2型糖尿病患者へのインプラント治療介入後にヘモグロビンA1cの改善が認められた1例

抄録

This clinical report describes a type 2 DM patient who successfully received full-mouth rehabilitation using dental implants and also experienced improvement of HbA1c with the progress of implant treatment.
A 68-year-old partially edentulous man was referred for dental implant treatment by his physician because he hoped for fixed prostheses. He presented with masticatory malfunction because of tooth mobility and posterior teeth loss. He had 18 remaining teeth, most with untreated severe chronic periodontitis. His past medical history was significant for type 2 DM, angina pectoris, and hypertension.
The patient started to receive oral hygiene instructions and nonsurgical periodontal treatment. Nine teeth were extracted and 12 implants were placed in 3 surgeries so that the patient could eat and maintain a proper esthetic appearance. Caries and endodontic treatments were performed for the residual natural teeth, which received provisional restorations. After detailed adjustment of the full-mouth provisional restorations, they were replaced with definitive restorations. A three-year followup of the case showed functionally and esthetically stable dental implant restorations with no signs of infection or bone loss. The HbA1c level decreased from 7.7% at the first visit to 5.4% after 3 years of definitive restoration delivery, although the patient's diabetes medications remained unchanged during the period.
In the present case, periodontal treatment and improvements in masticatory function associated with implant treatment may have improved glycemic control. However, a large clinical study must be undertaken to clarify the effect of periodontics and/or dental implant treatment on glycemic control.