Clinical performance of hydrophilic, titanium‐zirconium dental implants in patients with well‐controlled and poorly controlled type 2 diabetes: One‐year results of a dual‐center cohort study

Abstract

Background This study assessed the clinical performance of hydrophilic dental implants in a patient cohort with type 2 diabetes mellitus (T2DM). Methods Subjects with T2DM of ≥2‐years duration were allocated to either the well‐controlled (WC; HbA1c ≤ 7.0%,) or poorly‐controlled (PC; 7.5 < HbA1c < 10%) groups in a dual‐center, prospective cohort study. Each subject received a single, titanium‐zirconium (Ti‐Zr) dental implant with a chemically‐modified, hydrophilic (modSLA) surface in a posterior mandibular site. Postoperatively, subjects were followed at 1, 2, 4, 8, and 12‐week intervals. Post‐loading, subjects were followed at 3, 6, and 12‐months. Clinical and radiographic parameters of implant success, and dental patient‐reported outcomes were collected. Results Twenty‐one dental patients (NWC = 11; NPC = 10; mean age: 66.8 ± 7.5 years) were enrolled and the 1‐year implant success rate was 100%. Peri‐implant bone levels were stable with 0.15 ± 0.06 mm mean marginal loss at 1 year without significant inter‐group differences (P = 0.79). Postoperative pain was minimal at 1‐week, and OHIP‐5 scores decreased significantly over time as compared with preoperative levels (P < 0.001) suggesting significant improvement in patient‐perceived oral health following implant therapy. Conclusions Elevated HbA1c levels > 7.5% did not compromise 1‐year success rates, or oral health‐related quality of life in PC patients receiving modSLA, Ti‐Zr implants. Given that implant placement up to 10% HbA1c significantly enhanced oral health‐related quality of life without complications or morbidity, the safety and efficacy of implants to improve oral function in T2DM is supported, even without ideal glycemic control.

Efficiency of Nanohydroxyapatite on Repairing Type II Diabetes Dental Implant-Bone Defect

“…Diabetes can affect blood transport in the body, reduce the distribution of blood vessels in bone tissue, and increase the permeability of microcirculation capillaries. In turn, it affects the matrix composition and content around blood vessels and ultimately leads to delayed or nonunion of bone healing and even ischemic necrosis of bone in severe cases [ 26 ]. This work was to understand the effect of n-HA/PA66 material prepared in this experiment on bone defect healing of diabetic implants.…”

An Overview of Type 2 Diabetes Mellitus (T2DM): Dental Implant Survival Rates

“…18 Both studies are based on an immediate-loaded implant placement technique. The results of the research from Aguilar et al, were supported by Latimer et al, 8 which was conducted for 1 year that dental implant survival reached 100% when the glycemic control was between >7.5%-10%. Other research reveals, when implant placement uses a minimally invasive approach and preventive augmentation procedures, it will result in good implant integration so that a high survival rate will be obtained.…”

“…Histomorphometric results showed the highest BIC value were in implant surface modified with HA group, the highest new bone formation value in implant surface modified with SLA group, and increased osseointegration in both groups HA and SLA. 8,25 Therefore, implant surface modification with HA and SLA can be suggested in T2DM patients to enhance new bone formation and osseointegration.…”

“…7 An ISQ value >70 is considered optimal for implant success. 8 Meanwhile according to Sargolzaieet al, the optimum ISQ value as the implant success is >60. 9 To get a good implant adaptation to support the success of implant placement, the patient's condition before receiving a dental implant must be evaluated, namely those concerning the condition of the alveolar bone and systemic conditions of the patient such as diabetes, osteoporosis, obesity, and the use of drugs.…”

A systematic review comparing the macrophage inflammatory response to hydrophobic and hydrophilic sandblasted large grit, acid‐etched titanium or titanium–zirconium surfaces during in vitro studies

“…Diabetic wound healing has been associated with a dysregulated M1 macrophage phenotype, while normal healing is associated with an M2 macrophage phenotype(Louiselle et al, 2021). However, implant therapy using titanium-zirconium dental implants with a SLActive surface treatment has been shown to be 100% successful in well-controlled and poorly controlled type two diabetes patients, although these studies have short clinical follow-up times(Cabrera-Domínguez et al, 2020;Latimer et al, 2022). Further studies are required to determine the clinical benefit dental implants with SLActive surface treatment may have in patients with diabetes and other medical conditions which may predispose patients toward an M1 macrophage phenotype during healing.5 | CONCLUSIONSConsidering the limitations within this systematic review, a differing macrophage inflammatory response to hydrophilic SLA surfaces compared to hydrophobic SLA on titanium or titanium-zirconium surfaces during in vitro studies is present.…”