背景:糖尿病影响许多器官系统,包括骨组织.在糖尿病患者中,成骨细胞的活性被抑制,骨基质中破骨细胞的活性增加,骨形成减少,这可能会破坏骨整合的过程,并最终导致崩解和失败的植入物。根据上述情况,患有糖尿病,研究骨代谢对预测和动态控制种植牙非常重要。
目的:评估2型糖尿病骨内种植牙患者血清中骨代谢标志物骨钙蛋白和β-Cross-Laps的指标。
方法:该研究包括86名患者,2018-2023年诊断为2型糖尿病,部分或完全缺牙。在患者1组中使用367个UV功能化牙种植体进行牙周治疗后进行种植手术。患者2组使用54个未UV功能化的牙科植入物进行植入手术。最终进行了4-5个月的牙科修复。使用UV活化剂YWJ-QSY001(佛山,文建·MedikalEnstriman)20秒。采用酶联免疫吸附试验(ELISA,IFARoche诊断,巴塞尔,瑞士)根据制造商的协议进行牙科植入之前和之后。评估的结果包括;植入物存活率,男性MBL,PPD,防喷器,RFA,假肢成功。
结果:没有严重的生物或假体并发症的临床检查。不同浓度的骨钙蛋白或β-交叉圈与植入物的成功率之间存在相关性。与2组患者的平均骨生化标志物相比,植入物显示出血清中低浓度的骨钙蛋白和高浓度的β-交叉融合不成功。在第二组患者中,生化骨标志物指标均在正常范围内;骨整合失败与种植体周围炎并发症之间无相关性。短种植体成功率为96,7%,5年后,标准植入成功率为97,5。
结论:植入治疗可成功用于糖尿病患者的紫外光功能化植入物,血糖水平应经常维持在正常水平。监测2型糖尿病患者的骨代谢标志物可能对植入物具有预后价值,并鼓励从业者在违反标志物的情况下应用纠正性药物治疗。
BACKGROUND: Diabetes mellitus affects many organ systems, including bone tissue.In diabetic patients, the activity of osteoblasts is suppressed and the activity of osteoclasts in the bone matrix increases, bone formation decreases, which can disrupt the process of osseointegration and ultimately lead to disintegration and failed implants. Based on the foregoing, with diabetes, it is very important to study bone metabolism to predict and dynamically control dental implants.
OBJECTIVE: To assess the indicators of bone metabolism markers Osteocalcin and β-Cross-Laps in blood serum in patients with type 2 diabetes mellitus with intraosseous dental implants.
METHODS: The study included 86 patients, diagnosed type 2 diabetes mellitus in period 2018 - 2023 with partially or complete edentulous. Implant surgery was performed after periodontal therapy using 367 UV functionalized dental implants in patients 1 group. Patients 2 group was performed implant surgery using 54 dental implants that were not UV functionalization. Final dental prosthetics was performed 4-5 months. UV functionalization of the implant surface was carried out using a UV Activator YWJ-QSY001 (Foshan, Wenjian Medikal Enstriman) for 20 s. The content biochemical markers of bone Osteocalcin and β-Cross-Laps serum was determined by enzyme-linked immunosorbent assay ELISA (ELISA, IFA Roche Diagnostics, Basel, Switzerland) before and after dental implantation according to the manufacturers\' protocols. Outcomes assessed included; implant survival, men MBL, PPD, BOP, RFA, prosthetic success.
RESULTS: There were no clinical examinations of serious biological or prosthetic complications. There is a correlation between different concentrations of Osteocalcin or β-Cross- Laps and the success rate of implants. Implants were shown to be unsuccessful low concentrations of Osteocalcin and high concentrations β-Cross- Laps in serum compared with average mean biochemical markers of bone in 2 group patients. In patients of the 2nd group, the indicators of biochemical bone markers were within the normal range; no correlation was found between osseointegration failers and the complication of peri-implatitis. Short implants success rate was 96,7 %, standart implants success rate was after 97,5 after 5 years.
CONCLUSIONS: Implant therapy can be successfully used in diabetic patients with UV photofunctionalized implants, blood glucose levels should be constantly maintained at a normal level. Monitoring of bone metabolism markers in patients with type 2 diabetes mellitus may have prognostic value for implants and will encourage the practitioner to apply corrective drug therapy in case of violation of markers.