Periodontal Regenerative Therapy in Patient with Chronic Periodontitis and Type 2 Diabetes Mellitus: A Case Report.
We report a case of generalized chronic periodontitis and type 2 diabetes mellitus requiring periodontal treatment including regenerative therapy. The patient was a 66-year-old man who presented with the chief complaint of gingival inflammation and mobile teeth in the molar region. He had been being treated for type 2 diabetes mellitus since 1999. His glycated hemoglobin (HbA1c) level was 7.8%. An initial examination revealed sites with a probing depth of ≥7 mm in the molar region, and radiography revealed angular bone defects in this area. Based on a clinical diagnosis of generalized chronic periodontitis, the patient underwent initial periodontal therapy. An improvement was observed in periodontal conditions on reevaluation, and his HbA1c level showed a reduction to 6.9%. Periodontal regenerative therapy with enamel matrix derivative was then performed on #16, 26, and 27. Following another reevaluation, a removable partial denture was fabricated for #47 and the patient placed on supportive periodontal therapy (SPT). To date, periodontal conditions have remained stable and the patient's HbA1c level has increased to 7.5% during SPT. The results show the importance of collaboration between dentist and physician in managing periodontal and diabetic conditions in such patients.
Department of Periodontology, Tokyo Dental College.
Fumi
F
Seshima
Makiko
M
Nishina
Takashi
T
Namba
Atsushi
A
Saito
D000368:Aged; D016301:Alveolar Bone Loss / Q000209:etiology / Q000601:surgery*; D000539:Alveolar Process / Q000637:transplantation*; D001786:Blood Glucose / Q000378:metabolism; D016025:Bone Transplantation / Q000379:methods*; D055113:Chronic Periodontitis / Q000150:complications* / Q000628:therapy*; D015897:Comorbidity; D003746:Dental Enamel Proteins / Q000627:therapeutic use*; D003774:Dental Plaque Index; D012534:Dental Scaling; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000628:therapy; D005891:Gingivitis / Q000209:etiology / Q000628:therapy; D006442:Glycated Hemoglobin / Q000737:chemistry / Q000378:metabolism*; D016557:Guided Tissue Regeneration, Periodontal / Q000379:methods*; D006267:Health Education, Dental; D006509:Hepatitis B; D006801:Humans; D008297:Male; D008311:Malocclusion, Angle Class I / Q000628:therapy; D008963:Molar / Q000473:pathology / Q000601:surgery; D009910:Oral Hygiene / Q000193:education; D010347:Patient Care Planning; D017622:Periodontal Attachment Loss / Q000209:etiology / Q000628:therapy*; D010512:Periodontal Index; D010514:Periodontal Pocket / Q000601:surgery*; D011788:Quality of Life; D016745:Root Planing; D014081:Tooth Extraction; D014086:Tooth Mobility / Q000209:etiology / Q000628:therapy*; D014095:Tooth, Impacted / Q000601:surgery; D016896:Treatment Outcome
D001786:Blood Glucose; D003746:Dental Enamel Proteins; D006442:Glycated Hemoglobin; C109069:enamel matrix proteins