title: Effect of oral hygiene maintenance on HbA1c levels and peri-implant parameters around immediately-loaded dental implants placed in type-2 diabetic patients: 2 years follow-up.
abstract: OBJECTIVE
  The aim of the present 2-year follow-up study was to assess the effect of oral hygiene maintenance on hemoglobin Alc (HbA1c) levels and peri-implant parameters around immediately-loaded dental implants placed in type-2 diabetic patients with varying glycemic levels.
  
  
  METHODS
  Ninety-one individuals were divided into three groups. In group 1, 30 systemically healthy individuals were included (HbA1c < 6%). Patients in group 2 and 3, comprised of 30 patients with T2DM (HbA1c 6.1-8%); and 31 patients with T2DM (HbA1c 8.1-10%) respectively. In all groups, patients received immediately loaded bone level implants. All participants were enrolled in a 6 monthly periodontal/peri-implant maintenance program. Peri-implant bleeding on probing (BOP), probing depth (PD), and marginal bone loss (MBL) were measured at 6, 12, and 24 months of follow-up.
  
  
  RESULTS
  Mean preoperative HbA1c levels in patients in groups 1, 2, and 3 were 4.5%, 6.8%, and 8.7% respectively. In group-1, there was no significant difference in HbA1c levels at all follow-up durations. Among patients in groups 2 and 3, there was a significant decrease in HbA1c levels at 24-months follow-up than 6-months follow-up. At 6 months follow-up, BOP, PD, and MBL were significantly higher among patients in group-3 than group-1. At 12 and 24 months follow-up, there was no significant difference in BOP, PD, and MBL in all groups.
  
  
  CONCLUSIONS
  Oral hygiene maintenance reduces hyperglycemia and peri-implant inflammatory parameters around immediately loaded dental implants placed in type 2 diabetic patients.
authors.affiliation: Department of Prosthetic Dental Sciences, College of Dentistry, King Saud University, Riyadh, Saudi Arabia.
authors.forename: Mohammad D
authors.initials: MD
authors.lastname: Al Amri
authors.affiliation: Department of General Dentistry, Eastman Institute for Oral Health, University of Rochester, Rochester, NY, USA.
authors.forename: Sergio Varela
authors.initials: SV
authors.lastname: Kellesarian
authors.affiliation: Dental Health Department, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia.
authors.forename: Abdulaziz A
authors.initials: AA
authors.lastname: Al-Kheraif
authors.affiliation: Department of General Dentistry, Eastman Institute for Oral Health, University of Rochester, Rochester, NY, USA.
authors.forename: Hans
authors.initials: H
authors.lastname: Malmstrom
authors.affiliation: Department of General Dentistry, Eastman Institute for Oral Health, University of Rochester, Rochester, NY, USA.
authors.forename: Fawad
authors.initials: F
authors.lastname: Javed
authors.affiliation: Department of Periodontology, School of Dental Medicine, Stony Brook University, New York, NY, USA. Georgios.romanos@stonybrook.edu.|Department of Oral Surgery and Implant Dentistry, Dental School Frankfurt, Frankfurt, Germany. Georgios.romanos@stonybrook.edu.
authors.forename: Georgios E
authors.initials: GE
authors.lastname: Romanos
mesh_terms: D015921:Dental Implants; D003924:Diabetes Mellitus, Type 2 / Q000378:metabolism*; D005500:Follow-Up Studies; D006442:Glycated Hemoglobin / Q000378:metabolism*; D006801:Humans; D057893:Immediate Dental Implant Loading; D008297:Male; D008875:Middle Aged; D009910:Oral Hygiene; D010512:Periodontal Index
chemical_list: D015921:Dental Implants; D006442:Glycated Hemoglobin
keywords: immediately loaded implant; oral hygiene; peri-implant; type 2 diabetes mellitus