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The
impact of diabetes on the
success of dental
implants and
periodontal healing
Wings
T. Y. Loo1,
L. J. Jin1,
Mary N. B. Cheung1
and
Min
Wang2*
1Faculty
of Dentistry, The University of Hong Kong, Hong Kong, China.
2State
Key Laboratory for Oral Diseases and
Department of Prosthodontics, West China College of Stomatology, Sichuan
University, PR China.
*Corresponding author.
E-mail: wtyloo@gmail.com.
Tel: 86 28 61153338.
Fax: 86-28-85503479.
Accepted 3 September, 2009 |
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Dental
implant is one of the restorative methods to replace
missing
teeth.
As implants are directly anchored into bones, they provide
stability, a more natural appearance, and minimize the risk
of bone resorption and atrophy. However, studies found that
diabetes mellitus patients had a slower healing process
after surgery because of the reduction
of vascular supply due to microangiopathies, decreased host defense, formation of advanced glycation end-products (AGEs),
reduction of collagen production and increased collagenase
activity.
Diabetes mellitus patients may pose contraindications to
dental implants.
As a result
of that, dental implantation failure rate
in
diabetic patients
is much higher than
that in
non-diabetic patients. In this
clinical
experiment, we compared the amount
of blood cells,
and cytokines production
24 h
post implantations,
and
the
implant mobility
90 days
post-surgery
between controlled type
2 diabetic patients and
the
non-diabetic patients.
It was aimed to
investigate
the suitability of diabetic
patients to have dental implants
and the efficacy of the amount of dental implants related to
the success rates. 138
patients
with
type
2 diabetics
and 140 healthy subjects,
who had one to three adjacent edentulous spaces,
were selected.
Dental implantation surgeries were performed under local
anesthesia. Wounds were sutured and all subjects were given
0.2% chlorohexidine mouthwash for 14 days. Complete blood
picture and cytokines production were assayed before
operation,
as well as
on days
1,
2, and 5 after implantation.
Implant mobility
and
periodontal wound healing
were monitored
once in
a fortnight up to
90 days.
There were no statistically significant differences in the
production of
cytokines.
In
138 diabetic patients, 255
implants were presented with second degree mobility
90 days after
surgery while the same was demonstrated in 48
out of 346
implants from the
healthy subjects.
These implants were considered failures and were extracted.
Implant failure in diabetics was significantly greater than
that in non-diabetics when multiple
adjoining
implants
were placed.
Key
words:
Dental implant, diabetes mellitus, bone resorption,
periodontal healing,
chlorohexidine mouthwash,
tooth
mobility. |
