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Abstract
This study was conducted to evaluate clinically, radiographically and biochemically the success of placing two implants in the mandibular interforaminal regions to retain mandibular complete overdentures in diabetic patients.
Six male completely edentulous controlled type 2 diabetic patients who were treated by oral antidiabetic preparations were selected for this study.
Implant microdent system was used in this study with implant fixture of (14 mm) length and (3.8 mm) diameter and implant ball abutment. Each diabetic patient received two dental implants in the mandibular interforaminal regions 1-2 mm mesial to the mental foramina using the two-stage surgical protocol with an unloaded healing period of three months. After the three months healing period, the implant ball abutments were connected to the implant fixtures and left for two weeks. After two weeks each diabetic patient received mandibular implant retained overdenture using ball and socket attachment.
Clinical, radiographic and biochemical evaluation was carried out for every diabetic patient at regular recall appointments up to six months from the time of denture insertion. Clinical evaluation included the assessment of the following clinical parameters; plaque index, gingival index, probing depth, epithelial attachment level and mobility. While the radiographic evaluation included the use of indirect digital radiographs to measure the marginal bone level changes and bone density around the implant and the biochemical evaluation was performed using the new technique of measuring collagenase-2 level in peri-implant sulcular fluid.
From this study it could be concluded that:
• Results of the clinical evaluation demonstrated an increase in the plaque index and gingival index scores specially at the first month after final denture insertion but this increase was followed by a subsequent significant decrease up to the sixth month of study. Also increasing in probing depths and clinical attachment levels was insignificant with absence of mobility. So, all results of the clinical parameters were within the normal ranges recorded for healthy people.
• Radiographic evaluation revealed that the mean marginal bone level change was within the conventional limits generally accepted for osseointegrated dental implants and there was a significant increase in the mean peri-implant bone density indicating successful osseointegration.
• According to the biochemical evaluation results, implants were in a healthy condition demonstrated by a significant decrease in the collagenase-2 level in peri-implant sulcular fluid.
Needless to say, in this study all results of the clinical, radiographic and biochemical evaluations suggested that dental implants could be used as a successful and predictable treatment to retain mandibular complete overdentures in controlled type 2 diabetic patients with a success rate about 83%.