Clinicoradiographic markers of peri‐implantitis in cigarette‐smokers and never‐smokers with type 2 diabetes mellitus at 7‐years follow‐up

Abstract

Background It is hypothesized that in the long‐term, (a) peri‐implant inflammatory variables (plaque index [PI], bleeding on probing [BOP], probing depth (PD) and crestal bone loss [CBL]) are worse in cigarette‐smokers (CS) and patients with type‐2 diabetes mellitus (T2DM) than never‐smokers (NS) without T2DM. The aim of the present 7‐year follow‐up clinical observational study was to assess the survival of dental implant in CS and NS with T2DM. Methods Study participants were divided into four groups based on glycemic status and self‐reported cigarette‐smoking habit: a) CS with T2DM; b) CS without T2DM; c) NS with T2DM; and d) NS without T2DM. Demographic information was collected using a questionnaire and hemoglobin A1c (HbA1c) levels were measured. Peri‐implant PI, BOP, PD, and CBL were measured. Sample‐size was estimated was statistical analysis was done using analysis of variance. P <0.01 was considered significant. Results In total, 101 male patients were included. There was no significant contrast in age among the groups. Every partaker in the study groups had one dental implant placed in posterior maxilla or mandible. The mean HbA1c levels were significantly higher among CS (P <0.01) and NS (P <0.01) with T2DM than individuals without T2DM. Peri‐implant PI (P <0.01), PD (P <0.01), and CBL (P <0.01) were significantly higher among CS and NS with T2DM and CS without T2DM than NS without T2DM. Peri‐implant BOP was significantly higher among CS and NS with T2DM than CS and NS without T2DM (P <0.01). Conclusions Peri‐implant inflammatory variables were worse among CS and NS with T2DM than NS without T2DM. A state of chronic hyperglycemia seems to be a stronger mediator of inflammation than cigarette smoking in patients with T2DM.

Clinical sequelae and patients’ perception of dental implant removal: A cross‐sectional study

“…Furthermore, some systemic conditions have been attributed to implant failure, such as diabetes and smoking 38 (16.1% and 25.8% in our study, respectively)—though osteoporosis was the predominant systemic condition (25.8%) in our series. Peri‐implant inflammatory conditions are increased in smokers and patients with diabetes 38–40 . However, Dreyer et al 41 .…”

Pathogenic Molecular Mechanisms in Periodontitis and Peri-Implantitis: Role of Advanced Glycation End Products

“…Current research is focused on shedding light on the exact mechanisms and the different influence of smoking and DM on periimplant tissues. It has been observed that hyperglycemia rather than smoking induces inflammation in peri-implantitis, and at the absence of both nicotine and high glucose, smaller inflammatory responses are elicited [69]. Metanalysis data showed a 50% greater risk for peri-implantitis between diabetic and normoglycemic patients, while non-smoking diabetics exhibited almost 3.5-fold greater risk in comparison with non-smoking nondiabetic controls, indicating that hyperglycemia is an independent high-risk factor for periimplantitis.…”

Diabetes mellitus como factor de riesgo de la periimplantitis

“…Otros mecanismos por los que la periimplantitis se agrava en un paciente diabético mal controlado incluyen posibles alteraciones en la composición de la placa bacteriana y la acumulación de 13,23 productos finales de glicación avanzada. 24 Alqahtani et al evaluaron clínicamente las variables inflamatorias periimplantarias, indicando que estas fueron peores en fumadores y no fumadores con DM2 que no fumadores sin DM2, por lo que el estado de hiperglucemia crónica parece ser un mediador más fuerte de la inflamación periimplantaria que el tabaquismo en pacientes con DM2. para los implantes dentales.…”