Bone quality analysis of jaw bones in individuals with type 2 diabetes mellitus-post mortem anatomical and microstructural evaluation.

OBJECTIVES: With the higher risk of dental implant failure with type 2 diabetes mellitus (T2DM), there is a need to characterize the jaw bones in those individuals. The aim of this post mortem study was to compare jaw bone quality of individuals with T2DM to healthy controls. MATERIAL AND METHODS: Bone cores from the edentulous lower first molar region and the region of mandibular angle were collected from male individuals with T2DM (n = 10, 70.6 ± 4.5 years) and healthy controls (n = 11, 71.5 ± 3.8 years) during autopsy. Within the T2DM, a subgroup treated with oral antidiabetics (OAD) and one on insulin were identified. Bone quality assessment encompassed evaluation of bone microstructure, matrix composition, and cellular activity, using microcomputed tomography (micro-CT), quantitative backscattered electron imaging (qBEI), Raman spectroscopy, and bone histomorphometry. RESULTS: In the mandibular angle, T2DM showed 51% lower porosity of the lingual cortex (p = 0.004) and 21% higher trabecular thickness (p = 0.008) compared to control. More highly mineralized bone packets were found in the buccal cortex of the mandibular angle in insulin-treated compared to OAD-treated T2DM group (p = 0.034). In the molar region, we found higher heterogeneity of trabecular calcium content in T2DM insulin compared to controls (p = 0.015) and T2DM OAD (p = 0.019). T2DM was associated with lower osteocyte lacunar size in the trabecular bone of the molar region (vs. control p = 0.03). CONCLUSIONS: Alterations in microstructure, mineralization, and osteocyte morphology were determined in jaw bone of individuals with T2DM compared to controls. CLINICAL RELEVANCE: Future studies will have to verify if the mild changes determined in this study will translate to potential contraindications for dental implant placements.

Analysis of abutment teeth in partially edentulous patients.

The aim of the study was to examine changes in the position of the abutment teeth (AT), size of undercuts for a denture clasp, as well as an existence of an adequate preparation of abutment teeth. A total of 156 casts of partially edentulous jaws, with 460 AT, were analyzed. The size of undercuts, a degree of abutment rotation, inclination and migration were measured using a dental parallelometer. The abutment teeth position was related to the level of occlusal plane in a dental articulator. Furthermore, the existence of an adequate preparation of abutment teeth, as well as a type of a denture and a type of a denture retention element were also considered. Analysis were carried out twice on casts made from a hard stone, the first time before the denture treatment had begun and the second time on the new casts obtained after new dentures had been delivered. The first analysis (prior dental treatment) revealed that a total of 33.9% of the analyzed AT were rotated, 31.3% were inclined, 12.1% had migrated, and 57.3% were elongated above the occlusal plane. On the casts obtained after the new dentures had been made, it was observed that none of the AT had an adequate preparation. Only 37.6% of all retention elements were located in adequate undercut positions on the AT. Upon the results of the present study a conclusion can be established that many abutment teeth are rotated, elongated, inclined, and migrated, which point to a requirement for AT preparation prior the manufacture of new denture; however none of the AT was adequately prepared considering insertion plane and many denture elements were located in an inadequate undercut size.