周琦琪 韩祥祯 张文静 崔杰

[摘要]目的：探究糖尿病及牙周炎伴牙列缺損患者种植治疗的预后疗效，以此作为该类患者种植治疗术前评估，为提高种植成功率提供参考依据。方法：分别于种植前和种植后4周、12周与24周收集2型糖尿病患者组、牙周炎患者组以及对照组患者唾液，记录探诊深度、测量种植体稳定性，实验ELISA法检测唾液中的IL-1β与TNF-α，荧光定量PCR测量TF、Pg、Td、Fn的相对SQ值变化。结果：2型糖尿病患者组、牙周炎患者组的ISQ值与对照组比较无统计学差异（P<0.05），组内显示对比ISQ值在12周时明显高于术中，提示稳定性呈增加趋势，具有统计学意义（P<0.05）;两实验组的唾液中IL-1β和TNF-α的含量高于对照组，并有统计学意义（P<0.05），且两组随时间推移，唾液中IL-1β和TNF-α的含量均降低，具有统计学意义（P<0.05）;Tf、Pg、Fn 的相对SQ值四次检查结果逐渐减少，差异有统计学意义（P<0.05），Td相对SQ值四次检查结果无显著性差异（P>0.05）。结论：菌斑控制良好的牙周炎患者与血糖控制良好的糖尿病患者，均可取得与正常患者一致的种植初期稳定性，且炎性因子和细菌水平持续降低，提示两者均可以取得较好的种植预后效果。

[关键词]全唾液;糖尿病;慢性牙周炎;种植术;种植体稳定性

[中图分类号]R782.12    [文献标志码]A    [文章编号]1008-6455（2021）01-0104-05

Analysis of the Clinical Effect of Complete Saliva Analysis on the Repair of Dental Implant Denture in Patients with Diabetes and Periodontitis with Dentition Defect

ZHOU Qi-qi， HAN Xiang-zhen， ZHANG Wen-jing， CUI Jie

（Department of Prosthodontics， the First Affiliated Hospital of Xinjiang Medical University， Urumqi 830054， Xinjiang， China）

Abstract： Objective  To explore the prognosis of patients with diabetes and periodontitis with dentition defect，and to provide reference for improving the success rate of implantation. Methods  Saliva of patients with type 2 diabetes mellitus， periodontitis and control group were collected before implantation and 4 weeks， 12 weeks and 24 weeks after implantation， respectively. The depth of exploration was recorded and the stability of implantation was measured. IL-1B and TNF-α in saliva were detected by experimental ELISA， and the changes of TF，Pg，Td，Fn were measured by RT-PCR. Results There was no significant difference in ISQ between the two groups （P<0.05）. The results showed that the ISQ of the two groups was significantly higher than that of the control group at 12 weeks， suggesting that the stability was increasing （P<0.05）. The contents of IL-1β and TNF -α in saliva of the two experimental groups were higher than that of the control group （P<0.05）， and the two groups were statistically significant （P<0.05） .The contents of IL-1β and TNF-α in saliva were all decreased （P<0.05）.The relative SQ values of TF， PG and FN were gradually decreased （P<0.05）， and the difference was statistically significant （P<0.05）. Conclusion  In a short period of time， periodontitis patients with good plaque control and diabetes patients with good blood glucose control can achieve the same implant stability as normal patients， and the inflammatory inheritance and bacterial level are reduced， suggesting that they can achieve better implant prognosis.

Key words： whole unstimulated saliva;diabetes mellitus; chronic periodontitis; implantation;implant stability quotient

牙列缺损是常见的口腔疾病，该疾病患者主要集中在老年人中，而中老年患者随着年龄增加，患牙周病与2型糖尿病的风险也随之变大。牙列缺损会严重影响患者的美观以及咀嚼功能，甚至影响患者的心理健康，很大程度上降低了患者的生活质量[1]。现今，随着生活水平的日益提升及口腔修复学科的发展，口腔种植的技术也愈加成熟稳定，修复后具有对原口腔结构损伤小，术后咀嚼效率较高等优点被越来越多的接受，已成为公认的首选修复方式[2]。在我国，牙周炎导致牙齿缺失一直排在失牙原因的首位。调查显示[3]，我国成人拔牙总量的40%是由于牙周疾病导致的。……