Dental Implant in Patients With Type II Diabetes: Placement to 5 Years - A Clinical Study

Abstract

Unfortunately, recent data about the prevalence of diagnosed diabetes mellitus (DM) mainly type II and it is relation to dental implants in Yemen was not estimated. Several objectives have been considered in this study, 1- to establish baseline data for future research in dental implants in Yemen, 2- to study the success rate of dental implants for medically compromised patients in the Republic of Yemen. The study is the first to be conducted in the Republic of Yemen. Diabetes may affect as many as 18% of people over the age of 65, many of whom will be partially or edentulous. The disease has far-reaching systemic sequelae, including an increased susceptibility to caries and periodontal disease. It is also known to impair healing which increases the risk of tissue necrosis and infection. However, improvements in diabetic management have resulted in many patients being well-controlled with the stability of their blood glucose and metabolic control. These patients have been shown in previous studies to be suited to dental implant surgery, with an acceptable degree of predictability. This study reports retrospectively on the survival of dental implants placed into diabetic patients. 34 female and male patients with 227 implants were followed through to final restoration. Upon uncovering, 214 of the 227 implants were found to have osseointegrated, yielding a 94% success rate. Of the thirteen failed implants 10 were from the immediately loaded group and three from the bone grafting group. All other patients don’t lose any implants. Failures occurred either in the maxillary and in the mandibular jaws or the anterior and posterior segments. Five of the 13 surgical failures were in the posterior mandible, five were in the posterior maxilla, two were in the anterior maxilla, and one was in the anterior mandible. It was established that diabetes was categorized into uncontrolled diabetes and controlled diabetes. Only the former was identified as a contra-indication to dental implant treatment. It is important to extract a thorough medical history from the patient, who if diabetic, should be able to demonstrate a good level of control of blood glucose levels, with confirmation that they are metabolically stable before and at the time of implant surgery. Patients need to be advised of the importance of maintaining their drug regime throughout treatment and they should be routinely prescribed prophylactic antibiotics, using a broad-spectrum drug for 10 days. Under these circumstances, it can be concluded that the provision of implants in well-controlled diabetic patients yields a high success rate.