Thomas W Oates1, Patrick Galloway2, Peggy Alexander3, Adriana Vargas Green4, Guy Huynh-Ba5, Jocelyn Feine6, C Alex McMahan7. 1. Dr. Oates is a professor, Department of Periodontics, School of Dentistry, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, MCS 7888, San Antonio, Texas 78229-3900, e-mail oates@uthscsa.edu. Address correspondence to Dr. Oates. 2. Dr. Galloway is a former resident, Department of Periodontics, School of Dentistry, University of Texas Health Science Center at San Antonio. 3. Dr. Alexander is a clinical professor, Department of Periodontics, School of Dentistry, University of Texas Health Science Center at San Antonio. 4. Dr. Vargas Green is an associate professor, Department of Comprehensive Dentistry, School of Dentistry, University of Texas Health Science Center at San Antonio. 5. Dr. Huynh-Ba is an associate professor, Department of Periodontics, School of Dentistry, University of Texas Health Science Center at San Antonio. 6. Dr. Feine is a professor, Oral Health and Society Research Unit, Faculty of Dentistry, McGill University, Montreal, Quebec, Canada. 7. Dr. McMahan is a professor, Department of Pathology, University of Texas Health Science Center at San Antonio.
Abstract
BACKGROUND: The authors conducted a prospective cohort study to determine whether poor glycemic control is a contraindication to implant therapy in patients with type 2 diabetes. METHODS: The study sample consisted of 117 edentulous patients, each of whom received two mandibular implants, for a total of 234 implants. Implant-retained mandibular overdentures were loaded after a four-month healing period and followed up for an additional one year. The authors assessed implant survival and stability (by means of resonance frequency analysis) relative to glycated hemoglobin A1c (HbA1c) levels, with baseline levels up to 11.1 percent and levels as high as 13.3 percent over one year. RESULTS: Implant survival rates for 110 of 117 patients who were followed up for one year after loading were 99.0 percent, 98.9 percent and 100 percent, respectively, for patients who did not have diabetes (n = 47), those with well-controlled diabetes (n = 44) and those with poorly controlled diabetes (n = 19). The authors considered the seven patients lost to follow-up as having had failed implants; consequently, their conservative estimates of survival rates in the three groups were 93.0 percent, 92.6 percent and 95.0 percent (P = .6510). Two implants failed at four weeks, one in the nondiabetes group and the other in the well-controlled diabetes group. Delays in implant stabilization were related directly to poor glycemic control. CONCLUSIONS: The results of this study indicate that elevated HbA1c levels in patients with type 2 diabetes were not associated with altered implant survival one year after loading. However, alterations in early bone healing and implant stability were associated with hyperglycemia.
BACKGROUND: The authors conducted a prospective cohort study to determine whether poor glycemic control is a contraindication to implant therapy in patients with type 2 diabetes. METHODS: The study sample consisted of 117 edentulouspatients, each of whom received two mandibular implants, for a total of 234 implants. Implant-retained mandibular overdentures were loaded after a four-month healing period and followed up for an additional one year. The authors assessed implant survival and stability (by means of resonance frequency analysis) relative to glycated hemoglobin A1c (HbA1c) levels, with baseline levels up to 11.1 percent and levels as high as 13.3 percent over one year. RESULTS: Implant survival rates for 110 of 117 patients who were followed up for one year after loading were 99.0 percent, 98.9 percent and 100 percent, respectively, for patients who did not have diabetes (n = 47), those with well-controlled diabetes (n = 44) and those with poorly controlled diabetes (n = 19). The authors considered the seven patients lost to follow-up as having had failed implants; consequently, their conservative estimates of survival rates in the three groups were 93.0 percent, 92.6 percent and 95.0 percent (P = .6510). Two implants failed at four weeks, one in the nondiabetes group and the other in the well-controlled diabetes group. Delays in implant stabilization were related directly to poor glycemic control. CONCLUSIONS: The results of this study indicate that elevated HbA1c levels in patients with type 2 diabetes were not associated with altered implant survival one year after loading. However, alterations in early bone healing and implant stability were associated with hyperglycemia.
Entities:
Keywords:
Implantology; bone biology; diabetes; implant stability quotient; resonance frequency analysis
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