An Evidence-based Evaluation The Dental Implants Application To Diabetes Patients

Objectives: Diabetes Mellitus presents with many complications and impaired healing in diabetics is a well known fact. The suitability of multiple dental implants in diabetic patients has not been investigated. This study compares implant mobility 60 days post surgery in type-two-diabetic patients and non-diabetic patients with traumatic tooth loss.

Methods: The patients ranged from 38 to 50 years old. Inclusion criteria were two to three adjacent edentulous spaces due to physical traumatic tooth loss which happened at least 6 months before the study. 68 patients of the test group (47 females) were type-two-diabetics taking metformin 750mg BID monotherapy for at least one year, with mean fasting serum glucose of 7.6 mmol/L and BMI of 29.2 kg/m2. The control group consisted of 70 non-diabetic patients (32 females). Dental implantation surgery was performed under local anesthesia, wounds were sutured and all patients were given prophylactic amoxicillin 1g QD and acetaminophen 500mg BID for 1 week after surgery. Diabetic patients continued anti-glycemic medication through out the study and the blood glucose levels of the patients were well controlled. Follow up was conducted on days 1, 14, 30 and 60 after implantation, where white blood cell (WBC) count and mobility were monitored and dental radiographs were taken.

Results: WBC count was not significantly different between the two groups. Among the 170 implants from the 68 diabetic patients, 116 implants (68.2%) presented with second degree mobility at 60 days after surgery, at which point, these implants were considered failures and were extracted. The majority of patients with 3 implants lost 2 teeth, and those with 2 implants, lost 1 tooth. Only 6 teeth out of the 173 (3.5%) from the non-diabetic patients failed (X2: 89.638 p < 0.001).

Conclusions: Edentulous spaces in the oral cavity impairs normal daily functions. Implant failure in diabetics is significantly greater than non-diabetics when multiple implants on adjacent teeth are performed despite well controlled serum glucose levels.