The effectiveness of dental implantation in patients with type II diabetes mellitus

Abstract

The issue of the safety of dental implants in patients with diabetes mellitus, despite the increase in the number of orthopedic corrections of partial or complete adentia with their use, remains open [1].
 In such a situation, the most urgent question is the development of new, safe and less traumatic methods of dental implantation, which would expand the indications for prosthetics on implants for this category of persons and improve the quality of life of such patients through full-fledged correction of chewing function.
 The purpose of the study was to investigate the effectiveness and safety of the method of orthopedic rehabilitation proposed by the authors using implants in patients with type II diabetes mellitus.
 Material and methods. As part of the study, 68 patients were treated, who were divided into three groups: the main group (patients with DM operated without the formation of muco-periosteal flaps according to the protocol developed by us) — 34 patients (50 %); control group 1 (patients with DM operated according to the traditional protocol with the formation of muco-periosteal flaps) — 16 patients (24 %); control group 2 patients without diabetes, operated without formation of muco-periosteal flaps according to the protocol developed by us) — 18 patients (26 %).
 The effectiveness of dental implantation was evaluated after 2 years. Such indicators as the survival rate of dental implants and the level of bone resorption (according to the results of intraoral radiography were used as criteria. In addition, bone density was studied on the Hounsfield scale (HU).
 Results. It was found that in patients of the main group and control group 2, survival rates were 98.70 % and 98.72 %, respectively, in patients of control group 1, the survival rate of dental implants was 89.48 %, which is also comparable with literature data on dental implantation in patients with diabetes mellitus [2, 8, 9]. Possibly greater effectiveness in the main group and control group 2 is associated with a new method of dental implantation (RF Patent No. 2794843 dated 25.04.2023) [7] and the use of a collapsible navigational surgical template (Patent RU No. 2796749 dated 29.05.2023) [6], which allowed the main group and the control group to fix individual trajectories of articulation of the mandible (which further allowed to avoid incorrect orthopedic rehabilitation, which could lead to uneven or excessive load on dental implants), to avoid reduction of the alveolar ridge, to plan in advance the exact position of dental implants, and also eliminated the need for the formation of muco-periosteal flaps and further suturing.
 Conclusion. The use of the technique developed by us (RF patent No. 2794843 dated 25.04.2023) allows us to increase the effectiveness of treatment of patients with type II diabetes mellitus and bring it closer to the results of practically healthy people (according to retrospective observation for two years).