歯周病ブログ㉖

今回は2型DM無歯顎患者に対し3種類の総義歯サポート

下顎インプラントの生存率を調べることが目的です。

対象者はHbA1c正常域32名、2%未満の上昇者が34名

2%以上の上昇者が21名、2名がデータなしです。

Diabetes mellitus, a prevalent disorder worldwide, is associated with systemic adverse sequelae, such as wound healing alterations, which may affect osseointegration of dental implants. This prospective multicenter study assessed the success of 2-stage endosseous root-form implants (3 different implant systems) placed in the mandibular symphysis of 89 male type 2 diabetic subjects. The implants were uncovered approximately 4 months after placement, restored with an implant-supported, Hader bar clip-retained overdenture, and maintained at scheduled follow-up data collection examinations for 60 months after loading. Sixteen (9.0%) of the 178 implants failed. Life table methods calculated implant survival at approximately 88%, from prosthesis placement through the 60-month follow-up, and at approximately 90% from implant placement through the observation period. No implants failed between surgical placement and uncovering, 5 failed at uncovering, 7 failed after uncovering before prosthesis placement, and 4 failed after prosthesis placement. Fasting plasma glucose (FPG) and glycosylated hemoglobin (HbA1c) values were determined before implant placement (baseline) and approximately 4 months later at surgical uncovering (follow-up). The 5-year implant outcomes (successes versus failures) were analyzed against the following predictor variables: (1) baseline and follow-up FPG values, (2) baseline and follow-up HbA1c values, (3) subject age, (4) duration of diabetes (years), (5) baseline diabetic therapy, (6) smoking history, and (7) implant length. Regression analysis found only duration of diabetes (P < .025) and implant length (P < .001) to be statistically significant predictors of implant failure. There was no statistically significant difference in failure rates between the 3 different implant systems used. This study supports the use of dental implants in type 2 diabetic patients.

結果は

HbA1cのグループ間、また3種類のインプラント間において

インプラント生存率に差はなかった。

インプラント埋入5年後に16/178(9%)が失敗だった。

結論は

HbA1cはインプラントの治療結果に影響せず

2型男性DM患者にインプラント埋入は

禁忌ではないということです。

 

引用文献

Olson JW1, Shernoff AF, Tarlow JL, Colwell JA, Scheetz JP, Bingham SF.

Dental endosseous implant assessments in a type 2 diabetic population: a prospective study.

Int J Oral Maxillofac Implants. 2000 Nov-Dec;15(6):811-8.

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