今回の文献はインプラントの生存率、合併症発症
に対する2型DMの影響を調べることが目的です。
45名の糖尿病患者と45名の非糖尿病患者を
対象にしています。
インプラント埋入時の糖尿病患者のHbA1cは
いずれも7.2%以下です。
To investigate the effect of type-2 diabetes on implant survival and complication rate.
Prospective study enrolling type-2 diabetic patients suffering from edentulism, having a mean perioperative HbA1c level of 7.2%, and compliant with a maintenance program. All the patients underwent dental and periodontal examinations and had laboratory testing for HbA1c, fasting plasma glucose, blood lipids, and microalbuminuria. Nondiabetic patients matched for implant treatment indication served as controls. The influence of clinical diabetes-related factors and periodontal parameters (Plaque Index, bleeding on probing, probing depth) on implant survival were assessed via univariate then multivariate methods.
Forty-five diabetic patients, followed for 1 to 12 years, mean age 64.7 years, received 255 implants: 143 following a classical protocol and 112 in cases of sinus floor elevation, immediate loading, and guided bone regeneration. Forty-five nondiabetic control patients received 244 implants: 142 following a classical protocol and 102 in cases of advanced surgery. Implant survival following conventional or advanced implant therapy was not statistically different between the well-controlled (HbA1c < 7%, P = .33) and the fairly well-controlled group (HbA1c 7% to 9%, P = .37). The overall survival rate for the diabetic group was 97.2% (control 98.8%) and was not significantly different for age, gender, diabetes duration, smoking, or type of hypoglycemic therapy. The mean peri-implant bone loss was 0.41 +/- 0.58 mm (control, 0.49 +/- 0.64 mm). PI and BOP fairly correlated with postoperative complications. HbA1c was the only multivariate independent factor affecting the complication rate (P = .04). No statistically significant difference was found for patients (P = .81) or for implants (P = .66) for the advanced surgery cases or the conventional approach in diabetic patients compared to nondiabetic patients.
結果はコントロール良好(HbA1c＜7％)な患者と
やや良好(7％≦HbA1c≦9％)な患者では
非糖尿病者群とインプラント生存率において
有意差はなかった。
1～12年間の糖尿病患者群における
インプラント生存率は97.2％
非糖尿病者群では98.8％だった。
プラーク指数とプロービング時の出血の悪化は
インプラント周囲骨吸収と相関していた。
結論は、2型糖尿病患者のHbA1cがインプラント埋入時に
7～9％であれば、インプラント生存率において
非糖尿病者と差はないが
HbA1cはインプラント周囲炎等合併症率に
最も影響を与える因子である
ということです。
．
引用文献
Tawil G, Younan R, Azar P, Sleilati G.
Conventional and advanced implant treatment in the type II diabetic patient: surgical protocol and long-term clinical results.
Int J Oral Maxillofac Implants. 2008 Jul-Aug;23(4):744-52.