Частота осложнений челюстно-лицевых операций при сахарном диабете
Актуальность данное заболевание имеет в челюстно-лицевой хирургии, где нарушение репаративных процессов и склонность к инфекциям могут способствовать развитию осложнений. Целью настоящего исследования явилась оценка влияния сахарного диабета на риск послеоперационных осложнений у пациентов, перенесших челюстно-лицевые операции. Поиск публикаций проводился в международных и отечественных базах данных за период 2015–2025 гг. Всего было отобрано 25 исследований, охвативших 4 920 пациентов, из которых 2 028 имели сахарный диабет. Установлено, что осложнения возникали у 26,13 % пациентов с диабетом и у 28,04 % без диабета, что соответствует разнице абсолютных рисков -1,91 процентного пункта. Проведённый статистический анализ не подтвердил значимых различий (χ² с поправкой Йейтса, p = 0,148), а расчёт отношения шансов (OR = 0,91; 95 % ДИ: 0,80–1,03) указывает на отсутствие статистически значимых ассоциаций при тенденции к несколько более низкой частоте осложнений у пациентов с диабетом по сравнению с контрольной группой. Дополнительно выполненный анализ уровня HbA1c не продемонстрировал устойчивой прямой зависимости с частотой осложнений.
Гулиев Э.Э. оглы, Гречаный С.В., Тунекова Л.А., Русановский В.В., Романов В.В. 2026. Частота осложнений челюстно-лицевых операций при сахарном диабете. Актуальные проблемы медицины, 49(3): 335–345. DOI: 10.52575/2687-0940-2026-49-3-335-345. EDN: IQOBAH
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Список литературы
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Клинические рекомендации «Сахарный диабет 2 типа у взрослых» от 2022 № 290 // Министерство Здравоохранения Российской Федерации.
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Alenezi A. 2025. Effect of Diabetes Mellitus on Survival and Complication Rates of Tooth-Supported Fixed Dental Prostheses (FDPs): Long-Term Clinical Evaluation. J Clin Med. Aug 11; 14(16): 5673. https://doi.org/10.3390/jcm14165673
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Alsahhaf A., Alali Y., Albeshri S., Subayt A.K.A., Alomayri A., Abduljabbar T., Vohra F. 2022. Clinical, Radiographic, and Inflammatory Peri-Implant Parameters around Narrow Diameter Implant Crowns among Prediabetic and Non-Diabetic Subjects. Medicina, 58, 1839. https://doi.org/10.3390/medicina58121839
Alshahrani A., Al Deeb M., Alresayes S., Sameer A. Mokeem, Nawwaf Al-Hamoudi, Osama Alghamdi, Fahim Vohra1 and Tariq Abduljabbar. 2020. Comparison of Peri-Implant Soft Tissue and Crestal Bone Status of Dental Implants Placed in Prediabetic, Type 2 Diabetic, and Non-Diabetic Individuals: A Retrospective Cohort Study. Int J Implant Dent 6, 56 https://doi.org/10.1186/s40729-020-00255-1
Brinar S, Skvarča A, Gašpirc B, Schara R. 2023. The Effect of Antimicrobial Photodynamic Therapy on Periodontal Disease and Glycemic Control in Patients with Type 2 Diabetes Mellitus. Clin Oral Investig. 2023 Oct; 27(10): 6235–6244. doi: 10.1007/s00784-023-05239-0. Epub Sep 6. PMID: 37672083; PMCID: PMC10560165.
De Angelis P., Manicone P.F., Gasparini G., De Filippis I., Liguori M.G., De Angelis S., Cannata F., D'Addona A. 2021. The Effect of Controlled Diabetes and Hyperglycemia on Implant Placement with Simultaneous Horizontal Guided Bone Regeneration: A Clinical Retrospective Analysis. Biomed Res Int. Jun 14; 2021: 9931505. doi: 10.1155/2021/9931505. PMID: 34222488; PMCID: PMC8219425.
Dental Considerations for the Treatment of Patients with Diabetes Mellitus. Vernillo, Anthony T. The Journal of the American Dental Association, 2003. 134, 24–33. https://doi.org/10.14219/jada.archive.0366
Diehl D., Bespalov A., Yildiz M.S., Friedmann A. 2024. Restoration of Posterior Teeth by Narrow Diameter Implants in Hyperglycemic and Normoglycemic Patients - 4-Year Results of a Case-Control Study. Clin Oral Investig. Jun 22; 28(7): 392. doi: 10.1007/s00784-024-05786-0. PMID: 38907052; PMCID: PMC11192651.
D'Orto B., Polizzi E., Nagni M., Tetè G., Capparè P. 2022. Full Arch Implant-Prosthetic Rehabilitation in Patients with Type I Diabetes Mellitus: Retrospective Clinical Study with 10 Year Follow-Up. Int J Environ Res Public Health. Sep 17; 19(18): 11735. doi: 10.3390/ijerph191811735. PMID: 36142007; PMCID: PMC9517153.
Eskow C.C., Oates T.W. 2017. Dental Implant Survival and Complication Rate over 2 Years for Individuals with Poorly Controlled Type 2 Diabetes Mellitus. Clin Implant Dent Relat Res. Jun; 19(3): 423–431. doi: 10.1111/cid.12465. Epub Dec 19. PMID: 27990756; PMCID: PMC5453839. 2019
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Gadicherla S., Smriti K., Roy S., Pentapati K.C., Rajan J., Walia A. 2020. Comparison of Extraction Socket Healing in Non-Diabetic, Prediabetic, and Type 2 Diabetic Patients. Clin Cosmet Investig Dent. Jul 20; 12: 291–296. doi: 10.2147/CCIDE.S264196. PMID: 32765113; PMCID: PMC7381775.
Health Data Overview for the Russian Federation // World Health Organization: Data URL: https://data.who.int/countries/643
Juncar R.I., Precup A.I., Juncar M. 2020. Immediate Implant-Prosthetic Dental Rehabilitation of Patients with Diabetes Using Four Immediately Loaded Dental Implants: A Pilot Study. J Int Med Res. Mar; 48(3): 300060519897195. doi: 10.1177/0300060519897195. PMID: 32228306; PMCID: PMC7133089.
Masri D., Masri-Iraqi H., Nissan J., Nemcovsky C., Gillman L., Naishlos S., Chaushu L. 2022. On the Association between Implant-Supported Prosthesis and Glycemic Control (HbA1c Values). Int J Environ Res Public Health. Jun 6; 19(11): 6923. doi: 10.3390/ijerph19116923. PMID: 35682506; PMCID: PMC9180096.
Sălceanu M., Melian A., Giuroiu C.L., Dascălu C., Concita C., Topoliceanu C., Mârţu M.A. 2025. Influence of Diabetes on Periapical Pathology in Treated and Untreated Teeth: A Cross-Sectional Comparison with Non-Diabetic Patients. J Clin Med. Jun 2; 14(11): 3907. doi: 10.3390/jcm14113907. PMID: 40507669; PMCID: PMC12156074.
Sam L., Chattipakorn S., Khongkhunthian P. 2020. Osseointegration of Maxillary Dental Implants in Diabetes Mellitus Patients: A Randomized Clinical Trial Human Histomorphometric Study. Appl. Sci. 10, 6762. https://doi.org/10.3390/app1019676
Sghaireen M.G., Alduraywish A.A., Srivastava K.C., Shrivastava D., Patil S.R., Al Habib S., Hamza M., Ab Rahman S., Lynch E., Alam M.K. 2020. Comparative Evaluation of Dental Implant Failure among Healthy and Well-Controlled Diabetic Patients-A 3-Year Retrospective Study. Int J Environ Res Public Health. Jul 21; 17(14): 5253. doi: 10.3390/ijerph17145253. PMID: 32708165; PMCID: PMC7400304.
Sharma A., Deo A., Sharma A., Kumar D., Gupta P., Cheema M. 2023. Assessment of Prognosis of Dental Implants in Diabetic Patients: A Clinical Study. J Pharm Bioallied Sci. Jul; 15(Suppl 2): 920–922. https://doi.org/10.4103/jpbs.jpbs_35_23
Shigeishi H, Ohta K, Takechi M. 2015. Risk Factors for Postoperative Complications Following Oral Surgery. J Appl Oral Sci. Jul-Aug; 23(4): 419–23. https://doi.org/10.1590/1678-775720150130
Simon L.E., Karhade D.S., Tobey M.L. 2020. Oral Health Status of Hospitalized Patients With Type 2 Diabetes. Diabetes Spectr. Feb; 33(1): 58–65. https://doi.org/10.2337/ds18-0089
Stefanescu A., Sufaru I.G., Martu C., Anton D.M., Rotundu G., Earar K. 2024. Impact of Infrabony Defects Treatment on Periodontal Markers and Glycated Hemoglobin Using Platelet-Rich Fibrin, Guided Tissue Regeneration, and Access-Flap Surgery. Medicina (Kaunas). Oct 29; 60(11): 1769. doi: 10.3390/medicina60111769. PMID: 39596954; PMCID: PMC11596485.
Sultana Rafat, Raj Amit, Barbi Wagisha, Afridi Shakeb Khan, Mishra Bibhu Prasad, Malik Rajvir. 2021. A Comparative Study of Implantation Efficacy and Bone Loss in Patients with and without Diabetes. Journal of Pharmacy and Related Sciences. Nov.; 13(Suppl 2): S1410-S1413. doi: 10.4103/jpbs.jpbs_229_21
Urgent Action needed as Global Diabetes Cases Increase Four-Fold over Past Decades // World Health Organization/ 13 November 2024. URL: https://www.who.int/news/item/13-11-2024-urgent-action-needed-as-global-diabetes-cases-increase-four-fold-over-past-decades
Yamada S.I., Hasegawa T., Yoshimura N., Hakoyama Y., Nitta T., Hirahara N., Miyamoto H., Yoshimura H., Ueda N., Yamamura Y., Okuyama H., Takizawa A., Nakanishi Y., Iwata E., Akita D., Itoh R., Kubo K., Kondo S., Hata H., Koyama Y., Miyamoto Y., Nakahara H., Akashi M., Kirita T., Shibuya Y,. Umeda M., Kurita H. 2022. Prevalence of and Risk Factors for Postoperative Complications after Lower Third Molar Extraction: A Multicenter Prospective Observational Study in Japan. Medicine (Baltimore). Aug 12; 101(32): e29989. doi: 10.1097/MD.0000000000029989. PMID: 35960058; PMCID: PMC9371489.
Zeng X., Huang S., Ye X., Song S., He J., Hu L., Deng S., Liu F. Impact of HbA1c Control and Type 2 Diabetes Mellitus Exposure on the Oral Microbiome Profile in the Elderly Population. J Oral Microbiol. 2024 May 15; 16(1): 2345942. https://doi.org/10.1080/20002297.2024.2345942
References
Dedov I.I., M Shestakova V., Vikulova O.K., Zheleznyakova A.V., Isakov M.A., Sazonova D.V., Mokrysheva N.G. 2023. Diabetes Mellitus in the Russian Federation: Dynamics of Epidemiological Indicators According to the Federal Register of Diabetes Mellitus for the Period 2010–2022. Diabetes Mellitus. 26(2): 104–123 (in Russian). https://doi.org/10.14341/DM13035LE
Clinical Guidelines "Type 2 Diabetes Mellitus in Adults" dated 2022 No. 290 // Ministry of Health of the Russian Federation (in Russian). URL: <url> https://cr.minzdrav.gov.ru/view-cr/290_2
Al Zahrani S., Al Mutairi A.A. 2018. Crestal Bone Loss around Submerged and Non-Submerged Dental Implants in Individuals with Type-2 Diabetes Mellitus: A 7-Year Prospective Clinical Study. Med Princ Pract. 28(1): 75–81. doi: 10.1159/000495111. Epub Nov 5. PMID: 30396170; PMCID: PMC6558320.2019
Alberti A., Morandi P., Zotti B., Tironi F., Francetti L., Taschieri S., Corbella S. 2020. Influence of Diabetes on Implant Failure and Peri-Implant Diseases: A Retrospective Study. Dent J (Basel). Jul 4; 8(3): 70. https://doi.org/10.3390/dj8030070
Alenezi A. 2025. Effect of Diabetes Mellitus on Survival and Complication Rates of Tooth-Supported Fixed Dental Prostheses (FDPs): Long-Term Clinical Evaluation. J Clin Med. Aug 11; 14(16): 5673. https://doi.org/10.3390/jcm14165673
Al Helal A.A. 2024. Clinical Outcomes and Cytokine Profile of Standard and Short Implant-supported Prostheses in Diabetics Treated for Periodontal Disease: A 5-year Study. Oral Health Prev Dent. Dec 3; 22: 623–630. doi: 10.3290/j.ohpd.b5866861. PMID: 39625348; PMCID: PMC12094103.
Alsahhaf A., Alali Y., Albeshri S., Subayt A.K.A., Alomayri A., Abduljabbar T., Vohra F. 2022. Clinical, Radiographic, and Inflammatory Peri-Implant Parameters around Narrow Diameter Implant Crowns among Prediabetic and Non-Diabetic Subjects. Medicina, 58, 1839. https://doi.org/10.3390/medicina58121839
Alshahrani A., Al Deeb M., Alresayes S., Sameer A. Mokeem, Nawwaf Al-Hamoudi, Osama Alghamdi, Fahim Vohra1 and Tariq Abduljabbar. 2020. Comparison of Peri-Implant Soft Tissue and Crestal Bone Status of Dental Implants Placed in Prediabetic, Type 2 Diabetic, and Non-Diabetic Individuals: A Retrospective Cohort Study. Int J Implant Dent 6, 56 https://doi.org/10.1186/s40729-020-00255-1
Brinar S, Skvarča A, Gašpirc B, Schara R. 2023. The Effect of Antimicrobial Photodynamic Therapy on Periodontal Disease and Glycemic Control in Patients with Type 2 Diabetes Mellitus. Clin Oral Investig. 2023 Oct; 27(10): 6235–6244. doi: 10.1007/s00784-023-05239-0. Epub Sep 6. PMID: 37672083; PMCID: PMC10560165.
De Angelis P., Manicone P.F., Gasparini G., De Filippis I., Liguori M.G., De Angelis S., Cannata F., D'Addona A. 2021. The Effect of Controlled Diabetes and Hyperglycemia on Implant Placement with Simultaneous Horizontal Guided Bone Regeneration: A Clinical Retrospective Analysis. Biomed Res Int. Jun 14; 2021: 9931505. doi: 10.1155/2021/9931505. PMID: 34222488; PMCID: PMC8219425.
Dental Considerations for the Treatment of Patients with Diabetes Mellitus. Vernillo, Anthony T. The Journal of the American Dental Association, 2003. 134, 24–33. https://doi.org/10.14219/jada.archive.0366
Diehl D., Bespalov A., Yildiz M.S., Friedmann A. 2024. Restoration of Posterior Teeth by Narrow Diameter Implants in Hyperglycemic and Normoglycemic Patients - 4-Year Results of a Case-Control Study. Clin Oral Investig. Jun 22; 28(7): 392. doi: 10.1007/s00784-024-05786-0. PMID: 38907052; PMCID: PMC11192651.
D'Orto B., Polizzi E., Nagni M., Tetè G., Capparè P. 2022. Full Arch Implant-Prosthetic Rehabilitation in Patients with Type I Diabetes Mellitus: Retrospective Clinical Study with 10 Year Follow-Up. Int J Environ Res Public Health. Sep 17; 19(18): 11735. doi: 10.3390/ijerph191811735. PMID: 36142007; PMCID: PMC9517153.
Eskow C.C., Oates T.W. 2017. Dental Implant Survival and Complication Rate over 2 Years for Individuals with Poorly Controlled Type 2 Diabetes Mellitus. Clin Implant Dent Relat Res. Jun; 19(3): 423–431. doi: 10.1111/cid.12465. Epub Dec 19. PMID: 27990756; PMCID: PMC5453839. 2019
Farhan Raza Khan, Komal Iftikhar, Ayesha Hashmi, Madiha Ismail, Sheharyar Hameed Siddiqui, Humayun Kaleem Siddiqui. 2021. Complications of Extraction Socket among Diabetic, Hypertensive and Smokers in Comparison to Normal Patients, Advances in Oral and Maxillofacial Surgery, Vol. 2. 100032, ISSN 2667-1476, https://doi.org/10.1016/j.adoms.2021.100032.
Gadicherla S., Smriti K., Roy S., Pentapati K.C., Rajan J., Walia A. 2020. Comparison of Extraction Socket Healing in Non-Diabetic, Prediabetic, and Type 2 Diabetic Patients. Clin Cosmet Investig Dent. Jul 20; 12: 291–296. doi: 10.2147/CCIDE.S264196. PMID: 32765113; PMCID: PMC7381775.
Health Data Overview for the Russian Federation // World Health Organization: Data URL: https://data.who.int/countries/643
Juncar R.I., Precup A.I., Juncar M. 2020. Immediate Implant-Prosthetic Dental Rehabilitation of Patients with Diabetes Using Four Immediately Loaded Dental Implants: A Pilot Study. J Int Med Res. Mar; 48(3): 300060519897195. doi: 10.1177/0300060519897195. PMID: 32228306; PMCID: PMC7133089.
Masri D., Masri-Iraqi H., Nissan J., Nemcovsky C., Gillman L., Naishlos S., Chaushu L. 2022. On the Association between Implant-Supported Prosthesis and Glycemic Control (HbA1c Values). Int J Environ Res Public Health. Jun 6; 19(11): 6923. doi: 10.3390/ijerph19116923. PMID: 35682506; PMCID: PMC9180096.
Sălceanu M., Melian A., Giuroiu C.L., Dascălu C., Concita C., Topoliceanu C., Mârţu M.A. 2025. Influence of Diabetes on Periapical Pathology in Treated and Untreated Teeth: A Cross-Sectional Comparison with Non-Diabetic Patients. J Clin Med. Jun 2; 14(11): 3907. doi: 10.3390/jcm14113907. PMID: 40507669; PMCID: PMC12156074.
Sam L., Chattipakorn S., Khongkhunthian P. 2020. Osseointegration of Maxillary Dental Implants in Diabetes Mellitus Patients: A Randomized Clinical Trial Human Histomorphometric Study. Appl. Sci. 10, 6762. https://doi.org/10.3390/app1019676
Sghaireen M.G., Alduraywish A.A., Srivastava K.C., Shrivastava D., Patil S.R., Al Habib S., Hamza M., Ab Rahman S., Lynch E., Alam M.K. 2020. Comparative Evaluation of Dental Implant Failure among Healthy and Well-Controlled Diabetic Patients-A 3-Year Retrospective Study. Int J Environ Res Public Health. Jul 21; 17(14): 5253. doi: 10.3390/ijerph17145253. PMID: 32708165; PMCID: PMC7400304.
Sharma A., Deo A., Sharma A., Kumar D., Gupta P., Cheema M. 2023. Assessment of Prognosis of Dental Implants in Diabetic Patients: A Clinical Study. J Pharm Bioallied Sci. Jul; 15(Suppl 2): 920–922. https://doi.org/10.4103/jpbs.jpbs_35_23
Shigeishi H, Ohta K, Takechi M. 2015. Risk Factors for Postoperative Complications Following Oral Surgery. J Appl Oral Sci. Jul-Aug; 23(4): 419–23. https://doi.org/10.1590/1678-775720150130
Simon L.E., Karhade D.S., Tobey M.L. 2020. Oral Health Status of Hospitalized Patients With Type 2 Diabetes. Diabetes Spectr. Feb; 33(1): 58–65. https://doi.org/10.2337/ds18-0089
Stefanescu A., Sufaru I.G., Martu C., Anton D.M., Rotundu G., Earar K. 2024. Impact of Infrabony Defects Treatment on Periodontal Markers and Glycated Hemoglobin Using Platelet-Rich Fibrin, Guided Tissue Regeneration, and Access-Flap Surgery. Medicina (Kaunas). Oct 29; 60(11): 1769. doi: 10.3390/medicina60111769. PMID: 39596954; PMCID: PMC11596485.
Sultana Rafat, Raj Amit, Barbi Wagisha, Afridi Shakeb Khan, Mishra Bibhu Prasad, Malik Rajvir. 2021. A Comparative Study of Implantation Efficacy and Bone Loss in Patients with and without Diabetes. Journal of Pharmacy and Related Sciences. Nov.; 13(Suppl 2): S1410-S1413. doi: 10.4103/jpbs.jpbs_229_21
Urgent Action needed as Global Diabetes Cases Increase Four-Fold over Past Decades // World Health Organization/ 13 November 2024. URL: https://www.who.int/news/item/13-11-2024-urgent-action-needed-as-global-diabetes-cases-increase-four-fold-over-past-decades
Yamada S.I., Hasegawa T., Yoshimura N., Hakoyama Y., Nitta T., Hirahara N., Miyamoto H., Yoshimura H., Ueda N., Yamamura Y., Okuyama H., Takizawa A., Nakanishi Y., Iwata E., Akita D., Itoh R., Kubo K., Kondo S., Hata H., Koyama Y., Miyamoto Y., Nakahara H., Akashi M., Kirita T., Shibuya Y,. Umeda M., Kurita H. 2022. Prevalence of and Risk Factors for Postoperative Complications after Lower Third Molar Extraction: A Multicenter Prospective Observational Study in Japan. Medicine (Baltimore). Aug 12; 101(32): e29989. doi: 10.1097/MD.0000000000029989. PMID: 35960058; PMCID: PMC9371489.
Zeng X., Huang S., Ye X., Song S., He J., Hu L., Deng S., Liu F. Impact of HbA1c Control and Type 2 Diabetes Mellitus Exposure on the Oral Microbiome Profile in the Elderly Population. J Oral Microbiol. 2024 May 15; 16(1): 2345942. https://doi.org/10.1080/20002297.2024.2345942