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

Abstract

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.

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

“…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.…”

“…[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.…”

Immediate implant-prosthetic dental rehabilitation of patients with diabetes using four immediately loaded dental implants: a pilot study

“…20 Published data suggest that peri-implant hygiene and glycemic control are necessary for favorable postoperative evolution. 8,9,20 The immediate placement of dental implants into infected sockets remains controversial. Some studies 21 have shown no statistically significant difference in the risk of failure between dental implants placed immediately into infected sockets and dental implants placed into noninfected sites; conversely, other studies 22 have shown a three-fold increase in the risk of failure following immediate dental implant placement into an infected socket, compared with placement in an uninfected socket.…”

Narrow Diameter Dental Implants as an Alternative Treatment for Atrophic Alveolar Ridges. Systematic Review and Meta-Analysis

“…Of the 15 articles included, 7 are clinical trials [17,[19][20][21][22]27,31], 3 are randomized controlled clinical trials [18,24,28], 3 are cohort studies [25,26,29] and 2 are a case series [23,30], all of them published between 2010 and 2018 (Table 1).…”

“…Subsequently, the abstracts were read and 45 articles were obtained. Finally, after reading the full text, 15 articles were included in the review that met the established inclusion-exclusion criteria [17][18][19][20][21][22][23][24][25][26][27][28][29][30][31] (Figure 1).…”