The Effect of Moderately Controlled Type 2 Diabetes on Dental Implant Survival and Peri-implant Bone Loss: A Long-Term Retrospective Study.

PURPOSE: The objective of this study was to assess whether long-term implant survival rates and bone loss in patients with moderately controlled type 2 diabetes is similar to the rates reported in the nondiabetic population. MATERIALS AND METHODS: This retrospective observational study utilized patient medical records from a general practitioner's dental office. The records of patients who had moderately controlled type 2 diabetes with hemoglobin A1C (HbA1c) up to 8% and glucose level below 150 mg/dL were reviewed, as patients with HbA1c up to 7% are considered to be well-controlled type 2 diabetes. Follow-up data were recorded and analyzed. Inclusion criteria were as follows: partially edentulous patients with missing teeth who were subsequently treated with implant-supported prosthetic restorations; patients were at least 18 years of age and demonstrated the ability to maintain oral hygiene. Exclusion criteria were as follows: patients did not present for annual follow-up visits; patients presented with a neglected periodontal status; patient records had incomplete surgical or restorative data or nondiagnostic radiographs; implants with external hexagonal and machined surfaces. All the restorations were cement-retained. Three different implant insertion/placement methods were used: (1) implants immediately inserted following tooth extraction; (2) implants inserted 6 to 8 weeks after tooth extraction to allow for primary healing; and (3) implants inserted 4 to 6 months after tooth extraction. RESULTS: After review of more than 3,256 medical records, 169 patients were identified (with 1,112 implants) who met the inclusion criteria. The mean follow-up time was 8.7 years, with a minimum of 4.9 years. Sixty-seven implants failed, yielding a 94% overall implant survival rate. The overall mean bone loss around the implants was 1.98 (± 1.81) mm. Comparable to data published earlier, no statistical significance in survival rate was found between the nondiabetic and diabetic population. The delayed insertion protocol presented the least bone loss, compared with immediate insertion (P = .06), and compared with early insertion (P = .046). CONCLUSION: The results show that implant survival and bone loss levels were comparable to reported outcomes in the nondiabetic population. The delayed insertion protocol presented less bone loss compared with other insertion methods. Likewise, less bone loss was found in implants placed in the posterior region.

Dental Implant Thread Design and the Consequences on Long-Term Marginal Bone Loss.

AIM: The aim of this study was to present the implant macrostructure effect on marginal bone loss using 3 dental implant thread designs with differences in thread pitch, lead, and helix angle. All implants used were sourced from the same company and had the same microstructured surface. MATERIALS AND METHODS: This is a nonrandomized, retrospective, double-blind study. Data were collected by an independent Tel Aviv University group from a general practitioner's private practice patient records. In total, 1361 implants met the inclusion criteria representing the 3 types of implants macrostructure. RESULTS: Overall survival rate was 96.3% with 50 implants failing (3.7%) out of a total of 1361 implants. Survival rates for the 3 groups were: group A 96.6%, group B 95.9%, and in group C 100%. Average bone loss for groups A, B, and C were 2.02 (±1.70) mm, 2.10 (±1.73) mm, and 1.90 (±1.40) mm, respectively. Pairwise comparisons revealed that less bone loss occurred in group A compared with group B (P = 0.036). CONCLUSION: Favorable long-term bone loss results were found in implants with a larger pitch, deeper apical threads, and a narrower implant core. One-piece V-thread design implants demonstrated 100% survival rate.

Effect of implant insertion and loading protocol on long-term stability and crestal bone loss: A comparative study.

STATEMENT OF PROBLEM: Different insertion and loading protocols have been used to implement implant therapy; the consequences of these methods are unclear. PURPOSE: The purpose of this retrospective study was to compare the long-term outcomes of different implant insertion and loading protocols on crestal bone loss. MATERIAL AND METHODS: This was a nonrandomized retrospective study investigating data of patients in a private practice. Data were collected by an independent Tel Aviv University group from the patient records of a general practitioner's private practice. A total of 1688 implants were inserted in 343 patients whose records met the inclusion criteria, that is, 1317 immediately placed implants (IP group), 310 early placed implants (EP group) placed 6 to 8 weeks after implant placement, and 61 delayed placement implants (DP group) placed 4 to 6 months after extraction. The groups were also divided by implant loading method, giving 1203 immediately loaded implants (IL group), 273 early loaded implants (EL group) loaded within 4 to 10 weeks after implant placement, and 212 delayed loading implants (DL group) loaded within 3 to 6 months. Mixed model analysis was used to account for the different number of implants for each patient. RESULTS: The average follow-up time was 107 months, with a cumulative implant survival rate of 95.6% and an average crestal bone loss of 2.03 mm. No statistical differences (P>.05) were found among the insertion or loading protocols. However, additional statistical analysis showed the influence of implant type on marginal bone loss (P<.05). CONCLUSIONS: The 3-implant insertion and loading protocols exhibited minimal crestal bone loss and a high survival rate.

The efficacy of full-arch immediately restored implant-supported reconstructions in extraction and healed sites: a 36-month retrospective evaluation.

PURPOSE: Implants placed in fresh extraction sites and healed sites were restored simultaneously by cross-arch provisional fixed prostheses. Clinical and radiographic parameters were recorded for up to 36 months. MATERIALS AND METHODS: Treatment with a full-arch implant prosthesis, either screw-retained or cemented, was assigned to 54 patients. A total of 676 implants were placed in either immediate extraction sites (n = 367) or in healed alveoli (n = 309), followed by placement of a one-piece provisional prosthesis. The definitive restoration was placed 3 to 6 months after implant placement. Clinical parameters were recorded and digital radiographs obtained at 6, 18, and 36 months. The chi-square test, t test, and analysis of variance with repeated measures were used for statistical analysis of the outcomes. RESULTS: Osseointegration failed in 21 (3.1%) implants; 13 of these (62%) had been placed immediately after extraction. All occurred within 2 months of the surgical healing phase. Short (8-mm) and narrow (3.3-mm) implant configurations were significantly (P < .05) associated with failure. At 6, 18, and 36 months, average crestal bone resorption was 0.18 mm, 0.55 mm, and 0.79 mm for implants placed in fresh extraction sites and 0.31 mm, 0.78 mm, and 1.1 mm for implants placed in healed alveoli, respectively. These differences were statistically significant (P < .05 between sites at all examined periods). Crestal bone resorption also correlated to sites with simultaneous bone augmentation and implant placement. CONCLUSIONS: Implants placed and restored immediately in a cross-arch mode, whether in extraction sites or in healed alveoli, can be clinically successful and maintainable.