Clinical performance of titanium-zirconia tissue-level implants in patients with well-controlled and poorly controlled type 2 diabetes: a cohort study with chair-side assessment of oxidative stress.

Abstract

Purpose: Diabetes is associated to oxidative stress. This might jeopardize implant therapies. The aim of this cohort study was to investigate the survival and success rates of titanium-zirconia implants in patients with a history of type 2 diabetes (T2DM) according to glycemic control and oxidative stress levels.

Methods: Patients with T2DM of ≥2-year duration were allocated to either the well-controlled (HbA1c≤< 53 mmol/mol) or poorly-controlled (HbA1c>53 mmol/mol) groups in a prospective cohort fashion. Patients received titanium implants with a zirconia trans-gingival neck. Then, patients were followed at intervals for at least 1.5 years. Clinical and radiographic parameters describing implant success were collected. Rapid chair-side test for the peripheral blood and salivary oxidative stress were performed with spectrophotometer analysis and measured in U CARR units. 

Results: Thirty-seven implants in twenty-eight patients have been included in the analysis. The 1-year implant survival and success rates were 100%. No signs or symptoms of mucositis/peri-implantitis were recorded up to the last follow-up visit. The blood test for oxidative stress scored an average value of 367±71.8 U CARR, with no differences on the basis of glycemic control. The average salivary test score for oxidative stress was 2203±364 U CARR, which is within the limits of a healthy range. This  test was found to be higher in diabetic patients showing  poor glycemic control. 

Conclusion: Tissue level implants with a zirconia neck are a reliable solution in diabetic patients with varying levels of glycemic control and oxidative stress, as long as the general oral health is preserved.