Keywords
implant-supported fixed superstructures
individual oral hygiene means
peri-implant
How to Cite
Abstract
Abstract. Diabetes mellitus significantly contributes to peri-implant diseases, with even well-controlled type 2 diabetic patients at higher risk. Oral hygiene is crucial for implant success, making a preventive care plan with regular monitoring, professional cleaning, and effective daily hygiene products essential for long-term implant outcomes.
The aim of the study was to improve the effectiveness of orthopedic treatment for patients with a compensated form of type 2 diabetes mellitus (T2DM) undergoing prosthetics with implant-supported fixed superstructures by optimizing follow-up care and the selection of individual oral hygiene means.
Material and methods. This study included 48 partially edentulous patients aged 28 to 57 years who applied to the Bogomolets National Medical University between 2021 and 2023 for prosthetics on endosseous implants and were diagnosed with a compensated form of T2DM. All subjects received oral hygiene instructions and participated in maintenance and follow-up exams at 3, 6, 9, and 12 months to identify visual signs of peri-implant inflammation, also the Schiller-Pisarev test (SPT) Probing Depth (PD), Bleeding On Probing (BOP), Marginal Bone Loss (MBL); oral hygiene and the level of plaque control were assessed using the Implant Hygiene Index (IHI). Patients were divided into 3 groups based on compliance with recommendations: group 1 (n=22) – regularly came for examination, used a mechanical toothbrush and interdental hygiene products, with other means used, occasionally; group 2 (n=19) – regularly came for examination, all recommended personal hygiene products were used, including an ultrasound brush and an irrigator; group 3 (n=7) – for re-examination appeared after 12 months or more, there were errors in care.
Results. After 3 months the average value of the IHI was 0,89±0,34 in patients of group 1, in patients of group 2 the IHI decreased and became 0,59±0,27, after 6 months – 0,75±0,26 and 0,47±0,18 respectively. The best IHI values were recorded after 6-month examination period. There was no statistically significant difference in SPT, PD, BOP, MBL among patients in all groups.
Conclusions. The use of an ultrasonic brush and irrigator showed a statistically significant improvement in hygiene performance compared to a manual brush. Regular professional maintenance with a recall periodicity of every 3 months during the first year after implant restoration ensures long-term implant success and peri-implant health in patients with controlled T2DM.
References
Kassebaum NJ, Smith AGC, Bernabе E, Fleming TD, Reynolds AE, Vos T, et al. Global, regional, and national prevalence, incidence, and disability-adjusted life years for oral conditions for 195 countries, 1990-2015: a systematic analysis for the global burden of diseases, injuries, and risk factors. J Dent Res. 2017 Apr;96(4):380-7. doi: 10.1177/0022034517693566.
Orishko A, Imber JC, Roccuzzo A, Stдhli A, Salvi GE. Toothand implant-related prognostic factors in treatment planning. Periodontol 2000. 2024 Jun;95(1):102-28. doi: 10.1111/prd.12597.
Renvert S, Lindahl C, Persson GR. Occurrence of cases with periimplant mucositis or peri-implantitis in a 21-26 years follow-up study. J Clin Periodontol. 2018 Feb;45(2):233-40. doi: 10.1111/jcpe.12822.
Lee CT, Huang YW, Zhu L, Weltman R. Prevalences of periimplantitis and peri-implant mucositis: systematic review and meta-analysis. J Dent. 2017 Jul;62:1-12. doi: 10.1016/j. jdent.2017.04.011.
Korsch M, Robra BP, Walther W. Cement-associated signs of inflammation: retrospective analysis of the effect of excess cement on peri-implant tissue. Int J Prosthodont. 2015 Jan-Feb;28(1):11-8.doi: 10.11607/ijp.4043.
Wada M, Mameno T, Otsuki M, Kani M, Tsujioka Y, Ikebe K. Prevalence and risk indicators for peri-implant diseases: A literature review. Jpn Dent Sci Rev. 2021 Nov;57:78-84. doi: 10.1016/j.jdsr.2021.05.002.
Cheung MC, Hopcraft MS, Darby IB. Patient-reported oral hygiene and implant outcomes in general dental practice. Aust Dent J. 2021 Mar;66(1):49-60. doi: 10.1111/adj.12806.
Ramanauskaite A, Obreja K, Schwarz F, Jepsen K, Cosgarea R, Bunke J, et al. Reliability of probing depth assessments at healthy implant sites and natural teeth. Clin Oral Investig. 2023 Jun;27(6):2533-45. doi: 10.1007/s00784-022-04810-5.
Jepsen S, Caton JG, Albandar JM, Bissada NF, Bouchard P, Cortellini P, et al. Periodontal manifestations of systemic diseases and developmental and acquired conditions: consensus report of workgroup 3 of the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions. J Periodontol. 2018 Jun;89 Suppl 1:S237-48. doi: 10.1002/JPER.17-0733.
Sun H, Saeedi P, Karuranga S, Pinkepank M, Ogurtsova K, Duncan BB, et al. IDF Diabetes Atlas: Global, regional and countrylevel diabetes prevalence estimates for 2021 and projections for 2045. Diabetes Res Clin Pract. 2022 Jan;183:109119. doi: 10.1016/j.diabres.2021.109119.
Xourafa G, Korbmacher M, Roden M. Inter-organ crosstalk during development and progression of type 2 diabetes mellitus. Nat Rev Endocrinol. 2024 Jan;20(1):27-49. doi: 10.1038/s41574-023-00898-1.
Wagner J, Spille JH, Wiltfang J, Naujokat H. Systematic review on diabetes mellitus and dental implants: an update. Int J Implant Dent. 2022 Jan 3;8(1):1. doi: 10.1186/s40729-021-00399-8.
Jiang X, Zhu Y, Liu Z, Tian Z, Zhu S. Association between diabetes and dental implant complications: a systematic review and meta-analysis. Acta Odontol Scand. 2021 Jan;79(1):9-18. doi:10.1080/00016357.2020.1761031.
Javed F, Romanos GE. Impact of diabetes mellitus and glycemic control on the osseointegration of dental implants: a systematic literature review. J Periodontol. 2009 Nov;80(11):1719-30. doi: 10.1902/jop.2009.090283.
Lagunov VL, Sun J, George R. Evaluation of biologic implant success parameters in type 2 diabetic glycemic control patients versus health patients: A meta-analysis. J Investig Clin Dent. 2019 Nov;10(4):e12478. doi: 10.1111/jicd.12478.