Comparing marginal bone height changes around immediately and delayed implant-retained mandibular overdentures in controlled diabetic patients: a randomized clinical study

Eman Mostafa Ahmed Ibraheem,Ahmed Mostafa Esmat El-Sisy,Hoda Gaafar Hassan Hammad

doi:10.1186/s42269-019-0228-1

Eman Mostafa Ahmed Ibraheem, Ahmed Mostafa Esmat El-Sisy + Show 1 more

Open Access

https://doi.org/10.1186/s42269-019-0228-1

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Abstract

PurposeThis study was conducted to evaluate the marginal bone height changes around dental implants in mandibular implant-retained complete acrylic overdentures using cone beam computed tomography (CBCT) with implementation of both immediate and delayed loading protocols in controlled type II diabetes mellitus (DM) patients.Patients and methodsTwenty completely edentulous controlled diabetic patients were selected to participate in this study to receive mandibular implant-retained overdentures. Then, the study patients were randomly divided into two equal groups according to the loading protocol: group I, ten patients had received complete overdentures retained with two implants and two ball attachments while applying the immediate implant loading protocol and group II, ten patients had received complete overdentures retained with two implants and two ball attachments while applying the delayed implant loading protocol. For each patient, a computer-guided surgical stent was prepared for CBCT assessment to properly determine the dimensions and angulations of the two implants that were inserted in the inter-foraminal region. Afterward, the dental prosthetic was loaded, and a second CBCT was done for each patient to measure the marginal alveolar bone height. Then CBCTs were periodically performed after a period of 6 and 12 months after prosthetic loading in order to monitor the changes in marginal bone height surrounding the inserted dental implants.ResultsStatistical analysis of obtained records revealed no significant difference between the two loading protocols in the studied groups.ConclusionMarginal bone height changes around immediately and delayed implant-retained mandibular over dentures seem comparable in controlled type II diabetic patients.Trial registrationTrial registration number: 16086; date of registry, November 2016; date of the research, June 2017

Highlights

Teeth loss is followed by human alveolar bone resorption; this physiologic phenomenon decreases retention and stability of complete dentures
As a dental implant was inserted into bone and subjected into function, supporting alveolar bone remodeling became a critical aspect for implant survival
Statistical analysis was performed with SPSS 20®1, Graph Pad Prism®2 and Microsoft Excel 20163 with significant level set at P ≤ 0.05

Summary

Introduction

Teeth loss is followed by human alveolar bone resorption; this physiologic phenomenon decreases retention and stability of complete dentures. This problem is more prominent in mandibular complete dentures than the maxillary ones. Rehabilitation of completely edentulous mandible using dental implant retained (by two dental implants) overdenture was found a predictable successful long-term treatment modality (Chiapasco et al 2001). Implant-retained overdentures using two separate titanium implants had been reported to improve the function and had realized a success rate of about 97% to 100% (Liddelow and Henry 2007). As a dental implant was inserted into bone and subjected into function, supporting alveolar bone remodeling became a critical aspect for implant survival. Systemic disorders and metabolic diseases might influence osseointegration of dental implants that retain complete overdentures (Oates et al 2013)

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