Comparison of clinical and radiographic status around immediately loaded versus conventional loaded implants placed in patients with type 2 diabetes: 12‐ and 24‐month follow‐up results

Abstract

There are no studies that have compared the clinical and radiographic status around immediately loaded (IL) and conventional loaded (CL) implants placed in patients with type 2 diabetes mellitus (T2DM). The aim was to compare the clinical and radiographic status around IL and CL implants placed in T2DM patients. One hundred and eight diabetic patients [55 with IL implants (Group 1) and 53 with CL implants (Group 2)] were included in this cross-sectional study. All implants were placed in healed sites in the maxillary and mandibular premolar and molar regions and supported single restorations. All patients underwent full mouth mechanical debridement biannually. Haemoglobin A1c (HbA1c) levels, clinical [bleeding on probing (BOP) and probing depth (PD) ≥ 4 mm] and radiographic [crestal bone loss (CBL)] peri-implant parameters were measured for both groups at 12- and 24-month follow-up. Group comparisons were performed using the Mann-Whitney U-test (P < 0·05). The mean age and duration of T2DM in groups 1 and 2 were 50·6 ± 2·2 and 51·8 ± 1·7 years, and 9·2 ± 2·4 and 8·5 ± 0·4 years, respectively. At 12- and 24-month follow-up, the mean HbA1c levels in groups 1 and 2 were 5·4% (4·8-5·5%) and 5·1% (4·7-5·4%) and 5·1% (4·7-5·2%) and 4·9% (4·5-5·2%), respectively. At 12- and 24-month follow-up, there was no statistically significant difference in peri-implant BOP, PD and CBL in both groups. It was concluded that clinical and radiographic status is comparable around IL and CL implants placed in patients with T2DM. The contribution of careful case selection, oral hygiene maintenance and glycaemic control is emphasised.

Chronic hyperglycemia as a risk factor in implant therapy

“…The results showed no statistically significant difference in peri‐implant bleeding on probing, probing depth, and crestal bone loss for immediate and delayed loaded implants in either group. It is important to note that in the study by Al Amri et al, all of the patients had well‐controlled type 2 diabetes and were approximately 50 years old. Moreover, the maximum follow‐up periods in the studies by Dogan et al and Al Amri et al were 7 and 24 months, respectively.…”

“…It is important to note that in the study by Al Amri et al, all of the patients had well‐controlled type 2 diabetes and were approximately 50 years old. Moreover, the maximum follow‐up periods in the studies by Dogan et al and Al Amri et al were 7 and 24 months, respectively. It is hypothesized that crestal bone loss around dental implants placed in patients with type 2 diabetes would have been significantly higher compared with controls if the studies by Al‐Amri et al and Dogan et al each had a longer follow‐up period (≥ 5 years).…”

“…Although research has shown that dental implants can remain functionally stable in patients with diabetes, such outcomes should be interpreted with caution as these studies imposed strict eligibility criteria for inclusion. In the Manor et al study, patients with poorly controlled medical conditions, such as poorly controlled diabetes or hypertension, were excluded.…”

“…This study also reported that at follow‐up evaluation there was no statistically significant difference in peri‐implant bone levels in patients with or without type 2 diabetes. In another study, crestal bone levels were compared for immediate and delayed loaded dental implants placed in patients with and without type 2 diabetes. The results showed no statistically significant difference in peri‐implant bleeding on probing, probing depth, and crestal bone loss for immediate and delayed loaded implants in either group.…”

The medically compromised patient: Are dental implants a feasible option?

“…Diabetes mellitus is the most prevalent endocrine disorder. When the patient is well‐controlled, implant survival is comparable to that of healthy subjects; peri‐implant health is good and peri‐implant bone loss is comparable to controls (Abduljabbar, Javed, Malignaggi, Vohra, & Kellesarian, ; Al Amri et al., , ; de Araújo Nobre, Maló, Gonçalves, Sabas, & Salvado, ; Kotsakis et al., ; Monje, Catena, & Borgnakke, ; Shi, Xu, Huo, Cai, & Liu, ). In subjects with hyperglycemia, that is, less well‐controlled diabetics, the risk of developing peri‐implantitis has been shown to be increased (Monje et al., ; Turri et al., ), although other studies did not observe such an effect (Eskow & Oates, ).…”