Periodontal parameters in prediabetes, type 2 diabetes mellitus, and non-diabetic patients

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Background Studies evaluating and comparing clinical and radiographic peri‐implant indices around narrow diameter implants (NDIs; <3.3 mm) and regular diameter implants (RDIs) in type‐2 diabetes mellitus (T2DM) and non‐diabetic individuals are deficient. Objective To estimate and compare the clinical and radiographic indices around NDIs and RDIs placed in T2DM and non‐diabetic patients. Materials and Methods Eighty‐six patients requiring implant surgery in the posterior mandible were divided into two groups (42 T2DM and 44 non‐diabetic individuals). Patients were further categorized into two subgroups on the basis of diameter of implants: (1) patients with NDIs (3.3 mm ø) and (2) patients with RDIs (4.1 mm ø). Clinical indices evaluating plaque index (PI), bleeding on probing (BOP), probing depth (PD), and crestal bone levels (CBL) were recorded around all dental implants at 18 and 36 months follow up. Serum hemoglobin A1c (HbA1c) test was carried out for both groups to assess the profile of glycosylated hemoglobin at baseline, 18 and 36 months of follow up. Results The mean age of patients in T2DM group and non‐diabetic group was 45.2 and 41.6 years, respectively. At 18 and 36 months follow up, mean HbA1c levels were 6.5% and 4.5% and 6.7% and 4.5% in T2DM and non‐diabetic individuals, respectively. A statistically significant reduction in mean HbA1c levels from the baseline to respective follow‐up periods were seen in T2DM patients. There was no statistically significant difference in the overall mean scores of PI, BOP, PD, and CBL around NDIs and RDIs among T2DM and non‐diabetic patients at 18 and 36 months of follow up. Conclusion NDIs show reliable clinical stability and radiographic bone levels as RDIs placed in T2DM and non‐diabetic individuals, provided oral hygiene and glycemic status are strictly maintained.

Section: Introductionmentioning

confidence: 99%

Comparison of clinical peri‐implant indices and crestal bone levels around narrow and regular diameter implants placed in diabetic and non‐diabetic patients: A 3‐year follow‐up study

Al‐Shibani

Al‐Aali

Al-Hamdan

et al. 2019

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“…5 Substantial research in implant dentistry has led researchers to investigate several variations in implant therapy in terms of dental biomaterials, surface modifications, and various techniques. [15][16][17] Ample research on T2DM and clinical periodontal outcomes has been peformed, 18,19 Research suggests that poor glycemic control may demonstrate poor periodontal status and that periodontal therapy may have a significant effect on the glycemic status. 9,10 Nowadays, considerable research indicates that NDIs are also indicated in areas of narrow alveolar ridges, eluding complicated surgical interventions such as bone grafts and restoring geriatric patients with minimal invasive and cost-effective treatments.…”

Section: Introductionmentioning

confidence: 99%

“…[11][12][13][14] Numerous clinical trials investigating clinical and radiographic status of NDIs reported similar survival rates as those reported by regular diameter implants. [15][16][17] Ample research on T2DM and clinical periodontal outcomes has been peformed, 18,19 Research suggests that poor glycemic control may demonstrate poor periodontal status and that periodontal therapy may have a significant effect on the glycemic status. 20,21 From dental implant therapy standpoint, it was once believed that dental implants may not produce efficacious treatment outcomes in patients with chronic hyperglycemia.…”

Section: Introductionmentioning

confidence: 99%

Clinical and radiographic indices around narrow diameter implants placed in different glycemic‐level patients

Alsahhaf

Alshiddi

Alshagroud

et al. 2019

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Background: Studies assessing peri-implant clinical and marginal bone resorption (MBR) around narrow diameter implants (NDIs) placed in different glycemic levels are uninvestigated. Objective: The present 3-year retrospective follow-up investigation was designed to explore clinical and radiographic status of NDIs placed in individuals with different glycemic control levels. Materials and Methods: Patients with serum hemoglobin A1c (HbA1c) levels ≥6.5% (Group-1), 5.7%-6.4% (Group-2), and 4.0%-5.0% (Group-3) were included. Clinical indices evaluating bleeding on probing (BOP), plaque scores (PI), peri-implant probing depth (PD), and MBR were recorded around NDIs at 1-, 2-, and 3-year follow-up. Serum HbA1c test was carried out for all patients to assess the profile of glycosylated hemoglobin at 1 and 3 years of follow-up. Results: A significant reduction in mean HbA1c levels from year 1 to year 3 followup period was seen in Group-1 only. PI varied from 0.40 in Group 1 at 2 year and 0.42 at 3-year follow-up to 0.18 at 2-year (P = 0.032) and 0.17 at 3-year (P = 0.018) follow-up, respectively. Greater BOP was noted in Group 1 (0.53) as compared with Group 2 (0.42) and Group 3 (0.21) (P = 0.048) at 3-year follow-up. PD after 3 year ranged from 2.04 mm in Group 3 to 2.32 mm in Group 1 that showed statistically significant difference (P = 0.037). No statistical significant differences were observed in MBR at any time point between the groups. Conclusion: The results of this short-term follow-up study indicate that NDIs show clinical and radiographic stability, provided oral cleanliness and glycemic levels are relatively maintained. Further long-term clinical studies are needed to evaluate implant stability over the period along with controlled glycemic status. K E Y W O R D S crestal bone levels, hyperglycemia, narrow implants, radiographs

“…It is noted that in the current study, mean FBGL among obese patients was 122.4 mg/dL which indicates prediabetes. Therefore, it is supposed that the increased levels of proinflammatory cytokines and increased amount of peri‐implant destruction may be partly explained by the AGEs and partly by the oxidative stress (induced as a result of hyperglycemia) …”

Section: Discussionmentioning

confidence: 99%

“…Therefore, it is supposed that the increased levels of proinflammatory cytokines and increased amount of peri-implant destruction may be partly explained by the AGEs and partly by the oxidative stress (induced as a result of hyperglycemia). 33,34 The robust element of the current study lies in its evaluation of the two biomarker levels which are considered proinflammatory and destructive in nature and are implicated in causing hard and soft tissue inflammation around the dental implants. In this way, the current study pushes the association of obesity and how it modulates periimplant tissue inflammation into a new direction.…”

Section: Discussionmentioning

confidence: 99%

Clinical indices and local levels of inflammatory biomarkers in per‐implant health of obese and nonobese individuals

Alasqah

Al‐Shibani

Al‐Aali

et al. 2018

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Background Obesity seem to regulate peri‐implant health. It is proposed that peri‐implant crevicular fluid (PICF) levels of interleukin (IL)‐1β and IL‐6 are higher in obese as compared to nonobese individuals. Objective The purpose of the present clinico‐laboratory study is to estimate and compare the clinical and radiographic indices and PICF levels of IL‐1β and IL‐6 among obese and nonobese patients. Materials and Methods Fifty patients were divided into two groups (25 obese with ≥27.5 kg/m2 and 25 nonobese with <27.5 kg/m2 individuals). Clinical indices for both periodontal and peri‐implant evaluating plaque index (PI), bleeding on probing (BOP), probing depth (PD), clinical attachment level (CAL), and crestal bone loss (CBL) were recorded around teeth and implants. PICF was collected and assessed for the levels of IL‐1β and IL‐6 using enzyme‐linked immunosorbent assay. Results A significant difference was observed in PI and BOP around natural teeth and implants in obese patients, respectively (P < .05). CBL was found to be significantly higher among obese as compared to nonobese patients (P = .022). Peri‐implant and periodontal PD was higher in obese as compared to nonobese but did not reach statistical significance. Levels of IL‐1β and IL‐6 were statistically significantly higher among obese patients as compared to nonobese (P = .001). Pearson correlation analysis showed IL‐1β was positively correlated with CBL (P = .0079), whereas IL‐6 showed positive correlation with both BOP (P = .0019) and CBL (P = .015) among obese patients. Conclusions Clinical peri‐implant parameters were worse and proinflammatory biomarkers were significantly higher in obese patients compared with nonobese subjects. The findings of the present study suggests that increased proinflammatory biomarkers in PICF of obese patients may modulate peri‐implant inflammation around dental implants.