The impact of diabetes on the success of dental implants and periodontal healing

Abstract

Dental implant is one of the restorative methods to replace missing teeth. As implants are directly anchored into bones, they provide stability, a more natural appearance, and minimize the risk of bone resorption and atrophy. However, studies found that diabetes mellitus patients had a slower healing process after surgery because of the reduction of vascular supply due to microangiopathies, decreased host defense, formation of advanced glycation end-products (AGEs), reduction of collagen production and increased collagenase activity. Diabetes mellitus patients may pose contraindications to dental implants. As a result of that, dental implantation failure rate in diabetic patients is much higher than that in non-diabetic patients. In this clinical experiment, we compared the amount of blood cells, and cytokines production 24 h post implantations, and the implant mobility 90 days post-surgery between controlled type 2 diabetic patients and the non-diabetic patients. It was aimed to investigate the suitability of diabetic patients to have dental implants and the efficacy of the amount of dental implants related to the success rates. 138 patients with type 2 diabetics and 140 healthy subjects, who had one to three adjacent edentulous spaces, were selected. Dental implantation surgeries were performed under local anesthesia. Wounds were sutured and all subjects were given 0.2% chlorohexidine mouthwash for 14 days. Complete blood picture and cytokines production were assayed before operation, as well as on days 1, 2, and 5 after implantation. Implant mobility and periodontal wound healing were monitored once in a fortnight up to 90 days. There were no statistically significant differences in the production of cytokines. In 138 diabetic patients, 255 implants were presented with second degree mobility 90 days after surgery while the same was demonstrated in 48 out of 346 implants from the healthy subjects. These implants were considered failures and were extracted. Implant failure in diabetics was significantly greater than that in non-diabetics when multiple adjoining implants were placed. © 2009 Academic Journals.published_or_final_versio