The Effect of Controlled Diabetes and Hyperglycemia on Implant Placement with Simultaneous Horizontal Guided Bone Regeneration: A Clinical Retrospective Analysis

Abstract

Diabetes represents a challenge in implant therapy because hyperglycemia may negatively affect bone regeneration, directly compromising clinical outcomes and increasing clinical failures. The aim of this retrospective study is to analyse the prognostic significance of HbA1c levels in patients undergoing implant placement associated with horizontal guided bone regeneration. Thirty-four patients were divided into 3 groups according to their HbA1c levels: nondiabetic normoglycemic patients ( $\text{HbA}1\text{c}<5.7\%$ ), nondiabetic hyperglycemic patients ( $\text{HbA}1\text{c}<6.5\%$ ), and controlled diabetic patients ( $\text{HbA}1\text{c}<7\%$ ). Primary outcomes were dimensional changes in height (VDH) and width (DW) of the peri-implant defect. Secondary outcomes were evaluations of periodontal parameters of adjacent tooth sites, wound healing, marginal bone loss (MBL), and survival and success rates. At $T_1$ (6 months), mean VDH values in groups 1, 2, and 3 were, respectively, 0.07, 0.5, and 0.25 mm. Mean DW values in those same groups were, respectively, 0.07, 0.38, and 0.33 mm. HbA1c levels were not statistically related to VDH and DW values at $T_1$ . No statistically significant differences were observed in MBL between groups ( $p=0.230$ ). Implant survival and success rates were, respectively, 98% and 96%. Simultaneous guided bone regeneration is a feasible procedure for the treatment of horizontal bone deficiencies in controlled diabetic patients.