Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
Clinical Oral Investigations
Published in: Clinical Oral Investigations 1/2021

01-01-2021 | Antibiotic | Original Article

Do preoperative glycosylated hemoglobin (HbA1C) and random blood glucose levels predict wound healing complications following exodontia in type 2 diabetes mellitus patients?—a prospective observational study

Authors: B. Krishnan, G. Arun Prasad, R. Saravanan, B. Madhan, T. Kadhiravan

Published in: Clinical Oral Investigations | Issue 1/2021

Login to get access

Abstract

Background

Many dental surgeons consider a type 2 diabetic patient to be at higher risk for wound healing complications following exodontia. Random blood glucose (RBG) and glycosylated hemoglobin (HbA1C) values help the surgeon determine the glycemic control and assess if the patient can undergo the surgical procedure.

Objectives

The purpose of this study was to analyze if preoperative HbA1C and RBG testing could predict the risk of wound healing and infectious complications in type 2 DM patients undergoing exodontia in an office setting.

Methods

This prospective observational study included 133 type 2 diabetic patients and age- and gender-matched non-diabetic patients undergoing exodontia. Preoperative HbA1C values and random blood glucose levels were obtained for patients in both groups. Wound healing and infectious complications and additional interventions performed were recorded.

Results

Duration of diabetes ranged from 1 to 25 years. 80.5% of diabetics were treated with oral hypoglycemics. A vast majority of patients in both groups underwent extraction of only a single tooth. There was no significant difference in non-infectious complications between the two groups. The absolute risk of infectious complications in diabetics was 10.5% compared to a 6.8% risk among the control group. Age, RBG values, HbA1C, duration of DM, and number and nature of exodontia performed did not show any statistical significance.

Conclusion

This study observed a slight, but not statistically significant increase in the risk of infectious complications in type 2 DM patients undergoing exodontia. Surgical site infections were amenable to surgical drainage with or without oral antibiotics on an outpatient basis with favorable healing outcomes.

Clinical relevance

The RBG and HbA1C values were not significantly associated with risk of infectious complications. Resorting to prophylactic antibiotics and warning about possible adverse healing for routine exodontia in type 2 DM patients is unnecessary.
Literature
1.
Shetty P (2012) Public health: India’s diabetes time bomb. Nature. 17:S14–S16
2.
Guariguata L, Whiting DR, Hambleton I, Beagley J, Linnenkamp U, Shaw JE (2014) Global estimates of diabetes prevalence for 2013 and projections for 2035 for the IDF Diabetes Atlas. Diabetes Res Clin Pract 103:137–149CrossRef
3.
Mohan V, Sandeep S, Deepa R, Shah B, Varghese C (2007) Epidemiology of type 2 diabetes: Indian scenario. Indian J Med Res 125:217–223PubMed
4.
Tharkar S, Satyavani K, Viswanathan V (2009) Cost of medical care among type 2 diabetic patients with a co-morbid condition—hypertension in India. Diabetes Res Clin Pract 83:263–267CrossRef
5.
American Diabetes Association (2015) Classification and diagnosis of diabetes. Sec. 2. In Standards of medical care in diabetes. Diabetes Care 38(Suppl. 1):S8–S16CrossRef
6.
Zhang Y, Zheng QJ, Wang S, Zeng SX, Zhang YP, Bai XJ, Hou TY (2015) Diabetes mellitus is associated with increased risk of surgical site infections: a meta-analysis of prospective cohort studies. Am J Infect Control 43:810–815CrossRef
7.
Marchionni S, Toti P, Barone A, Covani U, Esposito M (2017) The effectiveness of systemic antibiotic prophylaxis in preventing local complications after tooth extraction. A systematic review. Eur J Oral Implantol 10:127–132PubMed
8.
Ramaraj PN, Cariappa KM (2006) Is there a need for antibiotic prophylaxis after routine dental extraction in diabetic patients? Br J Oral Maxillofac Surg 44:421CrossRef
9.
Huang S, Dang H, Huynh W, Sambrook PJ, Goss AN (2013) The healing of dental extraction sockets in patients with type 2 diabetes on oral hypoglycaemics: a prospective cohort. Aust Dent J 58:89–93CrossRef
10.
Aronovich S, Skope LW, Kelly JP, Kyriakides TC (2010) The relationship of glycemic control to the outcomes of dental extractions. J Oral Maxillofac Surg 68:2955–2956CrossRef
11.
Lodi G, Figini L, Sardella A, Carrassi A, Del Fabbro M, Furness S (2012) Antibiotics to prevent complications following tooth extractions. Cochrane Database Syst Rev (11)
12.
Otieno FC, Ng’ang’a L, Kariuki M (2002) Validity of random blood glucose as a predictor of the quality of glycaemic control by glycated haemoglobin in out-patient diabetic patients at Kenyatta National Hospital. East Afr Med J 79:491–495PubMed
13.
Ziemer DC, Kolm P, Foster JK, Weintraub WS, Vaccarino V, Rhee MK et al (2008) Random plasma glucose in serendipitous screening for glucose intolerance: screening for impaired glucose tolerance study 2. J Gen Intern Med 23:528–535CrossRef
14.
Gill GV, Hardy KJ, Patrick AW, Masterson A (1994) Random blood glucose estimation in type 2 diabetes: does it reflect overall glycemic control? Diabet Med 11:705–708CrossRef
15.
Martin ET, Kaye KS, Knott C, Nguyen H, Santarossa M, Evans R, Bertran E, Jaber L (2016 Jan) Diabetes and the risk of surgical site infections: a systematic review and meta analysis. Infect Control Hosp Epidemiol 37:88–99CrossRef
16.
Talbot TR (2005) Diabetes mellitus and cardiothoracic surgical site infections. Am J Infect Control 33:353–359CrossRef
17.
Ata A, Valerian BT, Lee EC, Bestle SL, Elmendorf SL, Stain SC (2010) The effect of diabetes mellitus on surgical site infections after colorectal and noncolorectal general surgical operations. Am Surg 76:697–702CrossRef
18.
Richards JE, Kauffmann RM, Zuckerman SL, Obremskey WT, May AK (2012) Relationship of hyperglycemia and surgical-site infection in orthopaedic surgery. J Bone Joint Surg Am 94:1181–1186CrossRef
19.
Narayan P, Kshirsagar SN, Mandal CK, Ghorai PA, Rao YM, Das D et al (2017) Preoperative glycosylated hemoglobin: a risk factor for patients undergoing coronary artery bypass. Ann Thorac Surg 104:606–612CrossRef
20.
Latham R, Lancaster AD, Covington JF, Pirolo JS, Thomas CS (2001) The association of diabetes and glucose control with surgical site infections among cardiothoracic surgery patients. Infect Control Hosp Epidemiol 22:607–612CrossRef
21.
Bishop JR, Moul JW, Sihelnik SA, Peppas DS, Gormley TS, McLeod DG (1992) Use of glycosylated hemoglobin to identify diabetics at high risk for penile periprosthetic infection. J Urol 147:386–388CrossRef
22.
Rollins KE, Varadhan KK, Dhatariya K, Lobo DN (2016) Systematic review of the impact of HbA1c on outcomes following surgery in patients with diabetes mellitus. Clin Nutr 35:308–316CrossRef
23.
Barasch A, Safford MM, Litaker MS, Gilbert GH (2008) Risk factors for oral postoperative infection in patients with diabetes. Spec Care Dentist 28:159–166CrossRef
24.
Shaikh-Khader A, Houreld NN, Rajendran NK, Abrahamse H (2019) The link between advanced glycation end products and apoptosis in delayed wound healing. Cell Biochem Funct 37:432–442CrossRef
25.
Mussavira S, Dharmalingam M, Omana SB (2015) Salivary glucose and antioxidant defense markers in type II diabetes mellitus. Turk J Med Sci 45:141–147CrossRef
26.
Devlin H, Garland H, Sloan P (1996) Healing of tooth extraction sockets in experimental diabetes mellitus. J Oral Maxillofac Surg 54:1087–1091CrossRef
27.
Alexander M, Krishnan B, Shenoy N (2008) Diabetes mellitus and odontogenic infections—an exaggerated risk? Oral Maxillofac Surg 12:129–130CrossRef
28.
Power DJ, Sambrook PJ, Goss AN (2019) The healing of dental extraction sockets in insulin-dependent diabetic patients: a prospective controlled observational study. Aust Dent J 64:111–116CrossRef
29.
Motta AC, Bataglion CA, Foss-Freitas MC, Foss MC, Komesu MC (2013) Can fasting plasma glucose and glycated hemoglobin levels predict oral complications following invasive dental procedures in patients with type 2 diabetes mellitus? A preliminary case-control study. Clinics 68:427–430CrossRef
30.
Fernandes KS, Glick M, de Souza MS, Kokron CM, Gallottini M (2015) Association between immunologic parameters, glycemic control, and post extraction complications in patients with type 2 diabetes. J Am Dent Assoc 146:592–599CrossRef
31.
Kamat RD, Dhupar V, Akkara F, Shetye O (2015) A comparative analysis of odontogenic maxillofacial infections in diabetic and nondiabetic patients: an institutional study. J Korean Assoc Oral Maxillofac Surg 41:176–180CrossRef
32.
Cosken H, Erisen L, Basut O (2000) Factors affecting wound infections rates in head and neck surgery. Otolaryngol Head Neck Surg 123:328–333CrossRef
33.
Rao DD, Desai A, Kulkarni RD, Gopalkrishnan K, Rao CB (2010) Comparison of maxillofacial space infection in diabetic and nondiabetic patients. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 110:e7–e12CrossRef
Metadata
Title
Do preoperative glycosylated hemoglobin (HbA1C) and random blood glucose levels predict wound healing complications following exodontia in type 2 diabetes mellitus patients?—a prospective observational study
Authors
B. Krishnan
G. Arun Prasad
R. Saravanan
B. Madhan
T. Kadhiravan
Publication date
01-01-2021
Publisher
Springer Berlin Heidelberg
Published in
Clinical Oral Investigations / Issue 1/2021
Print ISSN: 1432-6981
Electronic ISSN: 1436-3771
DOI
https://doi.org/10.1007/s00784-020-03349-7

Other articles of this Issue 1/2021

Clinical Oral Investigations 1/2021 Go to the issue

Original Article

Cleansing efficacy of an auto-cleaning electronic toothbrushing device: a randomized-controlled crossover pilot study

Original Article

Effect of interdental brush design on plaque during nonsurgical periodontal therapy

Original Article

The importance of multisection sagittal and coronal magnetic resonance imaging evaluation in the assessment of temporomandibular joint disc position

Letter to the Editor

Letter to the Editor about the article published in Clinical Oral Investigations titled “Effect of hyperextension of the neck (rose position) on cerebral blood oxygenation in patients who underwent cleft palate reconstructive surgery: prospective cohort study using near-infrared spectroscopy” (Smarius BJA, Breugem CC, Boasson MP, Alikhil J, van Norden S, Mink van der Molen AB, de Graaff JG. Clin Oral Invest, https://doi.org/10.1007/s00784-019-03157-8)

Original Article

Effect of Lactobacillus brevis CD2 containing lozenges and plaque pH and cariogenic bacteria in diabetic children: a randomised clinical trial

Original Article

Root-end microsurgery using a premixed tricalcium silicate putty as root-end filling material: a prospective study