Clinical and radiographic peri-implant variables around short dental implants in type 2 diabetic, prediabetic, and non-diabetic patients

Prediabetes and poorly controlled type-2 diabetes as risk indicators for peri-implant diseases:A systematic review and meta-analysis

OBJECTIVE

The study answers the PECO question: "In adults with dental implants (P), do subjects suffering from type-2 diabetes or prediabetes (E) have worse peri-implant conditions (O) than subjects without type-2 diabetes and prediabetes (C)?". Prediabetes (5.7-6.4 % HbA1c), and the different qualities of glycemic control in type-2 diabetes; well-controlled (>8 % HbA1c), and poorly controlled (>8 % HbA1c) individuals; were classified according to the recommendations of the American Diabetes Association.

DATA

Predefined search keys were used with search terms including: Dental implant, diabetes mellitus, glycemic control and HbA1c.

SOURCES

An electronic search in the MEDLINE, Embase, and Cochrane libraries were conducted without any filters or language restrictions. Additionally, manual search of the reference lists were carried out to identify all relevant articles.

STUDY SELECTION

Eligibility criteria were cohort, case-control and cross-sectional studies that answerd our PECO question with at least 1 year of follow-up. From a total of 2660 records, 35 articles (1761 individuals) were included in the analysis. Meta-analytic difference in means for crestal bone loss was 1.2 mm [95 % CI=0.4; 2.1] in patients with prediabetes, 1.8 mm [CI=1.0; 2.7] in poorly controlled patients, whereas 0.4 mm [CI=-0.3; 1.1] in well-controlled individuals. Meta-regression showed that 1 % increase in HbA1c increased crestal bone loss by 0.24 mm.

CONCLUSIONS

Within the limitations of the study, patients with poorly controlled type-2 diabetes or prediabetes may have worse peri-implant conditions compared to patients without diabetes and well-controlled type-2 diabetes. Well-controlled type-2 diabetes is not a risk indicator for peri-implant diseases.

CLINICAL SIGNIFICANCE

Clinicians should measure blood HbA1c levels when planning implant-supported restorations, thus patients with undiagnosed or poorly controlled type-2 diabetes can be identified, that allows for glycemic level adjustment prior to dental implant surgery, ensuring peri-implant health. PROTOCOL REGISTRATION NUMBER: (CRD42022375263).

Clinical and radiographic outcomes around 4 mandibular implant-retained overdentures in individuals with type 2 diabetes: A long-term retrospective study

OBJECTIVES

To report the implant survival rates, clinical, and radiographic status after a period of more than 5 years in the function of 4 inter-foraminal implants retaining mandibular overdentures (OVDs) in individuals with T2DM.

METHODS

78 completely edentulous participants with type 2 diabetic mellitus (T2DM) who had worn mandibular OVDs retained by 4 inter-foraminal implants for long-term functional life were selected for this study. The participants were divided into 2 groups according to glycosylated haemoglobin A1c (HbA1c) levels before implant placement: group I with an HbA1c value > 6.5 % (inadequately controlled T2DM), and group II with an HbA1c value ≤6.5 % (well-controlled T2DM). The inadequately controlled T2DM was further subdivided into 2 groups: Group IA with an HbA1c value > 6.5 % and ≤8 % (moderately controlled), and Group IB has an HbA1c value > 8 % (poorly controlled). Implant survival rate, plaque index (PI), bleeding on probing (BOP), probing depth (PD), and radiographic crestal bone level (CBL) around implants were measured.

RESULTS

Among 312 implants, 6 failed, 4 in well-controlled diabetics, and 2 in inadequately controlled diabetics. The overall survival rate was 98.07 %. The mean PI in group Ι was 36.4 (group IA =37.76, group IB = 34.27), and in group ΙΙ it was 19. The mean BOP in group Ι was 45.5 (group IA =47.84, group IB = 41.76), and in group ΙΙ it was 22. The mean PD in group Ι was 4.1 (group IA =4.3, group IB = 3.85) and in group ΙΙ was 2.2. The mean radiographic CBL in group Ι was 3.4 (group IA =3.7, group IB = 2.9), and in group ΙΙ was 1.5. Group IA exhibited a significantly greater level of PI, BOP, PD, and CBL compared to group IB and group IΙ (P1=0.017, P2=0.001).

CONCLUSIONS

Individuals with T2DM can benefit from 4 inter-foraminal implants retained mandibular OVDs, and their inability to maintain proper glucose control may not exclude implant success.

CLINICAL SIGNIFICANCE

This study is a significant step toward improving knowledge of options available for treatment and anticipated outcomes for T2DM completely edentulous populations undergoing implant therapy.

Dental Implant Placement in Medically Compromised Patients: A Literature Review

As a discipline of dentistry, oral implantology deals with the diagnosis, design, insertion, restoration, and/or management of alloplastic or autogenous oral structures for the purpose of regaining contour, function, aesthetics, and speech in a partially or completely edentulous patient. The present review aims to provide the currently available knowledge about the impact of certain systemic disorders and the usage of some medications on the survival rate of dental implant therapy and to highlight the importance of patient management under these conditions. Diabetes, osteoporosis, cardiovascular diseases, and the intake of some medications can increase the risk of the failure of a dental implant. Even though there are relatively few medical contraindications to dental implant treatment, certain conditions may increase the risk of failure or complications.

Primordial and primary prevention of peri-implant diseases: A systematic review and meta-analysis

AIM

This systematic review and meta-analysis aims to assess the efficacy of risk factor control to prevent the occurrence of peri-implant diseases (PIDs) in adult patients awaiting dental implant rehabilitation (primordial prevention) or in patients with dental implants surrounded by healthy peri-implant tissues (primary prevention).

MATERIALS AND METHODS

A literature search was performed without any time limit on different databases up to August 2022. Interventional and observational studies with at least 6 months of follow-up were considered. The occurrence of peri-implant mucositis and/or peri-implantitis was the primary outcome. Pooled data analyses were performed using random effect models according to the type of risk factor and outcome.

RESULTS

Overall, 48 studies were selected. None assessed the efficacy of primordial preventive interventions for PIDs. Indirect evidence on the primary prevention of PID indicated that diabetic patients with dental implants and good glycaemic control have a significantly lower risk of peri-implantitis (odds ratio [OR] = 0.16; 95% confidence interval [CI]: 0.03-0.96; I² : 0%), and lower marginal bone level (MBL) changes (OR = -0.36 mm; 95% CI: -0.65 to -0.07; I² : 95%) compared to diabetic patients with poor glycaemic control. Patients attending supportive periodontal/peri-implant care (SPC) regularly have a lower risk of overall PIDs (OR = 0.42; 95% CI: 0.24-0.75; I² : 57%) and peri-implantitis compared to irregular attendees. The risk of dental implant failure (OR = 3.76; 95% CI: 1.50-9.45; I² : 0%) appears to be greater under irregular or no SPC than regular SPC. Implants sites with augmented peri-implant keratinized mucosa (PIKM) show lower peri-implant inflammation (SMD = -1.18; 95% CI: -1.85 to -0.51; I² : 69%) and lower MBL changes (MD = -0.25; 95% CI: -0.45 to -0.05; I² : 62%) compared to dental implants with PIKM deficiency. Studies on smoking cessation and oral hygiene behaviors were inconclusive.

CONCLUSIONS

Within the limitations of available evidence, the present findings indicate that in patients with diabetes, glycaemic control should be promoted to avoid peri-implantitis development. The primary prevention of peri-implantitis should involve regular SPC. PIKM augmentation procedures, where a PIKM deficiency exists, may favour the control of peri-implant inflammation and the stability of MBL. Further studies are needed to assess the impact of smoking cessation and oral hygiene behaviours, as well as the implementation of standardized primordial and primary prevention protocols for PIDs.

Systemic Diseases and Biological Dental Implant Complications: A Narrative Review

The relationship between periodontitis and such systemic disorders as diabetes, cardiovascular disease and obesity has been extensively investigated. There is less scientific evidence available, however, regarding the influence of systemic diseases on the risk of late failure of dental implant rehabilitation due to peri-implantitis. The aim of the present study was to review the literature on the role of several common systemic disorders (diabetes, obesity, cardiovascular disease, hypertension and osteoporosis) in the onset of peri-implantitis. A database search initially yielded 2787 studies of potential interest published up to 1 March 2022 (993 in PubMed; 908 in Web of Science; and 886 in Scopus). After removing 1190 duplicate articles and checking the titles, abstracts and full texts for relevance, 70 articles were selected for the present analysis. Only cohort, case-control studies and clinical case series were considered. Most of the literature concludes for no association between diabetes, cardiovascular disease, hypertension or osteoporosis and the risk of peri-implantitis. On the other hand, almost all the studies that investigated obesity as a risk factor for implant rehabilitation found a positive association between the two. Further longitudinal studies are needed to better understand the effects of systemic diseases on rehabilitation with dental implants.

Impact of local predisposing/precipitating factors and systemic drivers on peri‐implant diseases

BACKGROUND

Strong evidence suggests the infectious nature of peri-implant diseases occurring in susceptible hosts. Epidemiological reports, though, indicate that peri-implantitis is a site-specific entity. Hence, the significance of local factors that may predispose/precipitate plaque accumulation and the impact of systemic drivers that alter the immune response are relevant in the prevention and management of peri-implant disorders.

PURPOSE

The purpose of the present review is to shed light on the significance of local and systemic factors on peri-implant diseases, making special emphasis on the associations with peri-implantitis.

METHODS

The biologic plausibility and supporting evidence aiming at providing a concluding remark were explored in the recent scientific literature for local predisposing/precipitating factors and systemic drivers related to peri-implant diseases.

RESULTS

Local predisposing factors such as soft tissue characteristics, implant position and prosthetic design proved being strongly associated with the occurrence of peri-implant diseases. Hard tissue characteristics, however, failed to demonstrate having a direct association with peri-implant diseases. Robust data points toward the strong link between residual sub-mucosal cement and peri-implant diseases, while limited data suggests the impact of residual sub-mucosal floss and peri-implantitis. Systemic drivers/habits such as hyperglycemia and smoking showed a strong negative impact on peri-implantitis. However, there is insufficient evidence to claim for any link between metabolic syndrome, atherosclerotic cardiovascular disease, and obesity and peri-implant diseases.

CONCLUSION

Local predisposing/precipitating factors and systemic drivers may increase the risk of peri-implant diseases. Therefore, comprehensive anamnesis of the patients, educational/motivational programs and exhaustive prosthetically-driven treatment planning must be fostered aiming at reducing the rate of biological complications in implant dentistry.

Clinical, Radiographic, and Inflammatory Peri-Implant Parameters around Narrow Diameter Implant Crowns among Prediabetic and Non-Diabetic Subjects

Background and Objectives: To compare the clinical, radiographic, and inflammatory peri-implant parameters around narrow diameter implants (NDI) supported single and splinted crowns in non-diabetics and prediabetes. Materials and Methods: The clinical and radiographic parameters and the levels of IL-6 and TNF-α in the peri-implant crevicular fluid (PICF) of narrow diameter single (NDISCs) and splinted (NDISPs) crown implants were assessed both in non-diabetics and participants with prediabetes. The glycemic state of the patient was assessed using glycated hemoglobin (HbA1c) levels. The peri-implant soft tissue indices (Plaque index (PI), bleeding on probing (BoP), probing depth (PD)) and marginal bone loss were recorded and compared between the groups. Success of the prosthesis was assessed by the frequency of technical complications and patient satisfaction. Inter-group comparison was performed using ANOVA (one-way analysis of variance) while the normal distribution of dependent variables was calculated using Shapiro-Wilk. A p-value of less than 0.05 was considered to be statistically significant. Results: Sixty participants (30 non-diabetics and 30 with prediabetes) with a total of 178 (118 NDISCs and 60 NDISPs) platform-switched NDIs were a part of the study. Of the 118 NDISCs, 56 were placed in the non-diabetic individuals and 62 were placed in the prediabetes group whereas 30 NDISPs each were placed in both the study groups. The clinical parameters of PI, BoP and PD in the single crown and splinted crown groups showed comparable results. However, a statistically significant difference (p-value of less than 0.05) in PI, BoP and PD and in the values of IL-6 and TNF-α was found when a comparison was made between the non-diabetes and prediabetes group. A total of 91% of the patients were satisfied with the esthetics of the implants while 79% of the patients showed satisfaction with function. Conclusions: All the clinical and radiographic parameters were statistically similar in both single and splinted types of narrow diameter implants. However, the bone loss, probing depth, plaque index, and levels of inflammatory markers were statistically higher in prediabetes as compared to non-diabetes implying that a slight hyperglycemic state impacts peri-implant health.

Clinical Evaluation of Short Tuberosity Implants among Type 2 Diabetic and Non-Diabetic Patients: A 5 Year Follow-Up

Aim: To assess clinical and radiographic parameters including bleeding on probing (BoP); probing depth (PD), plaque index (PI) and crestal bone loss (CBL) around short tuberosity implants (STI) supporting fixed partial dentures in patients with Type 2 diabetes mellitus (T2DM) and non-diabetics. Material and Methods: Participants with T2DM and without T2DM with at least one STI (6 mm) posteriorly restored with a fixed partial denture splinting premolar implant were included. A questionnaire collected demographic details including gender, age, duration of diabetes, habits of brushing, the total number of dental implants and location, implant loading after placement, restoration type, and family history of DM. Clinical and radiographic assessment of peri-implant parameters, i.e., bleeding on probing (BoP), probing depth (PD), plaque index (PI), and crestal bone loss (CBL) was performed. The restorative success of STI was determined by no sensation of the foreign body, lack of pain and dysesthesia, lack of infection, no radiolucency around the implant, and no mobility. The Kruskal-Wallis test was used for statistical analysis. A p-value of less than 0.05 was considered statistically significant. Results: Twenty-five T2DM (19 males and 6 females) and 25 non-diabetic (18 males and 7 females) participants were included. The number of STIs in T2DM was 41, whereas in non-diabetic it was 38. At 1 year follow-up, mean PI% in T2DM participants was 18.9% (19.2-21.4%) and in non-diabetics it was 17.6% (16.3-18.5%). The mean PD was recorded in diabetics (1.3 ± 5.0 mm) and non-diabetics (1.1 ± 3.2 mm). The BoP value in diabetics was 44.9% (39.8-46.4%) and 28.2% in non-diabetics (17.2-24.6%). At 5 years of follow-up, the mean PI% range in T2DM participants was 26.18% (25.4-29.1%) and 24.42% in non-diabetic (20.1-25.5%). The mean PD in millimeters around STI in T2DM was observed to be 2.3 ± 4.8 mm and 1.4 ± 3.4 mm in non-diabetics. In addition, BoP in diabetic participants was 39.54% (27.7-42.1%) and 24.42% in non-diabetics (20.1-25.5%). A total of six STIs failed, i.e., two in the non-diabetic and four in the T2DM group. Conclusions: Patients with T2DM have poor periodontal (BoP, PD, CBL) and restorative peri-implant parameters around STIs when compared to healthy (non-diabetic) participants at five years of follow-up. For long-term stability, glycemic control is pivotal along with following good plaque control.

Integration of collagen fibers in connective tissue with dental implant in the transmucosal region

Dental implants have been widely accepted as an ideal therapy to replace the missing teeth for its good performance in aspects of mechanical properties and aesthetic outcomes. Its restorative success is contributed by not only the successful osseointegration of the implant but also the tight soft tissue integration, especially the collagen fibers, in the transmucosal region. Soft tissue attaching to the dental implant/abutment is overall similar, but in some aspects distinct with that seen around natural teeth and soft tissue integration can be enhanced via several surface modification methods. This review is going to focus on the current knowledge of the transmucosal zone around the dental implants (compared with natural teeth), and latest strategies in use to fine-tune the collagen fibers assembly in the connective tissue, in an attempt to enhance soft tissue integration.

Should Quality of Glycemic Control Guide Dental Implant Therapy in Patients with Diabetes? Focus on: Peri-Implant Diseases

BACKGROUND AND AIM

Traditionally patients with metabolic conditions such as diabetes mellitus are considered not suitable candidates for dental implant therapy due to increased risk of infection, impaired bone healing or the potential for vascular complications. Peri-implantitis as the more progressive form of peri-implant disease involves bone loss and estimated to occur in nearly half of all implant cases long-term. Despite extensive research on association of hyperglycemia with dental implants in preclinical and animal models, translational effort to clinical practice is hampered by discrepancies in reported outcome indicators for peri-implantitis in patients with a spectrum of glycemic profiles. This review aims to evaluate clinical evidence for peri-implant disease in metabolically compromised patients and in particular in patients with poorly-controlled diabetes in order to inform clinical management of peri-implant disease.

MATERIALS AND METHODS

A comprehensive literature review was performed utilizing PubMed database and using the key word 'diabetes' combined with "dental implant" or "Periimplantitis" or/and "Preimplant disease".

RESULTS

Clinical studies with follow up more than 1year, systematic review and meta-analysis that evaluated peri-implant disease in diabetic patients in relation to glycemic control were taken into consideration in this review.

CONCLUSION

Studies reported conflicting results regarding the long-term effect of diabetes on peri-implant health regardless of the level glycemic control. Therefore, interpretation of finding and relevance to clinical practise should be considered on individual bases.

Can we improve dental treatment outcomes in patients with high-risk factors?

Aim The aim of the study was to identify best practice in relation to improving the periodontal conditions of patients and increasing the rate of treatment success, through the identification of risk factors and implementation of changes in lifestyle.Methods and materials The study used two search strategies to identify papers describing best practices and important lifestyle changes which improved periodontal conditions and treatment outcomes in patientsResults The study demonstrated that the two most important factors in terms of interventions to improve periodontal conditions and treatment outcomes were to improve the level of diabetes control and remove aggravating factors such as smoking.Conclusion Many studies have focused on improving treatment outcomes in patients with high-risk factors such as smoking and medical conditions. Strategies, guidelines and protocols that reflect the best practices and lifestyle changes to improve the level of treatment success in high-risk patients should be adapted within treatment planning and follow-up. Successful treatment outcomes are best achieved through controlling diseases affecting the oral cavity and supporting structures.

Immediate implant-prosthetic dental rehabilitation of patients with diabetes using four immediately loaded dental implants: a pilot study

Objectives

Type 2 diabetes mellitus (T2DM) involves endocrine changes that cause a persistent increase in blood glucose. Many disorders are associated with T2DM, including disorders that affect the oral cavity. Oral cavity disorders interfere with a patient’s capacity to follow a correct diet, which results in worsening systemic disease. Oral rehabilitation is necessary for patients with T2DM. Therefore, this prospective study was performed to evaluate the immediate dental rehabilitation capacity of patients with T2DM using four immediately loaded dental implants.

Methods

In this prospective study, four implants each were placed in four patients with T2DM and loaded within 24 hours. Demographic characteristics were assessed at baseline; systemic and oral health parameters were assessed at baseline and at 6 months after implant placement.

Results

The mean glycated hemoglobin (HbA1c) level was 7.05% (range, 6.8%–7.3%). The mean Implant Stability Quotient of the dental implants was 74.5 (range, 67–85). Postoperative evolution was favorable: only one implant exhibited inflammation of the prosthetic stump.

Conclusions

Immediate prosthetic rehabilitation using four maxillary dental implants was an effective treatment modality for patients with T2DM in this study. Larger studies are needed to confirm these findings.

Association between diabetes and dental implant complications: a systematic review and meta-analysis

OBJECTIVES

The aim of this study was to explore the possible association between diabetes mellitus and dental implant complications.

MATERIAL AND METHODS

A systematic literature review was conducted to answer the following PICO (Participants, Intervention, Comparison, and Outcome) question: Is there association between diabetes mellitus and dental implant complications? Two independent searchers performed a literature search of the PubMed/MEDLINE, Web of Science, Cochrane Library and EMBASE databases for studies published until February 2020, focussing on studies including continuous outcomes, marginal bone loss (primary outcome), probing depth, and bleeding upon probing (secondary outcomes).

RESULTS AND CONCLUSIONS

A final total of 10 published studies were included in this systematic review. There were statistically significant differences between the groups with regard to marginal bone loss (p < .00001), probing depth (p < .00001) and bleeding around dental implants (p < .00001), and subjects without diabetes had lower complication rates. Additionally, in the subgroup analysis performed with loading time and HbA1c levels, a more evident association was found in immediate loading for probing depth. Moreover, the analysis results of bleeding around dental implants suggested that as HbA1c level increases, the bleeding of the tissues surrounding the implant will also increase. With regard to dental implant complications, there were statistically significant differences favouring patients without diabetes mellitus.

Influence of glycemic control on survival of zygomatic implants in relation with type-2 diabetes mellitus: 10 years' follow-up results

It is hypothesized that under optimal glycemic control (GC), there is no difference in the survival of implants placed in the zygomatic bone of edentulous patient with and without type-2 diabetes mellitus (T2DM). Purpose: The aim was to assess the influence of GC on survival of implants placed in the zygomatic bone of edentulous patient with and without T2DM at 10-years' follow-up. Twenty patients with T2DM (10 with poorly- and 10 with well-controlled T2DM) and 12 patients without T2DM were included. Hemoglobin A1c (HbA1c) levels were recorded and demographic data was collected from all participants. Peri-implant inflammatory parameters (plaque index [PI], probing depth [PD], crestal bone loss [BL] and gingival index [GI]) were measured in all patients. Group comparisons were done and P-values, which were less than 0.01 were indicative of statistical significance. Twenty and 12 male patients with and without T2DM, respectively were included. Among patients with T2DM, 10 and 10 individuals had poorly- and well-controlled T2DM, respectively.  The mean HbA1c levels were significantly higher in patients with poorly- (9.2 ± 0.7%) compared with well-controlled T2DM (4.8 ± 0.3%) (P<0.01) and non-diabetic individuals (4.6 ± 0.3%) (P<0.01). The crestal BL on the mesial (P<0.01) and distal (P<0.01) surfaces, PD (P<0.01), PI (P<0.01), and GI (P<0.01) were significantly higher around all zygoma implants placed in patients with poorly-controlled T2DM compared with patients with well-controlled T2DM and patients without T2DM. These clinicoradiographic parameters were comparable around zygoma implants placed in patient with well-controlled T2DM and in subjects without T2DM.  Optimal glycemic control is essential for the long-term stability of zygomatic plants in patients with T2DM.

Comparison of peri-implant soft tissue and crestal bone status of dental implants placed in prediabetic, type 2 diabetic, and non-diabetic individuals: a retrospective cohort study

Background

Clinicoradiographic status of narrow-diameter implants (NDIs) among patients with prediabetes and type 2 diabetes mellitus (DM) is scarce. The aim was to address the clinicoradiographic status of NDIs placed prediabetic, type 2 diabetic, and non-diabetic individuals. In this retrospective cohort study, patients having undergone oral rehabilitation with NDI were included. The participants were divided into the following: (a) patients with prediabetes; (b) patients with poorly controlled type 2 DM; (c) patients with well-controlled type 2 DM; and (d) normoglycemic individuals. Demographic data was collected. In all groups, peri-implant plaque index (PI), gingival index (GI), probing depth (PD), and mesiodistal CBL were measured in all groups. Information related to implant dimensions, surface characteristics, insertion torque, implant geometry, duration of NDI in function, and jaw location of NDI was also recorded. Data normality was assessed and group comparisons were performed. A probability value under 0.01 was considered statistically significant.

Results

Eighty-three patients (20 patients had prediabetes, 22 with poorly controlled type 2 DM, 20 with well-controlled type 2 DM, and 20 self-reported non-diabetic individuals) were included. The mean HbA1c levels were significantly higher among patients with prediabetes (P < 0.01) and poorly controlled type 2 DM (P < 0.01) than patients with well-controlled type 2 DM and non-diabetic controls. Peri-implant PI, GI, PD, and mesiodistal CBL levels were significantly higher among patients with pre-diabetes (P < 0.01) and poorly controlled type 2 DM (P < 0.01) than patients with well-controlled type 2 DM and non-diabetic controls. Peri-implant PI, GI, PD, and mesiodistal CBL levels were significantly higher among patients with poorly controlled type 2 DM (P < 0.01) than patients with prediabetes.

Conclusion

Chronic hyperglycemia increases the risk of peri-implant diseases around NDIs.

Current status of dental implants survival and peri-implant bone loss in patients with uncontrolled type-2 diabetes mellitus

PURPOSE OF REVIEW

The current review summarizes recent evidence on the impact of type-2 diabetes mellitus (T2DM) on implant dentistry, highlighting the behavior of peri-implant bone.

RECENT FINDINGS

There is no definitive information on the development and course of peri-implant bone loss associated with T2DM; however, poorly controlled T2DM patients present worse outcomes. Nevertheless, dental implants may be a successful therapy for these patients in a manner similar to healthy individuals, when glycemic levels and oral hygiene are strictly maintained.

SUMMARY

The most recent literature on the impact of T2DM on peri-implant bone loss was reviewed to evaluate the feasibility of dental implant therapy over the time for these patients.

Clinical, radiographic, and restorative peri-implant measurements of narrow and standard diameter implants in obese and nonobese patients: A 3-year retrospective follow-up study

BACKGROUND

There is dearth of studies assessing clinical, restorative, and radiographic peri-implant outcomes around narrow diameter implants (NDIs) and standard diameter implants (SDIs) in obese and nonobese subjects.

OBJECTIVE

To assess clinical, restorative, and radiographic parameters of NDIs and SDIs placed in obese and nonobese individuals.

MATERIALS AND METHODS

Obese and nonobese patients requiring NDIs and SDIs in the anterior maxilla/mandible were included. Based on the implant diameter, participants were further divided into two subgroups: (a) NDIs (3.3 mm) and (b) SDIs (4.1 mm). Peri-implant clinical measurements including plaque index (PI), bleeding on probing (BOP), probing depth (PD), and radiographic crestal bone loss (CBL) were evaluated around NDIs and SDIs at 1 and 3-year follow-up.

RESULTS

A total of 70 patients (35 obese and 35 nonobese) were included. Only BOP showed statistically significant differences between both the groups at patient level at 1 and 3-year follow-up (P < .05). There was no statistically significant difference in PI and PD around NDIs and SDIs between obese and nonobase patients. Statistical significant differences were observed in the total CBL around NDIs and RDIs among obese and nonbase subjects at 3 year follow-up (P < .05).

CONCLUSION

Both NDIs and SDIs show consistent clinical stability among obese and nonobase patients. Higher amount of bone loss was observed in obese patients compared to nonobase patients despite regular hygiene maintenance.