甲状腺疾病对口腔种植影响的研究进展

doi:10.13701/j.cnki.kqyxyj.2025.10.001

摘要/Abstract

摘要： 种植修复是牙列缺损的主要修复方式之一,种植体初期稳定性、软硬组织愈合情况、种植体周围黏膜健康状况对种植修复预后影响重大。甲状腺疾病是一大类临床常见的内分泌系统疾病,甲状腺激素水平异常可直接导致骨代谢紊乱、黏膜组织水肿等问题,甲状腺疾病相关治疗(药物治疗、放射治疗)也会导致口腔及全身并发症。本文旨在分析甲状腺疾病及其相关治疗对种植修复的影响,为预测和规避种植修复风险、改善临床预后提供指导和帮助。

关键词: 甲状腺疾病, 甲状腺激素, 口腔种植, 骨整合, 药物治疗

Abstract: Dental implant is one of the main restorative methods for dentition defects, and the initial stability of the implant, the healing of hard and soft tissues, and the health of the mucosa around the implant have a significant impact on the prognosis of dental implant. Thyroid disorders are a large group of common clinical endocrine disorders. Abnormal thyroid hormone levels can be the cause of bone metabolism disorders, mucosal tissue oedema and other problems. Related treatments for thyroid disease (drug therapy, radiotherapy) can also incur certain complications. The aim of this article is to analyze the impact of thyroid disorders and their associated treatments on implant restorations, and to provide guidance and assistance in predicting and avoiding implant restoration risks, and improving clinical prognosis.

Key words: thyroid disease, thyroid hormones, dental implant, osseointegration, drug therapy

夏雨天, 李蜀鄂. 甲状腺疾病对口腔种植影响的研究进展[J]. 口腔医学研究, 2025, 41(10): 833-837.

XIA Yutian, LI Shue. Research Progress in Effect of Thyroid Disease on Dental Implant[J]. Journal of Oral Science Research, 2025, 41(10): 833-837.

参考文献

[1] Sinha RA, Yen PM. Metabolic messengers: Thyroid hormones [J]. Nat Metab, 2024, 6(4): 639-650.
[2] Li Y, Teng D, Ba J, et al. Efficacy and safety of long-term universal salt iodization on thyroid disorders: Epidemiological evidence from 31 provinces of mainland China [J]. Thyroid, 2020, 30(4): 568-579.
[3] 郑荣寿,孙可欣,张思维,等.2015年中国恶性肿瘤流行情况分析[J].中华肿瘤杂志,2019,41(1): 19-28.
[4] Sehravat R, Malik P, Rathee M. Endocrine diseases treatment consideration in dental implants [J]. Int R J Pharm Sci, 2015, 6(1): 1-3.
[5] Babi Leko M, Gunjaa I, Plei N, et al. Environmental factors affecting thyroid-stimulating hormone and thyroid hormone levels [J]. Int J Mol Sci, 2021, 22(12): 6521.
[6] Amin MF, Zubair MS, Ammar M. A short review on the role of thyroxine in fast wound healing and tissue regeneration [J]. Tissue Cell, 2023, 82: 102115.
[7] Davis PJ, Mousa SA, Lin HY. Nongenomic actions of thyroid hormone: The integrin component [J]. Physiol Rev, 2021, 101(1): 319-352.
[8] Delitala AP, Scuteri A, Doria C. Thyroid hormone diseases and osteoporosis [J]. J Clin Med, 2020, 9(4): 1034.
[9] Wu J, Huang H, Yu X. How does Hashimoto’s thyroiditis affect bone metabolism? [J]. Rev Endocr Metab Disord, 2023, 24(2): 191-205.
[10] Deng T, Zhang W, Zhang Y, et al. Thyroid-stimulating hormone decreases the risk of osteoporosis by regulating osteoblast proliferation and differentiation [J]. BMC Endocr Disord, 2021, 21(1): 49.
[11] Wang Y, Fan Y, Lin Z, et al. Survival rate and potential risk indicators of implant loss in non-smokers and systemically healthy periodontitis patients: An up to 9-year retrospective study [J]. J Periodont Res, 2021, 56(3): 547-557.
[12] Pjetursson BE, Heimisdottir K. Dental implants-are they better than natural teeth? [J]. Eur J Oral Sci, 2018, 126 Suppl 1: 81-87.
[13] Torrejon-Moya A, Izquierdo-Gómez K, Pérez-Sayáns M, et al. Patients with thyroid disorder, a contraindication for dental implants? A systematic review [J]. J Clin Med, 2022, 11(9): 2399.
[14] Alsaadi G, Quirynen M, Michiles K, et al. Impact of local and systemic factors on the incidence of failures up to abutment connection with modified surface oral implants [J]. J Clin Periodontol, 2008, 35(1): 51-57.
[15] Alsaadi G, Quirynen M, Komárek A, et al. Impact of local and systemic factors on the incidence of oral implant failures, up to abutment connection [J]. J Clin Periodontol, 2007, 34(7): 610-617.
[16] Ursomanno BL, Cohen RE, Levine MJ, et al. The effect of hypothyroidism on bone loss at dental implants [J]. J Oral Implantol, 2021, 47(2): 131-134.
[17] Saravi BE, Putz M, Patzelt S, et al. Marginal bone loss around oral implants supporting fixed versus removable prostheses: A systematic review [J]. Int J Implant Dent, 2020, 6(1): 20.
[18] Lee SY, Pearce EN. Hyperthyroidism: A review [J]. JAMA, 2023, 330(15): 1472-1483.
[19] 中华医学会,中华医学会杂志社,中华医学会全科医学分会等.甲状腺功能亢进症基层诊疗指南(2019年)[J].中华全科医师杂志,2019,18(12):1118-1128.
[20] Farooqi S, Raj S, Koyfman A, et al. High risk and low prevalence diseases: Thyroid storm [J]. Am J Emerg Med, 2023, 69: 127-135.
[21] Davies TF, Andersen S, Latif R, et al. Graves’ disease [J]. Nat Rev Dis Primers, 2020, 6(1): 1-23.
[22] He Q, Li M, Ji P, et al. Comparison of drug-induced liver injury risk between propylthiouracil and methimazole: A quantitative systems toxicology approach [J]. Toxicol Appl Pharmacol, 2024, 491:117064.
[23] 李响,聂然,吴梓齐,等.抗甲状腺药物致粒细胞缺乏引发严重口腔感染1例[J].临床口腔医学杂志,2023,39(8): 450+511.
[24] 黄倩,方坚,阮梅,等.抗甲状腺药物所致肝损伤的研究进展[J].药物评价研究,2024,47(5): 927-932.
[25] Chaker L, Razvi S, Bensenor IM, et al. Hypothyroidism [J]. Nat Rev Dis Primers, 2022, 8(1): 30.
[26] 中华医学会,中华医学会杂志社,中华医学会全科医学分会等.甲状腺功能减退症基层诊疗指南(2019年)[J].中华全科医师杂志,2019,18(11):1022-1028.
[27] Attard NJ, Zarb GA. A study of dental implants in medically treated hypothyroid patients [J]. Clin Implant Dent Relat Res, 2002, 4(4): 220-231.
[28] Sunavala-Dossabhoy G. Radioactive iodine: An unappreciated threat to salivary gland function [J]. Oral Dis, 2018, 24(1-2): 198-201.
[29] 中华医学会核医学分会.¹³¹I治疗分化型甲状腺癌指南(2021版)[J].中华核医学与分子影像杂志,2021,41(4): 218-241.
[30] Savage MW, Sobel RK, Hoffman HT, et al. Salivary gland dysfunction and nasolacrimal duct obstruction: Stenotic changes following I-131 therapy [J]. Ophthalmic Plast Reconstr Surg, 2015, 31(3): e50-e52.
[31] Piciu D, Bran S, Moldovan M, et al. Radioiodine-131 therapy used for differentiated thyroid cancer can impair titanium dental implants: an in vitro analysis [J]. Cancers (Basel), 2023, 15(9): 2558.
[32] Yu H, Zhou A, Liu J, et al. Management of systemic risk factors ahead of dental implant therapy: A beard well lathered is half shaved [J]. J Leukocyte Biol, 2021, 110(3): 591-604.
[33] Terefe M, Belay Bizuneh Y, Addisu Nigatu Y, et al. Perioperative management of the thyrotoxic patients: A systematic review [J]. Ann Med Surg, 2022, 81: 104487.
[34] Mosaddad SA, Talebi S, Keyhan SO, et al. Dental implant considerations in patients with systemic diseases: An updated comprehensive review [J]. J Oral Rehabil, 2024, 51(7): 1250-1302.
[35] Xu T, Zheng X, Wei T. Preoperative preparation for Graves’ disease [J]. Front Endocrinol (Lausanne), 2023, 14: 1234056.
[36] Khan AA, Ata F, Aziz A, et al. Clinical characteristics and outcomes of patients with antithyroid drug-related liver injury [J]. J Endocr Soc, 2023, 8(1): 133.
[37] Bonatto MDS, Feltran GDS, Barbosa TP, et al. Green tea and hyaluronic acid gel enhance fibroblast activation and improves the gingival healing post-third molar extraction [J]. Sci Rep, 2024, 14(1):7124.
[38] 陆英,王似鋆,邹多宏.浓缩生长因子在口腔组织再生工程中的应用研究新进展[J].中国医学科学院学报,2023,45(3): 500-505.
[39] Ahmad W, Pishevar N, Cochrane LJ, et al. Antibiotic prophylaxis dysregulates dental implant placement surgery-induced osteoimmune wound healing and attenuates the alveolar bone-implant interface in mice [J]. J Clin Periodontol, 2023, 50(12): 1670-1684.
[40] D’Addazio G, Manciocchi E, Tafuri G, et al. Long-term efficacy of chlorhexidine gel in single-crown implant rehabilitation: A five-year follow-up study [J]. Dent J (Basel), 2023, 11(10): 228.
[41] Ouldyerou A, Merdji A, Aminallah L, et al. Biomechanical evaluation of marginal bone loss in the surrounding bone under different loading: 3d finite element analysis study [J]. Int J Multiscale Comput Eng, 2022, 20(4): 43-56.
[42] 刘修玉,吕慧欣,周延民.改性钛基材料调控巨噬细胞表型促进免疫成骨进程研究进展[J].中国实用口腔科杂志,2023,16(6):742-747.
[43] 中华医学会内分泌学分会, 中华医学会外科学分会甲状腺及代谢外科学组, 中国抗癌协会头颈肿瘤专业委员会, 等. 甲状腺结节和分化型甲状腺癌诊治指南(第二版)[J].中华内分泌代谢杂志,2023,39(3): 181-226.
[44] Son SH, Lee CH, Jung JH, et al. The preventive effect of parotid gland massage on salivary gland dysfunction during high-dose radioactive iodine therapy for differentiated thyroid cancer: A randomized clinical trial [J]. Clin Nucl Med, 2019, 44(8): 625-633.
[45] Cheng Y, Tong H, Li X, et al. Effect of vitamin E and supragingival scaling on salivary gland function in patients with differentiated thyroid cancer treated with 131I [J]. Nucl Med Commun, 2022, 43(9): 995-1003.