Clinical performance of hydrophilic, titanium-zirconium dental implants in patients with well-controlled and poorly controlled type 2 diabetes: One-year results of a dual-center cohort study.

BACKGROUND: This study assessed the clinical performance of hydrophilic dental implants in a patient cohort with type 2 diabetes mellitus (T2DM). METHODS: Subjects with T2DM of ≥2-years duration were allocated to either the well-controlled (WC; HbA1c ≤ 7.0%,) or poorly-controlled (PC; 7.5 < HbA1c < 10%) groups in a dual-center, prospective cohort study. Each subject received a single, titanium-zirconium (Ti-Zr) dental implant with a chemically-modified, hydrophilic (modSLA) surface in a posterior mandibular site. Postoperatively, subjects were followed at 1, 2, 4, 8, and 12-week intervals. Post-loading, subjects were followed at 3, 6, and 12-months. Clinical and radiographic parameters of implant success, and dental patient-reported outcomes were collected. RESULTS: Twenty-one dental patients (NWC  = 11; NPC  = 10; mean age: 66.8 ± 7.5 years) were enrolled and the 1-year implant success rate was 100%. Peri-implant bone levels were stable with 0.15 ± 0.06 mm mean marginal loss at 1 year without significant inter-group differences (P = 0.79). Postoperative pain was minimal at 1-week, and OHIP-5 scores decreased significantly over time as compared with preoperative levels (P < 0.001) suggesting significant improvement in patient-perceived oral health following implant therapy. CONCLUSIONS: Elevated HbA1c levels > 7.5% did not compromise 1-year success rates, or oral health-related quality of life in PC patients receiving modSLA, Ti-Zr implants. Given that implant placement up to 10% HbA1c significantly enhanced oral health-related quality of life without complications or morbidity, the safety and efficacy of implants to improve oral function in T2DM is supported, even without ideal glycemic control.

Patients' Perception of Recovery after Dental Implant Placement.

Background and Objectives: The success rates of surgical dental implant insertions are high. However, knowledge of patients' recovery is still lacking. "Health-related quality of life" (HRQOL) questionnaires are gaining popularity in all fields of medicine. The present survey assessed the perception of recovery after the surgical placement of dental implants. Materials and Methods: Forty individuals (26 women and 14 men; mean age, 55 ± 12 years) filled a questionnaire evaluating patients' perception of recovery for 7 consecutive days post-surgery. Confounding factors included age, gender, oral habits, smoking, bruxism, bone quality (tactile evaluation) and quantity, implant location, number of implants, implant type, length and diameter, one-stage vs. two-stage, and the need for bone grafting. Results: The most serious difficulties were found in swelling, which became minimal after 5 days, followed by eating everyday food, ability to enjoy everyday food, maximal pain and average pain (3 days); analgesics consumption (2.5 days); limitations in daily routine, mouth opening, and speech (2 days); swallowing and sleep (1.5 days); and, within 1 day, all other measures attained minimal levels. Gender, and implant location (anterior vs. posterior) were significant predictor variables exerting their different characteristic delayed recoveries. Conclusions: (1) Patients should expect, in general, recovery within 4 days after dental implant placement; (2) women will experience a delayed recovery, (3) implants placed in the intercanine area will result in postoperative eating difficulties for nearly one week, and (4) the number of implants placed during the same appointment has no effect on post treatment recovery.

Continuous Periosteal Strapping Sutures for Stabilization of Osseous Grafts With Resorbable Membranes for Buccal Ridge Augmentation: A Technique Report.

Alveolar bone loss occurs after extraction with loss of a premolar or anterior tooth; the residual supporting alveolar bone loss averages 1.53 mm of crestal bone height and 3.87 mm of buccolingual width, with most of the bone loss occurring at the facial plate. Socket preservation does not completely preserve the original ridge contours but can be an effective means of reducing bone loss following extraction. Attempts to rebuild the alveolar ridge structure after tooth loss often employ the concept of guided bone regeneration, a technique-sensitive procedure that routinely involves placement of particulate bone with or without fixation screws and either a resorbable or a nonresorbable membrane. We present a novel technique for stabilizing a resorbable membrane and underlying particulate graft allowing for predictable bone grafting across multiple edentulous sites.