title: Clinical, microbiological, and salivary biomarker profiles of dental implant patients with type 2 diabetes.
abstract: OBJECTIVE
  Regulators of peri-implant bone loss in patients with diabetes appear to involve multiple risk factors that have not been clearly elucidated. This study was conducted to explore putative local etiologic factors on implant bone loss in relation to type 2 diabetes mellitus, including clinical, microbial, salivary biomarker, and psychosocial factors.
  
  
  METHODS
  Thirty-two subjects (divided into type 2 diabetes mellitus and non-diabetic controls), having at least one functional implant and six teeth, were enrolled in a 1-year longitudinal investigation. Analyses of clinical measurements and standardized intra-oral radiographs, saliva and serum biomarkers (via protein arrays for 20 selected markers), and plaque biofilm (via qPCR for eight periodontal pathogens) were performed at baseline and 1 year. In addition, the subjects were asked to respond to questionnaires to assess behavioral and psychosocial variables.
  
  
  RESULTS
  There was a significant increase from baseline to 1 year in the probing depth of implants in the diabetes group (1.95 mm to 2.35 mm, P = 0.015). The average radiographic bone loss during the study period marginally increased at dental implants compared to natural teeth over the study period (0.08 mm vs. 0.05 mm; P = 0.043). The control group harbored higher levels of Treponema denticola at their teeth at baseline (P = 0.046), and the levels of the pathogen increased significantly over time around the implants of the same group (P = 0.003). Salivary osteoprotegerin (OPG) levels were higher in the diabetes group than the control group at baseline only; in addition, the salivary levels of IL-4, IL-10, and OPG associated with host defense were significantly reduced in the diabetes group (P = 0.010, P = 0.019, and P = 0.024), while controls showed an increase in the salivary OPG levels (P = 0.005). For psychosocial factors, there were not many significant changes over the observation period, except for some findings related to coping behaviors at baseline.
  
  
  CONCLUSIONS
  The study suggests that the clinical, microbiological, salivary biomarker, and psychosocial profiles of dental implant patients with type 2 diabetes who are under good metabolic control and regular maintenance care are very similar to those of non-diabetic individuals. Future studies are warranted to validate the findings in longer-term and larger clinical trials (ClinicalTrials.gov # NCT00933491).
authors: Department of Periodontics and Oral Medicine, Michigan Center for Oral Health Research, University of Michigan School of Dentistry, Ann Arbor, MI, USA.
authors: Nikolaos
authors: N
authors: Tatarakis
authors: Janet S
authors: JS
authors: Kinney
authors: Marita
authors: M
authors: Inglehart
authors: Thomas M
authors: TM
authors: Braun
authors: Charles
authors: C
authors: Shelburne
authors: Niklaus P
authors: NP
authors: Lang
authors: William V
authors: WV
authors: Giannobile
authors: Tae-Ju
authors: TJ
authors: Oh
mesh_terms: D000368:Aged; D016301:Alveolar Bone Loss / Q000000981:diagnostic imaging / Q000209:etiology*; D018441:Biofilms; D015415:Biomarkers / Q000032:analysis*; D015921:Dental Implants; D003924:Diabetes Mellitus, Type 2; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D011859:Radiography; D012307:Risk Factors; D012463:Saliva / Q000737:chemistry*; D011795:Surveys and Questionnaires
chemical_list: D015415:Biomarkers; D015921:Dental Implants
keywords: alveolar bone loss; dental implants; diabetes mellitus; microbiology; psychosocial indicator; salivary diagnostics