ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM
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Title Limited Evidence On Soft Tissue Oral Wound Healing In Patients With Type 2 Diabetes Mellitus Following Oral Surgical Procedures
Clinical Question In adults with uncontrolled diabetes mellitus, is oral wound healing following oral surgical procedures compromised when compared to controlled and normal patients?
Clinical Bottom Line Overall limited data are available to address this question, however this study directly examines oral wound healing in diabetic patients ranging from well controlled to poorly controlled, and suggests no compromises following oral surgical procedures based on glycemic control.
Best Evidence (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 20950911Aronovich/2010115 Human; ages 39-94, type II diabetesProspective cohort study
Key resultsGlycemic control appears to have no influence on healing with respect to epithelialization of extraction sites.
Evidence Search ("Wound Healing"[Mesh] AND "Diabetes Mellitus"[Mesh]) AND "Tooth Extraction"[Mesh]
Comments on
The Evidence
Non-fasting blood glucose levels were gathered by either the hospital laboratory or the patients primary care physician. Patients with diabetes mellitus were categorized as well-controlled blood glucose (BG) level ≤ 180 mg/dl n=55 and poorly controlled BG level > 180 mg/dl n=23. Of this group n=70 had HbA1c values updated and were categorized into 3 groups A1c <7.0% n=37, A1c=7.1-9.0% n=21, and A1c >9.0% n=12. Postoperative epithelialization measurements were done in a blinded manner to reduce potential bias.
Applicability This article is valid with regard to studying on human subjects with diabetes mellitus but there is still limited evidence in providing the concerns for poorly controlled diabetics with oral wound healing.
Specialty/Discipline (Oral Surgery) (Periodontics)
Keywords Wound healing, blood glucose, diabetes mellitus, humans,
ID# 2233
Date of submission: 04/12/2012spacer
E-mail vargasu@livemail.uthscsa.edu
Author Ulysses Joseph Vargas
Co-author(s)
Co-author(s) e-mail
Faculty mentor/Co-author Thomas Oates, DMD, PhD
Faculty mentor/Co-author e-mail oates@uthscsa.edu
Basic Science Rationale
(Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?)
post a rationale
None available
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Comments on the CAT
(FOR PRACTICING DENTISTS' and/or FACULTY COMMENTS ON PUBLISHED CATs)
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by Mariyam Shah, Cesar Gonzalez (San Antonio, Texas) on 12/11/2017
A PubMed search conducted in 2017 found a newer study related to the topic of this CAT: Huang/2013, PMID #23441797. This study was a prospective cohort study, and the findings were relatively similar to those supporting the published CAT; the view on diabetes and delayed wound healing is not supported. There is still limited data. Another study by Fernandes/2015, PMID #26227644, concluded that "type 2 diabetes per se or glycemic control is not a risk factor for experiencing postoperative complications in people undergoing dental extractions." In order to better understand the relationship between glycemic control and healing of the periodontium, larger and more carefully conducted studies are still needed.
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