title: Influence of Glycemic Control on Peri-Implant Bone Healing: 12-Month Outcomes of Local Release of Bone-Related Factors and Implant Stabilization in Type 2 Diabetics.
abstract: BACKGROUND
  The poor glycemic status seems to be an important factor affecting implant complication rates, including peri-implant bone loss.
  
  
  OBJECTIVE
  This trial evaluated the influence of glycemic control of type 2 diabetes mellitus (T2DM) patients on implant stabilization and on the levels of bone markers in peri-implant fluid during the healing.
  
  
  METHODS
  Systemically healthy patients (SH,n = 19), better-controlled T2DM (BCDM,n = 16), and poorly controlled T2DM (PCDM,n = 16) indicated for implant therapy were recruited. The implant stability quotient (ISQ) was determined at implant placement, 3, 6, and 12 months. Levels of transforming growth factor- β (TGF-β), fibroblast growth factor (FGF), osteopontin (OPN), osteocalcin (OC), and osteoprotegerin (OPG) in the peri-implant fluid were quantified at 15 days, and 3, 6, and 12 months, using the Luminex assay.
  
  
  RESULTS
  OPG and OPN levels were higher in SH at 12 months than at15 days (p < .05), whereas OC and TGF-β were lower in PCDM at 12 months compared with the 15-day and 3-month follow-ups, respectively (p < .05). Inter-group analyses showed lower OPN levels in PCDM compared with SH at 12 months (p < .05). The ISQ was higher at 12 months when compared with baseline and 3 months in SH (p < .05), whereas no differences were observed during follow-up in diabetics, regardless of glycemic control (p > .05). No difference in ISQ was observed among groups over time (p > .05).
  
  
  CONCLUSIONS
  Poor glycemic control negatively modulated the bone factors during healing, although T2DM, regardless of glycemic status, had no effect on implant stabilization.
authors.affiliation: Paulista University, São Paulo, Brazil.
authors.forename: Bruna
authors.initials: B
authors.lastname: Ghiraldini
authors.affiliation: Paulista University, São Paulo, Brazil.
authors.forename: Alexandre
authors.initials: A
authors.lastname: Conte
authors.affiliation: Paulista University, São Paulo, Brazil.
authors.forename: Renato Correa
authors.initials: RC
authors.lastname: Casarin
authors.affiliation: Paulista University, São Paulo, Brazil.
authors.forename: Marcio Zaffalon
authors.initials: MZ
authors.lastname: Casati
authors.affiliation: Paulista University, São Paulo, Brazil.
authors.forename: Suzana Peres
authors.initials: SP
authors.lastname: Pimentel
authors.affiliation: Paulista University, São Paulo, Brazil.
authors.forename: Fabiano Ribeiro
authors.initials: FR
authors.lastname: Cirano
authors.affiliation: Paulista University, São Paulo, Brazil.
authors.forename: Fernanda Vieira
authors.initials: FV
authors.lastname: Ribeiro
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000032:analysis; D001786:Blood Glucose / Q000378:metabolism; D001861:Bone Regeneration / Q000502:physiology*; D015921:Dental Implants; D003924:Diabetes Mellitus, Type 2 / Q000378:metabolism / Q000503:physiopathology*; D005260:Female; D005883:Gingival Crevicular Fluid / Q000737:chemistry*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015675:Osteocalcin / Q000032:analysis; D053495:Osteopontin / Q000032:analysis; D053244:Osteoprotegerin / Q000032:analysis; D016037:Single-Blind Method; D016212:Transforming Growth Factor beta / Q000032:analysis
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D015921:Dental Implants; D053244:Osteoprotegerin; C506895:SPP1 protein, human; D016212:Transforming Growth Factor beta; D015675:Osteocalcin; D053495:Osteopontin
keywords: biological markers; bone and bones; dental implants; diabetes mellitus; osseointegration