中国口腔颌面外科杂志

中国口腔颌面外科杂志 ›› 2020, Vol. 18 ›› Issue (3): 231-235.doi: 10.19438/j.cjoms.2020.03.008

• 论著 • 上一篇    下一篇

2型糖尿病患者术前预防性应用抗生素对口腔种植疗效的影响：3~5年回顾性研究

阮丹平, 杨奕辰, 邓思楠, 赵怨怨, 吴春云   

  1. 复旦大学附属闵行医院（上海市闵行区中心医院） 口腔科,上海 201100
  • 收稿日期:2019-12-09 修回日期:2020-01-20 发布日期:2020-06-18
  • 通讯作者: 吴春云,E-mail: wyzsq6492@163.com
  • 作者简介:阮丹平（1978-）,女,硕士,副主任医师,E-mail: ruandanping1978@163.com
  • 基金资助:
    闵行区科委科研项目(2017MHZ62)

The effect of preoperative prophylactic antibiotics on dental implants in patients with type 2 diabetes mellitus: 3-5-years retrospective study

RUAN Dan-ping, YANG Yi-chen, DENG Si-nan, ZHAO Yuan-yuan, WU Chun-yun   

  1. Department of Stomatology, Minhang Hospital, Fudan University. Shanghai 201100, China
  • Received:2019-12-09 Revised:2020-01-20 Published:2020-06-18

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摘要： 目的 评价血糖控制良好和轻度控制不良的2型糖尿病（T2DM）患者口腔种植术前应用抗生素对口腔种植疗效的影响,研究术前预防性应用抗生素的必要性。方法 回顾2014年5月—2016年5月于上海市闵行区中心医院口腔科就诊并接受口腔种植治疗的控制良好和轻度控制不良的T2DM患者,随访3~5年,开展临床检查和影像学评价。采用SPSS 20.0软件包分别进行t检验和χ2检验,分析组间差别,并采用Kaplan-Meier方法计算生存率。结果 共纳入种植修复的T2DM患者57例,其中血糖控制良好组30例（用药13例,未用药17例）,血糖轻度控制不良组27例（用药15例,未用药12例）。全部患者术后3 d和7 d复查时,创口愈合良好,未见明显红肿。回访期种植体留存率、探诊出血指数%、改良菌斑指数、种植体周探诊深度、边缘骨吸收量等指标均无统计学差异。结论 口腔种植术前预防性使用抗生素不能改善种植术后创口愈合过程、口腔种植长期留存率和边缘骨吸收状况。控制良好和轻度控制不良的T2DM患者,口腔种植术前预防性系统性应用抗生素的必要性缺乏足够的证据支持。

关键词: 口腔种植, 2型糖尿病, 抗生素

Abstract: PURPOSE: To evaluate the effect of preoperative antibiotic application on the effect of dental implantation in patients with good controlled blood glucose and mild poor controlled type 2 diabetes mellitus (T2DM), and to study the necessity of preoperative prophylactic use of antibiotics. METHODS: According to the inclusion criteria of this study, we reviewed T2DM patients with good controlled and mildly poor controlled T2DM, who received dental implant from May 2014 to May 2016. The patients were followed regularlly, then clinical examination and radiographic evaluation were carried out. The differences between groups were analyzed by t test and Chi-square test respectively with SPSS 20.0 software package. Kaplan-Meier method was used to calculate survival rate. RESULTS: A total of 57 T2DM patients were included in this retrospect study, including 30 patients in the group with good blood glucose control (13 patients with medication, 17 patients without medication), 27 patients in the group with mild poorly blood glucose control(15 patients with medication, 12 patients without medication). The wounds healed well and no infection was found in all patients. During the follow-up period, there was no significant difference in implant survival rate, bleeding on probing%, modified plaque index, periimplant probing depth and marginal bone loss. CONCLUSIONS: Prophylactic use of antibiotics before dental implantation surgery can not improve wound healing, long-term survival rate and marginal bone loss. There is a lack of evidence to support the necessity of systemic antibiotic prophylaxis in T2DM patients with good and mild poorly controlled blood glucose.

Key words: Dental implants, Type 2 diabetes mellitus, Antibiotics

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