18C06)。

摘　　要：目的 分析不同修复材料对合并2型糖尿病(T2DM)的老年上颌前磨牙龈下楔状缺损患者牙龈组织生化指标及修复效果的影响。方法 选取2021年1月至2023年5月武汉市第三医院收治的合并T2DM的老年上颌前磨牙龈下楔状缺损患者195例为研究对象,根据补牙材料不同分为A组(多功能玻璃离子)、B组(聚酸改性复合树脂/复合体)和C组(光固化复合树脂)3组,每组65例。另选取65例未合并T2DM的老年上颌前磨牙龈下楔状缺损患者作为D组(修复方式同C组),对比4组患者治疗12个月内牙周组织中龈沟液量、出血指数(BOP)、牙龈指数(GI)、天冬氨酸氨基转移酶(AST)和碱性磷酸酶(ALP)、白细胞介素-1β(IL-1β)水平。结果 修复1个月后,4组患者龈沟液量、BOP、GI水平均高于修复前(P<0.05);修复6、12个月后,B、C、D组龈沟液量、BOP、GI水平均低于A组(P<0.05);且D组龈沟液量、BOP、GI水平均低于A、B、C组(P<0.05);修复1、6、12个月后,4组患者AST、ALP水平均高于修复前,IL-1β水平低于修复前(P<0.05);修复6、12个月,D组AST、ALP、IL-1β水平均低于其他3组(P<0.05),4组试件轴壁及龈壁边缘染色深度比较,差异无统计学意义(P>0.05);术后12个月内,4组患者填充物脱落率比较,差异均无统计学意义(P>0.05)。结论 合并T2DM严重影响老年上颌前磨牙龈下楔状缺损的修复效果,采用光固化复合树脂作为修复材料对牙周组织的刺激最弱,患者术后远期恢复最佳。Objective To analyze the effects of different restorative materials on the biochemical indexes of periodontal tissues in elderly patients with subgingival wedge-shaped defects of maxillary premolar teeth combined with type 2 diabetes mellitus(T2DM).Methods A total of 195 older adults with subgingival wedge-shaped defects of maxillary premolar teeth combined with T2DM admitted to Wuhan Third Hospital from January 2021 to May 2023 were selected for the study.They were divided into 3 groups according to the different restorative materials used by the patients,namely,Group A(Fuji multi-functional glass ionomer,n=65),Group B(polyacid-modified composite resin/composite,n=65)and Group C(light-curing composite resin,n=65).Another 65 patients with subgingival wedge-shaped defects of maxillary premolar teeth and without T2DM were selected as Group D(the restoration method was the same as that of Group C).The periodontal biochemical indexes[gingival crevicular fluid(GCF)volume,bleeding on probing(BOP),gingival index(GI),aspartate aminotransferase(AST),alkaline phosphatase(ALP),and interleukin-1β(IL-1β)]of the 4 groups of patients within 12 months after restoration were compared.Results One month after restoration,the GCF volume,BOP,and GI levels were higher than those before restoration in all 4 groups(P<0.05).At 6 and 12 months after restoration,the GCF volume,BOP and GI levels in Groups B,C and D were lower than those in Group A(P<0.05),and the above indicators in Group D were lower than those in Groups A,B and C(P<0.05).At 1,6 and 12 months after restoration,all 4 groups showed increased AST and ALP levels but decreased IL-1βlevel(P<0.05).At 6 and 12 months after restoration,all 4 groups showed increased AST and ALP levels but decreased IL-1βlevels(P<0.05).There was no statistical significance in the depth of staining of axial and gingival wall margins of the specimens of the 4 groups(P>0.05).There was no statistical significance in the rate of detachment within 12 months after restoration among the 4 groups(P>0.05).

关 键 词：充填材料 上颌前磨牙 龈下楔状缺损 2型糖尿病 牙周组织 

分 类 号：R587.1[医药卫生—内分泌] R781.2[医药卫生—内科学]