中国实用口腔科杂志

中国实用口腔科杂志

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可摘局部义齿对老年中重度牙周炎伴2型糖尿病患者牙周状况及全唾液中MMP-8水平的影响研究

苏哲君a，王鹏a，霍峰a，陈雪a，赵维川b    

  1. 承德医学院附属医院a口腔科，b检验科，河北  承德  067000
  • 出版日期:2018-07-15 发布日期:2018-11-08
  • 基金资助:

    河北省科技计划项目（17277760D）；承德市科学技术研究与发展计划项目（20142052）；政府资助临床医学优秀人才培养和基础课题研究项目（2016）

  • Online:2018-07-15 Published:2018-11-08

摘要：

目的    探讨戴用可摘局部义齿对老年中重度牙周炎伴2型糖尿病患者牙周状况及全唾液中基质金属蛋白酶（MMP）-8水平的影响。方法    选取2015年7—12月在承德医学院附属医院口腔科行远中游离端铸造支架式可摘局部义齿修复的老年中重度牙周炎伴2型糖尿病患者16例（试验组）和单纯老年中重度牙周炎患者14例（对照组），分别于可摘局部义齿修复前及戴用义齿1、3个月后检测两组患者基牙临床牙周指标和全唾液中MMP-8含量。 结果    两组患者戴用义齿1、3个月后的各项牙周指标值及全唾液中MMP-8水平均明显高于义齿修复前（P < 0.05）；与戴用义齿1个月后相比较，戴用义齿3个月后牙龈指数（GI）及全唾液中MMP-8水平显著降低（P < 0 .05）；戴用义齿1、3个月两次复查时，两组患者颊舌侧的菌斑指数（PLI）存在显著性差异（P < 0.05），舌侧PLI明显高于颊侧。两组间比较，患者在修复前、戴用义齿1个月后的各牙周指标值相似，差异无统计学意义（P > 0.05）；戴用义齿3个月后，两组患者的基牙PLI值差异不明显，而基牙GI及全唾液中MMP-8水平的差异有统计学意义（P < 0.05），试验组明显高于对照组。结论    老年中重度牙周炎伴2型糖尿病患者戴用可摘局部义齿后牙龈炎症较重；戴用可摘局部义齿可引起老年中重度牙周炎伴2型糖尿病患者全唾液中MMP-8表达水平升高。

关键词: 2型糖尿病, 中重度牙周炎, 可摘局部义齿, 基质金属蛋白酶（MMP）-8

Abstract:

Objective    To investigate the effects of removable partial denture on periodontitis status and the level of matrix metalloproteinase（MMP）-8 in whole saliva of elderly patients with moderate to advanced periodontitis and type 2 diabetes. Methods    Totally 16 cases of elderly patients with moderate to advanced periodontitis and type 2 diabetes were included in the experiment group，and 14 patients with moderate to advanced periodontitis in the Department of Stomatology of Affiliated Hospital of Chengde Medical College from July to December 2015 were included as control group. The clinical periodontal index and whole saliva MMP-8 content of two groups were detected before and after 1 month and 3 months of treatment，respectively. Results    After 1 month and 3 months of wearing denture，the periodontal indexes and the MMP-8 level in the whole saliva of the two groups were significantly higher than those before treatment（P < 0.05）. Three months after wearing denture，gingival index （GI） and MMP-8 level in the two groups were significantly lower than those in after 1 month（P < 0.05）. There was a significant difference in the level of plaque index （PLI） on the cheek side（P < 0.05），and the level of PLI on the lingual side was significantly higher than that in the buccal side after 1 month and 3 months of wearing denture. There was no significant difference in periodontal index between the two groups after 1 month of wearing denture. After 3 months of wearing denture，there was no significant difference in PLI between the two groups. There was a significant difference in GI of the abutment and the level of MMP-8 in whole saliva（P < 0.05），the experiment group being significantly higher than the control group. Conclusion    Elderly patients with moderate to advanced periodontitis and type 2 diabetes mellitus have severe gingivitis after wearing removable partial dentures. Wearing removable partial dentures can increase the expression of MMP-8 in whole saliva of elderly patients with moderate to severe periodontitis and type 2 diabetes.

Key words: type 2 diabetes mellitus, moderate to advanced periodontitis, removable partial dentures, matrix metalloproteinase（MMP）-8