Abstract
In this case report, we describe the management of chronic periodontitis in a patient with type 2 diabetes mellitus, including periodontal, implant and restorative treatment, tooth extraction, and maintenance care for 5 years. A 57-year-old male visited our clinic complaining of pain and mobility of 17 teeth. The patient had been diagnosed as having type 2 diabetes for 15 years previously. The mean probing depth (PD) at the first visit was 3.4 mm, the percentage of tooth sites with PD 4 mm or more was 24.4%, the rate of bleeding on probing was 30.8%, and the OʼLearyʼs plaque control record was 36.6%. As vertical and horizontal bone loss was also observed on the radiograph. Although 24.4% of the total number of sites had PD 4 mm or more at the first visit,re-evaluation after periodontal initial therapy revealed reduction of the mean PD to 6.1%. We performed implant surgery and periodontal tissue regenerative therapy with enamel matrix derivative. After re-evaluation, the final restoration was placed and the patient entered the maintenance phase. In the present case, it was possible to perform periodontal treatment while stable glycemic control was maintained. However, if the HbA1c level exceeds 7.4% (NGSP) after the patient enters the maintenance phase, re-motivation for diabetes treatment will be necessary. The blood glucose levels should be continuously and carefully monitored while the patient is in the maintenance phase. Nihon Shishubyo Gakkai Kaishi (J Jpn Soc Periodontol) 55(2)：189-199, 2013.
