Pathogenesis and treatment of wound healing in patients with diabetes after tooth extraction

Abstract

Diabetes mellitus is a common systematic chronic disease amongst dental patients. The elevated glucose microenvironment can prolong the healing of tooth extraction sockets. Therefore, the promotion of healing up tooth extraction sockets is of great clinical importance to the patients with diabetes mellitus. The current evidence indicates the mechanism of the recovery period of extraction sockets in hyperglycaemia conditions from physiological, inflammation, immune, endocrine and neural aspects. New advancements have been made in varied curative approaches and drugs in the management of wound healing of tooth extraction sockets in diabetes. However, most of the interventions are still in the stage of animal experiments, and whether it can be put into clinical application still needs further explorations. Specifically, our work showed topical administration of plasma-rich growth factor, advanced platelet-rich fibrin, leukocyte- and platelet-rich fibrin and hyaluronic acid as well as maxillary immediate complete denture is regarded as a promising approach for clinical management of diabetic patients requiring extractions. Overall, recent studies present a blueprint for new advances in novel and effective approaches for this worldwide health ailment and tooth extraction sockets healing.

Is alveolar ridge preservation an overtreatment?

“…The physiological and metabolic processes involved in wound healing can be adversely affected by systemic conditions such as diabetes, 56 vascular disease, malnutrition, 57 radiation exposure, immunodeficiency, osteoporosis, 58,59 renal disease, 60 endocrine disorders, and smoking 61 . As a result, these conditions may impact postextraction remodeling by reducing and delaying hard and soft tissue healing.…”

“…51 In addition, the surgical trauma from tooth extraction, 52,53 pre-existing bone loss, or concurrent chronic infection 54,55 may increase and accelerate bone resorption of the | 291 surrounding socket walls, while the extraction of single or adjacent multiple teeth may also influence the extent of the vertical and horizontal oral tissue reduction. 10,53,55 The physiological and metabolic processes involved in wound healing can be adversely affected by systemic conditions such as diabetes, 56 vascular disease, malnutrition, 57 radiation exposure, immunodeficiency, osteoporosis, 58,59 renal disease, 60 endocrine disorders, and smoking. 61 As a result, these conditions may impact postextraction remodeling by reducing and delaying hard and soft tissue healing.…”

Preoperative HbA1c and Blood Glucose Measurements in Diabetes Mellitus before Oral Surgery and Implantology Treatments

“…This results in the formation of destructive inflammatory cytokines causing delay in the healing process [ 34 ]. The majority of oral surgeons are uncertain of the threshold limit of HbA1c or blood glucose levels from where it poses an elevated risk in developing harmful complications [ 35 ].…”