title: Peri-implant evaluation of immediately loaded implants placed in esthetic zone in patients with diabetes mellitus type 2: a two-year study.
abstract: OBJECTIVE
  The aim of this study was to evaluate implant survival and primary stability parameters in patients with diabetes with different levels of glycosylated hemoglobin Alc (HbA1c) treated with immediate placement and provisionalization of implant-supported, single-tooth replacements over 2 years.
  
  
  METHODS
  Eighty-five patients were divided into three groups according to their HbA1c levels: 33 patients in Group 1 (<6, control group); 30 patients in Group 2 (6.1-8); and 22 patients in Group 3 (8.1-10). Each patient received one-one-piece implant in the anterior zone of the upper maxillary. The implant survival rate was analyzed for each group, together with three variables to evaluate the general state of peri-implant health: probe depth, bleeding on probing, marginal bone loss.
  
  
  RESULTS
  Marginal bone loss increased in relation with higher HbA1c levels. For marginal bone loss in Group 1, mean resorption values ranged from 0.51 after 6 months to 0.72 after 2 years in comparison with respective values of 1.33 and 1.92 in Group 3. This pattern was repeated for bleeding on probing, both parameters showing significant differences between groups. For bleeding on probing, mean bleeding levels varied from 0.36 in Group I at 6 months after implant placement, to 0.59 in Group 3 (P = 0.041 between the three groups). Peri-implant pocket depth showed the same tendency to increase in relation to HbA1C but differences between groups did not reach statistical significance.
  
  
  CONCLUSIONS
  Patients with diabetes can receive implant-based treatments with immediate loading safely, providing they present moderate HbA1c values.
authors.affiliation: Department of Pharmacological Research in Dentistry, Faculty of Dentistry, University of Granada, Granada, Spain.
authors.forename: Antonio
authors.initials: A
authors.lastname: Aguilar-Salvatierra
authors.affiliation: Department of Implant Dentistry, Master of Implant Dentistry and Biomaterials, School of Medicine and Dentistry, University of Murcia, Murcia, Spain.
authors.forename: José Luis
authors.identifier: http://orcid.org/0000-0002-9860-5416
authors.initials: JL
authors.lastname: Calvo-Guirado
authors.affiliation: Department of Periodontology, Master of Periodontology and Implant Dentistry, Faculty of Dentistry, University of Granada, Granada, Spain.
authors.forename: Maximino
authors.initials: M
authors.lastname: González-Jaranay
authors.affiliation: Department of Periodontology, Master of Periodontology and Implant Dentistry, Faculty of Dentistry, University of Granada, Granada, Spain.
authors.forename: Gerardo
authors.initials: G
authors.lastname: Moreu
authors.affiliation: School of Dental Medicine, Stony Brook University, Stony Brook, NY, USA.
authors.forename: Rafael Arcesio
authors.identifier: http://orcid.org/0000-0003-1721-0509
authors.initials: RA
authors.lastname: Delgado-Ruiz
authors.affiliation: Department of Special Care in Dentistry, Pharmacological Research in Dentistry, Master of Periodontology and Implant Dentistry, Faculty of Dentistry, University of Granada, Granada, Spain.
authors.forename: Gerardo
authors.initials: G
authors.lastname: Gómez-Moreno
mesh_terms: D016301:Alveolar Bone Loss / Q000209:etiology; D019250:Dental Implants, Single-Tooth; D019094:Dental Prosthesis, Implant-Supported; D003924:Diabetes Mellitus, Type 2; D004955:Esthetics, Dental; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism*; D006454:Hemoglobins; D006801:Humans; D057893:Immediate Dental Implant Loading; D008297:Male; D008875:Middle Aged; D010512:Periodontal Index; D011446:Prospective Studies; D016896:Treatment Outcome
chemical_list: D006442:Glycated Hemoglobin; D006454:Hemoglobins
keywords: dental implants; immediate loading; marginal bone loss; peri-implantitis; type 2 diabetes mellitus