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Journal of Pakistan Dental Association
MANAGEMENT OF DIABETES
MELLITUS PATIENTS IN
PROSTHODONTICS
Mehmood Hussain,
BDS,
Nazia Yazdanie
BDS,MSc, Ph.D
Jodat Askari
BDS,FCPS
INTRODUCTION
iabetes Mellitus is a clinical syndrome
Always use an occlusal scheme that has narrow buccolingual dimension and shortened mesiodistal length. This
approach will decrease the stress on the underlying tissue
to retard bone resorption, concept of neutral zone can also
be employed. Denture flanges should be smooth and
polished. There should be no working or non-working
occlusal interference between opposing teeth. 15
It is also mandatory for the dentist to fully educate and
motivate the patient to the importance of maintaining good
oral hygiene and towards the importance of regular followup visits to the dentist.
This will ensure the long term heath of the oral tissues by
preventing chronic infection states such as denture related
stomatitis and denture hyperplasia that could lead to more
serious conditions. Diabetic patients are more susceptible
to infections which in severe cases may lead to excessive
oral tissue destructions, such patients may need
obturators. Fabrication of obturator require special care in
every patient and especially in diabetic patient. 16
For patients requiring a fixed prosthesis like crown or fixed
partial denture (FPD), the finish-line of the preparation
should be placed supragingival and to provide chamfer
finish-line on the facial aspect of prepared tooth as it is
better than shoulder because shoulder can concentrate
stresses on weakened tooth/ teeth. Antes law should be
obeyed; minimal preparation like three quarter crown can
be done on teeth like pre molar.
A narrow occlusal table, group function or mutually
protected occlusal scheme is better choice for periodontally
compromised teeth.17. In certain cases procedures like
crown lengthening, periodontal surgery and orthodontic
extrusion of tooth will further improve the quality of fixed
prosthesis in diabetic patients.18 Implant supported
prosthesis are not advised for patients whose blood sugar
level remains uncontrollable but if conditions are
favorable , then this type of prosthesis can be planned. Like
Conclusion
Diabetes Mellitus is a complex disorder having many oral
and systemic problems. Multi disciplinary approach is
needed for the management of diabetes mellitus.
Fabrication of dental prosthesis would only be started after
complete evaluation of diabetic patients through history,
examination and making diagnostic cast. Before embarking
any procedure for dental prosthesis, oral hygiene of the
diabetic patients must be evaluated and should be
improved through different surgical and non-surgical
periodontal therapies and restorative techniques. Apart
from conventional removable or fixed dental prosthesis,
introduction of dental implants helps to improve the quality
of life of the patients by better masticatory ability of the
dental prosthesis. In this article along with oral
complications of Diabetes Mellitus, various Prosthodontics
treatment options available for diabetic patients are
discussed Management of diabetic patients in
Prosthodontics should be done carefully. Before embarking
dental treatment it is better to consult patients physician.
Good oral and denture hygiene maintenance is a pre
requisite for ensuring the long term successful
Prosthodontics treatment. With an increasing incidence and
prevalence of Diabetes Mellitus, the role of oral health care
provider becomes very important
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