本文選題：糖尿病　切入點：種植義齒　出處：《華北理工大學(xué)》2017年碩士論文

【摘要】：目的以糖化血紅蛋白(Hb A1c)的高低值為分組標(biāo)準(zhǔn),通過對比三組不同范圍Hb A1c的糖尿病患者種植體周圍軟硬組織的變化情況以及種植體周圍組織病的發(fā)生率和種植體的成功率,來研究Hb A1c水平高低對種植體周圍軟硬組織的影響,從而為糖尿病(DM)種植患者后期的種植體維護和血糖的控制范圍提供理論依據(jù)和數(shù)據(jù)支持。方法實驗對象的選擇:根據(jù)病例納入和排除標(biāo)準(zhǔn),選取我院口腔科2014年1月至2016年7月以來期望進行口腔種植的患者,其中2型DM患者48例,健康者36例。對患者術(shù)前1個月,術(shù)后3、6、9、12個月的Hb A1c水平進行監(jiān)測,排除Hb A1c波動水平較大者(即CV%10%),然后將Hb A1c平均值作為分組依據(jù)將DM患者分為B組(6Hb A1c≤8.0)30例,C組(8.0Hb A1c10.0)18例,健康組為A組(Hb A1c≤6.0)36例。實驗方法:記錄患者年齡和性別,手術(shù)當(dāng)天測空腹血糖,要求控制在6.7~12.2mmol/L以內(nèi)。在手術(shù)后4個月左右進行冠修復(fù),要求患者按時隨訪復(fù)診,測量并記錄三組種植體修復(fù)時、修復(fù)后半年和一年,三次復(fù)查時的種植體的改良齦溝出血指數(shù)(ms BI)、探診深度(PD)和邊緣骨水平(MBL)的變化值,并評估種植體周圍組織病的發(fā)生率和種植成功率。統(tǒng)計學(xué)方法:PD及MBL變化值的組間比較采用單因素方差分析,率的比較采用卡方檢驗,ms BI計分數(shù)的組間比較采用秩和檢驗,統(tǒng)計學(xué)軟件采用SPSS19.0。結(jié)果1三組性別、年齡比較無差異(P均0.05);2對種植體修復(fù)時、修復(fù)后半年和修復(fù)后一年時PD的變化值進行A、B、C三組間的比較,方差分析結(jié)果顯示組間差異無統(tǒng)計學(xué)意義(P0.05);3對A、B、C三組種植體修復(fù)時、修復(fù)后半年和修復(fù)后一年時MBL的變化值進行組間比較,兩兩比較的方差分析結(jié)果顯示C組MBL的變化值均高于A、B兩組(半年時P_A=0.041,P_B=0.035;一年時P_A=0.021,P_B=0.032),差異均具有統(tǒng)計學(xué)意義,而A、B兩組間比較無統(tǒng)計學(xué)差異,而修復(fù)后半年和修復(fù)后一年時MBL的變化值組間比較差異無統(tǒng)計學(xué)意義;4對A、B、C三組種植體在修復(fù)時的ms BI計分數(shù)進行比較,秩和檢驗結(jié)果顯示組間差異無統(tǒng)計學(xué)意義(P0.05),在對種植修復(fù)后半年和一年的ms BI計分數(shù)進行比較時,C組的ms BI計分數(shù)均要高于A、B兩組(半年時P_A=0.016,P_B=0.028;一年時P_A=0.034,P_B=0.031),差異均具有統(tǒng)計學(xué)意義,而A、B兩組間比較無統(tǒng)計學(xué)差異;5種植體修復(fù)一年后發(fā)現(xiàn),三組間周圍組織病發(fā)生率比較有統(tǒng)計學(xué)差異(P=0.048);6種植體修復(fù)一年后發(fā)現(xiàn),三組間種植成功率的比較無統(tǒng)計學(xué)差異(P0.05)。結(jié)論1種植義齒骨結(jié)合成功率較高,但高HbA1c水平會增加骨的吸收;2Hb A1c水平升高,會增加種植體周圍探診出血的可能性;3 DM患者種植的成功率在短期內(nèi)(一年內(nèi))較高,遠期效果如何需長期隨訪觀察;4 Hb A1c的升高會增加種植體周圍組織病的發(fā)生率,2型DM患者的牙周組織變化與血糖控制有關(guān)。
[Abstract]:With the purpose of glycosylated hemoglobin (Hb A1c) the level of value for patients with diabetes by grouping criteria, compared three groups of different Hb A1c planting changes of body hard and soft tissue and peri implant tissue disease incidence rate and the success rate of implant, to study effects of Hb A1c on the level of peri implant soft tissue diabetes mellitus (DM), so as to provide a theoretical basis and data support the control range of implants with the late implant maintenance and blood glucose. Methods the choice: according to the inclusion and exclusion criteria, since January 2014 to July 2016 in our hospital department of Stomatology expectations for oral implant patients, including 48 cases of type 2 DM patients, 36 cases healthy subjects. In 1 patients before operation, monitoring the level of A1c Hb 3,6,9,12 months after operation, Hb A1c excluded larger fluctuation level (CV%10%), and then Hb A1c as average packet On the basis of the DM patients were divided into B group (6Hb A1c 8) 30 cases, group C (8.0Hb A1c10.0) 18 cases, healthy group and A group (Hb A1c 6) in 36 cases. Methods: records of patients age and gender, the day of surgery fasting blood glucose control, within 6.7~12.2mmol/L after the operation. About 4 months of crown repair, requiring patients to follow-up on time, measure and record the three groups of implant restoration, repair after half a year and one year, modified sulcus implant three review the bleeding index (MS BI), probing depth (PD) and the marginal bone level (MBL) changes the value and evaluation of peri implant disease incidence rate and success rate of planting. Statistical methods: PD and MBL values were compared by single factor variance analysis, were compared using the chi square test, MS BI scores between groups using the Wilcoxon rank sum test, using statistical software SPSS19.0. 1 results in three groups there is no gender, age 宸紓(P鍧，

本文編號：1666108