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Successful Management of the Diabetic Patient

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Duration:

20:46

Instructor:

Dr. Dr. Tröltzsch

Diabetes is a systemic illness that must be taken into consideration in the context of dental treatment. In this presentation, Dr. Markus Tröltzsch explains the pathophysiological fundamentals of the illness, the options in terms of appropriate therapy, as well as the impact of diabetes on wound healing in affected patients.

Regardless of the type of diabetes – type I diabetes is a congenital autoimmune condition characterised by a complete insulin deficiency, while type II diabetes is an acquired resistance to insulin – it will, if untreated, lead to increased HbAIc levels in patients as well as the formation of advanced glycation end-products, resulting in greater proinflammatory potential. The consequences of this range from macrovascular and microvascular damage to substantial delays in wound healing, which can also have a severely detrimental impact on the outcome of dental treatment. In a similar fashion to the condition known as diabetic foot, which can be caused by vascular damage and neuropathy following minor injury, the periapical tissue and mucosa can also be affected by dental treatment and demonstrate diminished wound-healing capacity. Surgical procedures should therefore be carried out at HbAIc levels below 7.5% as well as using local antiseptic, and where appropriate with systemic antibiotics. In addition, suturing without tension and allowing sutures to remain in situ after the generally-applicable healing period helps prevent complications in the treatment of patients with diabetes.


Content of the expert video

Where required, glucose molecules are mobilised from the liver's glycogen stores for transport via the circulatory system to the organs to be supplied.
Where required, glucose molecules are mobilised from the liver's glycogen stores for transport via the circulatory system to the organs to be supplied.
The beta cells of the endocrine pancreas produce the insulin that is essential for the absorption of glucose in the cells of the body.
The beta cells of the endocrine pancreas produce the insulin that is essential for the absorption of glucose in the cells of the body.
One of the goals when treating diabetes mellitus is to bring the patient's HbAIc reading to a level below 7.5%.
One of the goals when treating diabetes mellitus is to bring the patient's HbAIc reading to a level below 7.5%.
Glycation of proteins results in AGE (advanced glycation end-products). These act as antigens and demonstrate inflammatory potential.
Glycation of proteins results in AGE (advanced glycation end-products). These act as antigens and demonstrate inflammatory potential.

The expert

Dr. Dr. Markus Tröltzsch

Practice Dr. Dr. Tröltzsch in Ansbach

Dr. Tröltzsch graduated in dentistry at the University of Erlangen-Nuremberg 2005 and subsequently he graduated in medicine at the same university 2010. 
During his medicine studies, he did continuing studies with the curriculum for aesthetic dentistry of the Academy of Practice and Science and at the Department for Surgery of the University of Sydney and the Department for Oral and Maxillofacial Surgery at the University of Zurich. 
Dr. Tröltzsch works in the research group of Professor Messlinger (Department of Physiology at the University of Erlangen-Nuremberg), worked at the Depart ...more »
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Dental Online College: professional training + continuing education
in dental medicine, dentistry and oral surgery.

The Dental Online College is an online learning platform for dental surgeons and students. This service focuses on providing superior-quality professional training videos in the area of dental medicine that can be called up from an Internet platform. As a professional online training platform, the Dental Online College provides dental surgeons and students with instruction in surgical procedure, demonstrating challenging surgical techniques using easy to understand videos, and including interviews that provide further detail, video presentations, and documentation on performing the procedures in question.

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