Oral Wound Healing In Patients With Type 2 Diabetes Mellitus

Objectives: Wound healing is thought compromised in patients with type 2 diabetes, but there is little information available as to the effects of diabetes and glycemic control on oral wound healing. The objective of this study is to determine the influence of type 2 diabetes and glycemic status on post-operative soft tissue wound healing in the oral cavity. 

Methods: Edentate patients with (n=46) or without (n=36) type 2 diabetes undergoing surgical placement of 2 mandibular implants were assessed for healing complications 1 week post-operatively. Clinical assessments of complications were made of healing by a single masked examiner, and of inflammation by 3 independent examiners using standardized photographs.  Clinical evaluations were based on a 4-point scale (0=none; 1=mild; 2=moderate; 3=severe) for erythema, edema, exudate, flap closure, infection and hematoma.  Pain was rated using a visual analog scale (VAS) and self-reported days of pain.  Assessment of the severity of post-operative healing complications and inflammation were comparatively assessed based on diabetes status and on levels of glycemic control at baseline (HbA1c ranged from 5.2% to 9.8%).

Results: All mean scores for clinical complications were <1 (mild), mean days of pain were 3.5, and VAS_pain was 35.2 out of 100.  Mean complication scores (p=0.775), mean inflammation scores (p=0.786), VAS_pain (p=0.14), and days of pain (p=0.94) taken 1 week following implant surgery were not significantly correlated with either diabetes status or level of glycemic control. No patients had significant clinical complications requiring additional therapy at the 1 week post-operative visit.

Conclusions: This study failed to identify a relationship between diabetes status and glycemic control with post-operative complications, suggesting that patients with type 2 diabetes within this range of glycemic control may not be as susceptible to compromised oral wound healing as thought. Study supported by NIDCR (DE018902).