Dental implant tedavisi alan bireylerde diabet ve sigaranın uzun dönem periimplant sulkus mikroflorasına etkisinin değerlendirilmesi
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2018
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İnönü Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
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Dental İmplant Tedavisi Alan Bireylerde Diabet Ve Sigaranın Uzun Dönem Periimplant Sulkus Mikroflorasına Etkisinin Değerlendirilmesi Amaç: Bu çalışmada en az 3 yıldır fonksiyonda dental implantları olan bireylerin implantlarından ve doğal dişlerinden elde edilen klinik ve mikrobiyolojik bulguların diabetes mellitus (DM) varlığı ve sigara kullanımına göre karşılaştırmalı değerlendirilmesi amaçlandı. Materyal ve metot: Çalışmaya İnönü Üniversitesi Diş Hekimliği Fakültesi Periodontoloji Anabilim Dalı'nda 2010-2015 yılları arasında dental implant tedavisi alan DM olan ve olmayan 35 birey dahil edildi. Çalışmaya dahil edilen bireylere çalışmanın amacı ve yöntemi hakkında bilgi verilip imzalı onayları alındı. Çalışma protokolu gereği çalışmaya dahil edilen bireyler; Sigara kullanan DM olan bireyler (S-D), sigara kullanmayan DM olan bireyler (NS-D), sigara kullanan sağlıklı bireyler (S-ND), sigara kullanmayan sağlıklı bireyler (NS-ND) olarak 4 gruba ayrıldı. Çalışma kapsamındaki katılımcıların tüm implant ve dişlerinden klinik değerlendirme amacıyla plak indeksi (Pİ), gingival indeks (Gİ), sondalamada kanama (SK) ve sondalama derinliği (SD) ölçümleri gerçekleştirildi. Radyografik değerlendirme için bireylerden panoramik radyografiler alındı. Subgingival mikroflora içeriğinin değerlendirilmesi için implant ve dişlerden subgingival mikrobiyolojik örnekler alındı. Elde dilen örnekler İnönü üniversitesi Tıp Fakültesi Mikrobiyoloji Anabilim Dalı'nda PZR yöntemi ile analiz edildi. Klinik ve labaratuar bulgularının karşılaştırmalarında niceliksel verileri karşılaştırmak için Oneway Anova testi kulanılırken niteliksel verileri karşılaştırmak için de Ki-Kare testi, Fisher's Exact Ki-Kare testi, Continuity (Yates) düzeltmesi ve Fisher Freeman Halton testi kullanıldı. Bulgular: Bu çalışmada S-D grubunda periimplant bölge durumunun değerlendirilmesinde implantların periimplantitis olma oranı anlamlı derecede yüksekti. NS-ND grubunda ise implantların sağlıklı olma oranı ve periodontal durumun gingivitis olma oranı istatistiksel olarak anlamlı derecede yüksekti (p<0.05). İncelenen mikroorganizmalardan Fusobacterium nucleatum, Porphyromonas gingivalis, Prevotella intermedia ve Eikenella corrodens görülme oranları tüm gruplarda benzerdi (p>0.05). Prevotella nigrescens, Streptococcus mutans, Peptostreptococcus, Treponema denticola türlerinin sigara içen gruplarda istatistiksel olarak anlamlı derecede yüksek olduğu tespit edildi. Tannerella forsythia ve Campylobacter rectus türleri NS-D grubunda, Streptococcus sanguinis ise hem S-D hem de S-ND gruplarında anlamlı derecede düşük olduğu görüldü (p<0.05). vii Sigara içen DM'li grupta implantlarda Prevotella nigrescens görülme oranının dişlerden istatistiksel olarak anlamlı derecede yüksek olduğu görüldü (p:0.039; p<0.05). Diğer gruplarda diş ve implantlar arasında mikroorganizmaların dağılımları benzerdi (p>0.05). NS- ND grubunda PD 0-4 mm arasında olan bölgelerde Tannerella forsythia ve Treponema denticola görülme oranının, PD 4-6 mm arasında olan bölgelere göre anlamlı düzeyde düşük olduğu görüldü. PD >6mm olan bölgelerde NS-D grubunda Eikenella corrodens, S-ND grubunda Porphyromonas gingivalis, S-D grubunda ise Campylobacter rectus ve Tannerella forsythia oranının anlamlı düzeyde yüksek olduğu görüldü (p<0.05). Sonuç: Sonuç olarak bulgular DM'li hastalarda periodontal ve periimplant durumun daha kötü olduğunu, sigaranın diabetli ve sağlıklı bireylerde uzun dönem fonksiyonda olan implantlarda periimplant mikroflora kompozisyonunu daha kompleks hale getirdiğini göstermektedir. Anahtar kelimeler: Dental implantlar, mikrobiyoloji, diabetes mellitus, sigara
Evaluation Of The Effects Of Diabetes Mellitus And Smoking On Long Term Periimplant Sulcus Microflora İn Patients With Dental İmplant Aim: In this study, it was aimed to compare clinical and microbiological findings obtained from implants and teeth of individuals with dental implants in function for at least 3 years with respect to presence of.diabetes mellitus (DM) and smoking. Material and Methods: The study included 35 individuals with and without DM who have been rehabilitated by dental implants between 2010 and 2015 at the Department of Periodontology, Faculty of Dentistry, Inonu University. Informed consent was obtained from all subjects who were willing to participate in this study. According to the study protocol, individuals included in the study were divided into 4 groups; Smoking individuals with DM (S-D), non-smoking individuals with DM (NS-D), smoking healthy individuals (S-ND) and healthy non-smoking individuals. During clinical evaluation, plaque index (PI), gingival index (GI), bleeding on probing (BOP) and probing depth (PD) measurements were performed for all implants and teeth of the study subjects. Panoramic radiographs were taken from the individuals for radiographic evaluation. Subgingival microbiological samples were taken from the implants and teeth for the evaluation of the content of subgingival microflora. The samples obtained were analyzed by PCR (polymerase chain reaction) method at the Department of Microbiology, Faculty of Medicine, Inonu University. For comparing clinical and laboratory findings, Oneway Anova test was used for quantitative data whereas Chi-square test, Fisher's Exact Chi-square test, Continuity (Yates) correction and Fisher Freeman Halton test were used for qualitative data. Results: In this study, during the evaluation of periimplant site the rate of periimplantitis in the S-D group and the rate of healthy implants and the rate of gingivitis in the NS-ND group were statistically significant (p <0.05). The incidence of Fusobacterium nucleatum, Porphyromonas gingivalis, Prevotella intermedia and Eikenella corrodens among the microorganisms examined was similar in all groups (p> 0.05). Prevotella nigrescens, Streptococcus mutans, Peptostreptococcus and Treponema denticola species were found to be statistically significantly higher in smoking groups. Tannerella forsythia and Campylobacter rectus were found to be significantly lower in non-smoking diabetic patients while Streptococcus sanguinis was significantly lower in smoking groups (p <0.05). ix The incidence of Prevotella nigrescens in smokers with diabetes mellitus was found statistically significantly higher in the implants than in the teeth (p: 0.039, p <0.05). In the other groups, the distribution of the microorganisms was similar both on teeth and implants (p> 0.05). In the NS-ND group, the incidence of Tannerella forsythia and Treponema denticola was found significantly lower in the PD 0-4 mm area than in the PD 4-6 mm area. In the areas with PD> 6 mm, the ratio of Eikenella corrodens in S-ND group, Porphyromonas gingivalis in S-ND group and Campylobacter rectus and Tannerella forsythia in S-D group were significantly higher (p <0.05). Conclusion: In conclusion, our findings suggest that periodontal and periimplant clinical findings are worse in patients with diabetes and smoking makes the periimplant microflora composition more complex at long-term implants in diabetic and healthy individuals. Key Words: Dental implants, microbiology, diabetes mellitus, cigarette.
Evaluation Of The Effects Of Diabetes Mellitus And Smoking On Long Term Periimplant Sulcus Microflora İn Patients With Dental İmplant Aim: In this study, it was aimed to compare clinical and microbiological findings obtained from implants and teeth of individuals with dental implants in function for at least 3 years with respect to presence of.diabetes mellitus (DM) and smoking. Material and Methods: The study included 35 individuals with and without DM who have been rehabilitated by dental implants between 2010 and 2015 at the Department of Periodontology, Faculty of Dentistry, Inonu University. Informed consent was obtained from all subjects who were willing to participate in this study. According to the study protocol, individuals included in the study were divided into 4 groups; Smoking individuals with DM (S-D), non-smoking individuals with DM (NS-D), smoking healthy individuals (S-ND) and healthy non-smoking individuals. During clinical evaluation, plaque index (PI), gingival index (GI), bleeding on probing (BOP) and probing depth (PD) measurements were performed for all implants and teeth of the study subjects. Panoramic radiographs were taken from the individuals for radiographic evaluation. Subgingival microbiological samples were taken from the implants and teeth for the evaluation of the content of subgingival microflora. The samples obtained were analyzed by PCR (polymerase chain reaction) method at the Department of Microbiology, Faculty of Medicine, Inonu University. For comparing clinical and laboratory findings, Oneway Anova test was used for quantitative data whereas Chi-square test, Fisher's Exact Chi-square test, Continuity (Yates) correction and Fisher Freeman Halton test were used for qualitative data. Results: In this study, during the evaluation of periimplant site the rate of periimplantitis in the S-D group and the rate of healthy implants and the rate of gingivitis in the NS-ND group were statistically significant (p <0.05). The incidence of Fusobacterium nucleatum, Porphyromonas gingivalis, Prevotella intermedia and Eikenella corrodens among the microorganisms examined was similar in all groups (p> 0.05). Prevotella nigrescens, Streptococcus mutans, Peptostreptococcus and Treponema denticola species were found to be statistically significantly higher in smoking groups. Tannerella forsythia and Campylobacter rectus were found to be significantly lower in non-smoking diabetic patients while Streptococcus sanguinis was significantly lower in smoking groups (p <0.05). ix The incidence of Prevotella nigrescens in smokers with diabetes mellitus was found statistically significantly higher in the implants than in the teeth (p: 0.039, p <0.05). In the other groups, the distribution of the microorganisms was similar both on teeth and implants (p> 0.05). In the NS-ND group, the incidence of Tannerella forsythia and Treponema denticola was found significantly lower in the PD 0-4 mm area than in the PD 4-6 mm area. In the areas with PD> 6 mm, the ratio of Eikenella corrodens in S-ND group, Porphyromonas gingivalis in S-ND group and Campylobacter rectus and Tannerella forsythia in S-D group were significantly higher (p <0.05). Conclusion: In conclusion, our findings suggest that periodontal and periimplant clinical findings are worse in patients with diabetes and smoking makes the periimplant microflora composition more complex at long-term implants in diabetic and healthy individuals. Key Words: Dental implants, microbiology, diabetes mellitus, cigarette.
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SABANCI, A.(2018). Dental implant tedavisi alan bireylerde diabet ve sigaranın uzun dönem periimplant sulkus mikroflorasına etkisinin değerlendirilmesi,İnönü Üniversitesi / Diş Hekimliği Fakültesi / Periodontoloji Ana Bilim Dalı.
