The Impact of Different Implant Approaches in Overdenture Rehabilitated Diabetic Patients: A Two-Year Follow-Up

Abstract

Diabetes Mellitus (DM) is identified as an important condition that leads to implant complications, and the apico-coronal position and the prosthetic abutment seem to interfere with peri-implant tissue behavior This study aimed at assessing the effect on peri-implant parameters after implant loading of two different methodologies in type two diabetics patients (T2DM) who received implant muco-retained overdentures. Twenty-two mandibular edentulous T2DM received two implants: Test group: prosthetic abutment of a diameter smaller than the platform of the implant and a morse taper subcrestal implant level; Control group: prosthetic abutment of diameter identical to the platform and hexagonal external implant placed at crestal bone level. Clinical, inflammatory, and tomographic evaluations were performed at baseline (after prosthesis installation), and twelve and twenty-four months after implant loading. Test implants presented inferior probing depth and clinical attachment level compared to control at baseline and 12 months (p < 0.05). Test implants presented reduced levels of pro-inflammatory cytokines at 24 months compared to the control implants (p < 0.05). The control group had more changes in bone parameters from baseline to the first and second years (p < 0.05). The test group resulted in reduced bone remodeling and better clinical conditions and positively modulated peri-implant immunoinflammatory molecules. Trial identification UTN code: U1111-1239-3638.