The impact of implant-retained overdentures on type-2 diabetic and non-diabetic edentulous patients: Satisfaction and quality of life in a prospective cohort study.

OBJECTIVES: To evaluate the benefits of implant therapy for patients with diabetes, we compared (i) healthy, (ii) well controlled T2DM and (iii) poorly controlled T2DM patients, in terms of oral health-related quality of life (OHRQoL) and satisfaction with mandibular 2-implant overdentures over 12 months following restoration. MATERIALS AND METHODS: This single-center, prospective, cohort study recruited 165 edentulous adults (HbA1c<12%) to receive two endosseous implants in the anterior mandible to support mandibular overdentures. Participants were enrolled as having T2DM or not, with T2DM participants divided according to HbA1c into well-controlled (<8.1%) and poorly controlled (≥ 8.1%) groups. Participants provided responses to the OHIP-20 (OHRQoL) and the McGill Denture Satisfaction Questionnaire, before implant therapy and 6 and 12 months after overdenture insertion using Locator attachments. HbA1c was measured at the same time points. The effect of groups and time was verified using generalized estimating equations (α=0.025). RESULTS: At 12 months, 137 participants provided responses. The two diabetes groups showed improvements in OHRQoL to the same extent as the non-diabetic control group at both 6 and 12 months. Patient satisfaction showed similar improvements with no between-group differences and similar increases identified at 6 and 12 months. HbA1c was not affected by time or groups. CONCLUSIONS: Dental implant therapy provided significant improvements in patient-perceived benefits of mandibular two-implant overdentures for T2DM individuals, which are similar to those found for healthy edentulous individuals. Importantly, those benefits extend to those individuals with poorly controlled glycaemia. The addition of 2-implant supported mandibular overdentures did not affect glycaemic status over 12 months following insertion. CLINICAL SIGNIFICANCE: As risks for implant therapy relative to glycaemic status are better understood, this study documents that implant therapy may offer important benefits in QoL for T2DM patients independent of glycaemic status.

Conventional SLA and chemically modified SLA implants in patients with poorly controlled type 2 diabetes mellitus--a randomized controlled trial.

OBJECTIVE: The objective of this study was to evaluate the potential for a chemically modified Sand blasted, Large grit, Acid etched (SLA) surface, compared with a conventional SLA surface, to enhance implant healing and integration in poorly controlled diabetic patients, a group previously demonstrated to have compromises and delays in implant stabilization during the metabolically active healing period following implant placement. MATERIALS AND METHODS: The study enrolled 24 patients with type 2 diabetes, baseline HbA1c levels between 7.5-11.4%, and a minimum of two posterior mandibular tooth sites at least 4 months following extraction and appropriate for implant placement. Each patient, at a randomly selected site, received an implant with the conventional SLA surface; at the second site, the patient received an implant with the chemically modified SLA (modSLA) surface. Thus, 48 study implants were placed. Implant stability was assessed using Resonance Frequency Analysis (RFA). Readings were taken from the buccal and proximal directions for each implant. Implant stability (ISQ) was assessed at the time of surgical placement (baseline) and 2, 3, 4, 6, 8, 10, 12, and 16 weeks following implant placement. RESULTS: No significant differences in implant stability were observed between conventional SLA implants and modSLA implants, and the time courses of implant stabilization following implant placement were similar for the two implant types. Baseline ISQ and minimum ISQ was slightly higher in subjects with higher HbA1c levels, but were similar during 12-16 weeks following implant placement. Forty-seven (98%) of the 48 implants were determined to be successfully osseointegrated and continued to restoration. CONCLUSION: Implant stabilization was similar for the conventional SLA and chemically modified SLA implants in type 2 diabetic patients with relatively poor glycemic control. Furthermore, this study demonstrated clinically successful implant placement even in poorly controlled diabetic patients.