Journal of Prevention and Treatment for Stomatological Diseases ›› 2021, Vol. 29 ›› Issue (2): 110-114.DOI: 10.12016/j.issn.2096-1456.2021.02.007

• Review Articles • Previous Articles     Next Articles

The effect of hypoglycemic drugs on bone metabolism and dental implantation in type 2 diabetes mellitus patients

SHI Shaojie(),LIU Xiangdong,SONG Yingliang()   

  1. State key Laboratory of military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Engineering Research Center for Dental Materials and Advanced Manufacture, Department of Oral Implants, School of Stomatology, The Fourth Military Medical University, Xi′an 710032, China
  • Received:2020-06-02 Revised:2020-07-14 Online:2021-02-20 Published:2020-12-21
  • Contact: Yingliang SONG
  • Supported by:
    grants from National Natural Science Foundation of China(81771107)

降糖药物骨代谢效应及对糖尿病患者牙种植的影响

施少杰[Author]) AND 1[Journal]) AND year[Order])" target="_blank">施少杰(),刘向东[Author]) AND 1[Journal]) AND year[Order])" target="_blank">刘向东,宋应亮[Author]) AND 1[Journal]) AND year[Order])" target="_blank">宋应亮()   

  1. 军事口腔医学国家重点实验室 国家口腔疾病临床医学研究中心 陕西省口腔生物工程技术研究中心 第四军医大学口腔医院种植科,陕西 西安(710032)
  • 通讯作者: 宋应亮
  • 作者简介:施少杰,本科,Email: chenyewuxin@163.com
  • 基金资助:
    国家自然科学基金项目(81771107)

Abstract:

Patients with type 2 diabetes mellitus (T2DM) have a large demand for dental implants, but the pathologic state of T2DM patients could compromise the efficacy of implant treatment. Glycemic control can improve the success rate of implants in the T2DM population, but the early osseointegration of individuals still needs to be improved. Strengthening early osseointegration in patients with T2DM is one of the urgent problems for clinicians. The pharmacological mechanisms of hypoglycemic drugs on the market for bone metabolism are different and may require different interventions on the bone around the implant, but there is a lack of direct clinical evidence of the protective effect of hypoglycemic drugs. This review integrated the bone metabolic effect of drugs in clinical medical research and dental implant research. The aim was to provide medication guidance for T2DM patients who require implant surgery, and it is recommended to avoid the use of drugs with negative effects on bone as far as possible without violating the clinical medication guidelines, including SGLT-2 inhibitors and thiazolidinediones. Instead, they should choose glucose-lowering drugs that are beneficial to bone metabolism, such as insulin, metformin and GLP-1 receptor agonists. However, the comparative clinical effects of these drugs on periimplant bone need to be further elucidated. The researcher should select appropriate drugs (incretin drugs) to enhance the early osseointegration of implants in patients with T2DM.

Key words: type 2 diabetes mellitus, type 2 diabetes mellitus, blood glucose, blood glucose, hypoglycemic medication, hypoglycemic medication, insulin, insulin, metformin, metformin, glucagon-like peptide1, glucagon-like peptide1, bone metabolism, bone metabolism, dental implant, dental implant, osseointegration, osseointegration

摘要:

2型糖尿病(type 2 diabetes mellitus,T2DM)患者的牙种植修复需求较大,但T2DM患者机体的病理环境影响了该人群的牙种植效果。牙种植术前后控制血糖稳定可提高该人群的种植成功率,然而个体的早期骨结合强度仍有待提高,增强T2DM患者种植体的早期骨结合是当前口腔种植医生急需解决的问题之一。降糖药物的骨代谢效应各不相同,可能会对种植体周围骨组织产生不同的干预作用,但是目前缺乏降糖药物对种植体周围骨组织保护作用的直接临床证据。文章整合了临床内科研究和种植牙研究中降糖药物的骨代谢效应,为即将接受种植手术的T2DM患者提出用药指导,建议在不违反临床用药准则的前提下,种植期间尽量避免使用可能不利于骨组织的药物,如钠-葡萄糖协同转运蛋白2抑制剂及噻唑烷二酮类;选择对骨代谢有益的降糖药物,如胰岛素、二甲双胍及GLP-1受体激动剂。但这些药物对牙种植体周围骨作用的临床效应对比尚需要进一步阐明。建议选取适宜的药物(肠促胰岛素类药物)进行增强T2DM患者牙种植体早期骨结合的深入研究。

关键词: 2型糖尿病, 2型糖尿病, 血糖, 血糖, 降糖药物, 降糖药物, 胰岛素, 胰岛素, 二甲双胍, 二甲双胍, 胰高血糖素样肽-1, 胰高血糖素样肽-1, 骨代谢, 骨代谢, 种植牙, 种植牙, 骨结合, 骨结合

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