One-year performance of posterior narrow diameter implants in hyperglycemic and normo-glycemic patients—a pilot study

Abstract

Objectives The aim of the study was to compare the performance of narrow diameter implants in patients with uncontrolled diabetes mellitus type 2 (T2DM) and normo-glycemic individuals during the first 12 months after implant loading. Material and methods In 16 T2DM patients with HbA1C > 6.5% (test group) and 16 normo-glycemic patients (HbA1C < 6.0%; control group), one to two narrow diameter tissue level implants were placed in the posterior maxilla or mandible. After 3-month lasting integration period, implants were loaded by fixed dentures. The clinical parameters probing depth (PD), bleeding on probing (BOP), attachment loss (CAL), recession and papilla bleeding index (PBI) were assessed manually at loading and after 12 months of function. The paired digital periapical radiographs were analyzed with regard to the change in marginal bone level (MBL) from baseline to 12 months’ control. The mean values calculated for both patient groups were statistically analyzed. The technical complications were recorded. Results The T2DM group accounted 13 patients due to 3 dropouts. The overall implant survival rate after 12 months was 100%. The differences in means for the clinical parameters and the MBL were statistically non-significant between the T2DM and normo-glycemic patients for the short period of loaded function reported here. No technical complications were recorded. Conclusions The study demonstrated an encouraging clinical outcome with narrow diameter implants in patients with uncontrolled T2DM compared to non-diabetics after 12 months post loading. For the short observation period, no biological and technical complications were reported regardless the glycemic status. Clinical relevance Patients with HbA1C > 6.5% may benefit from the treatment with narrow diameter implants by avoiding complex surgical interventions with augmentation procedures. Trial registration Clinicaltrials.gov: NCT04630691

Implant stability of narrow diameter implants in hyperglycemic patients—A 3‐month case–control study

“…Furthermore, numerous studies reported encouraging results for NDI in diabetic patients. In particular, chemical modifications to the implant surface may counterbalance hyperglycemia‐induced impairment of bone healing around dental implants (Cabrera‐Domínguez et al, 2020; Friedmann et al, 2021). Therefore, our study outcome corroborates the previous data: NDI display similar values for the quantitative estimation of osseointegration as measured by ISQ in both, T2DM and healthy patients.…”

“…Narrow‐diameter implants (NDI) were developed for sites with diminished ridge dimensions, which result from numerous clinical reasons and a plethora of studies indicate their clinical success (Klein et al, 2014). By circumventing the need for invasive augmentation procedures and thus the wound healing burden, NDI present a suitable treatment option reducing the wound healing burden in T2DM patients with a diminished alveolar ridge dimension (Friedmann et al, 2021). Recent meta‐analysis and literature reviews attest that NDI are a feasible hardware choice in the posterior region (Schiegnitz & Al‐Nawas, 2018).…”

“…By circumventing the need for invasive augmentation procedures and thus the wound healing burden, NDI present a suitable treatment option reducing the wound healing burden in T2DM patients with a diminished alveolar ridge dimension (Friedmann et al, 2021). Recent meta-analysis and literature reviews attest that NDI are a feasible hardware choice in the posterior region (Schiegnitz & Al-Nawas, 2018).…”

Microcirculation and neutrophil-related cytokine concentrations are not altered around narrow diameter implants in T2DM patients during wound healing

“…The study protocol was nested inside a 1-year prospective case–control trial [ 23 ]. The Witten/Herdecke University Ethics Committee approved the study protocol (108/2012) and the study is in accordance with the Declaration of Helsinki.…”

“…In T2DM patients, NDI may represent a less invasive treatment option by reducing the need for lateral ridge augmentation procedures and preventing an extended wound healing burden. Recently, in a 1-year clinical case and control pilot study, we were able to demonstrate the positive outcomes of NDI in T2DM patients [ 23 ].…”