Osseointegration of maxillary dental implants in diabetes mellitus patients: A one-year clinical outcome of dental implant treatment and the correlation between histomorphometric study and dental implant stability

Aim Osseointegration in type 2 diabetic mellitus (T2DM) seems to be inferior in healthy patients. However, the clinical outcome of dental treatment in well controlled T2DM is comparable to healthy patients.  The purposes of the study were to compare dental implant success at one-year follow-up, implant stability (ISQ), and the correlation among these parameters (ISQ, bone implant contact, new bone formation) in T2DM and healthy patients. 

Materials and methods Ten well-controlled T2DM (HbA1c<8%) patients (test group) and 10 healthy patients (control group) received one micro-implant (2.5 mmx 5 mm) in the maxilla (premolar/molar area). The micro-implant was retrieved after 2 months for histomorphometric evaluation and a conventional implant (4.2 mm/5 mm diameter x 10mm/12mm length) was placed immediately after bone preparation. Implant stability, by resonance frequency analysis (ISQ), was recorded at the following timepoints: immediate post surgical implant placement, 1 week, 2 week, 4 week, 6 week, 8 week, 12 week after placement and 1 year after prosthetic function. Implant success at one-year was evaluated following Pisa consensus conference guideline. Patients’ satisfaction with visual analog scale (VAS) was also registered. Statistical analysis on the correlation among those mentioned parameters was performed.

Results 1 out of 10 implants (90%) in T2DM  group failed comparing to 100% success in control group, and the marginal bone change (0.11 ± 0.07 mm vs 0.24 ± 0.10 mm, p>0.05) was not significantly different after one-year functioning. Resonance frequency analysis demonstrated the normal pattern of bone healing around implants in both groups. All the integrated implants showed high mean ISQ value (81.03 ± 0.68 in T2DM vs 81.66 ± 0.67) at one-year follow-up. All patients with successful implants (19 out of 20) were satisfied with the implant treatment in terms of function, esthetic and ease of cleaning. However, no correlation among ISQ, BIC and new bone formation from histomorphometric evaluation was found (p>0.05). 

Conclusion Within the limitation of the study, it may be concluded that clinical success and implant stability of dental implant treatment in well-controlled T2DM is comparable to healthy individuals after one-year of function. No correlation was found among ISQ, BIC and bone formation around dental implant.