Dental endosseous implant assessments in a type 2 diabetic population: a prospective study.
Diabetes mellitus, a prevalent disorder worldwide, is associated with systemic adverse sequelae, such as wound healing alterations, which may affect osseointegration of dental implants. This prospective multicenter study assessed the success of 2-stage endosseous root-form implants (3 different implant systems) placed in the mandibular symphysis of 89 male type 2 diabetic subjects. The implants were uncovered approximately 4 months after placement, restored with an implant-supported, Hader bar clip-retained overdenture, and maintained at scheduled follow-up data collection examinations for 60 months after loading. Sixteen (9.0%) of the 178 implants failed. Life table methods calculated implant survival at approximately 88%, from prosthesis placement through the 60-month follow-up, and at approximately 90% from implant placement through the observation period. No implants failed between surgical placement and uncovering, 5 failed at uncovering, 7 failed after uncovering before prosthesis placement, and 4 failed after prosthesis placement. Fasting plasma glucose (FPG) and glycosylated hemoglobin (HbA1c) values were determined before implant placement (baseline) and approximately 4 months later at surgical uncovering (follow-up). The 5-year implant outcomes (successes versus failures) were analyzed against the following predictor variables: (1) baseline and follow-up FPG values, (2) baseline and follow-up HbA1c values, (3) subject age, (4) duration of diabetes (years), (5) baseline diabetic therapy, (6) smoking history, and (7) implant length. Regression analysis found only duration of diabetes (P < .025) and implant length (P < .001) to be statistically significant predictors of implant failure. There was no statistically significant difference in failure rates between the 3 different implant systems used. This study supports the use of dental implants in type 2 diabetic patients.
Olson
J W
JW
Department of Periodontics, Endodontics, and Dental Hygiene, School of Dentistry, University of Louisville, Louisville, Kentucky 40292, USA. j.olson@louisville.edu
Shernoff
A F
AF
Tarlow
J L
JL
Colwell
J A
JA
Scheetz
J P
JP
Bingham
S F
SF
D000328:Adult; D000367:Age Factors; D000368:Aged; D001786:Blood Glucose / Q000032:analysis; D003758:Dental Implantation, Endosseous; D015921:Dental Implants; D017267:Dental Prosthesis Design; D019094:Dental Prosthesis, Implant-Supported; D019232:Dental Restoration Failure; D003828:Denture, Overlay; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000503:physiopathology* / Q000517:prevention & control; D005500:Follow-Up Studies; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007575:Jaw, Edentulous / Q000534:rehabilitation / Q000601:surgery; D008297:Male; D008334:Mandible / Q000601:surgery; D008875:Middle Aged; D016348:Osseointegration; D011446:Prospective Studies; D012044:Regression Analysis; D012907:Smoking / Q000503:physiopathology; D013997:Time Factors; D016896:Treatment Outcome; D014945:Wound Healing
D001786:Blood Glucose; D015921:Dental Implants; D006442:Glycated Hemoglobin