IMMEDIATE VERSUS DELAYED IMPLANT PLACEMENT IN DIABETIC PATIENTS REHABILITATED WITH MANDIBULAR OVERDENTURES – A SPLIT MOUTH STUDY

Abstract

Purpose: This comparative controlled trial (CCT) evaluates the survival rate of implants placed into fresh extraction sockets and compare it with implants placed in healed sites in type 2 diabetic, completely edentulous subjects rehabilitated with mandibular implant overdentures (MIODs) fol- lowing a delayed loading protocol and opposed with conventional complete dentures. Materials and Methods: Fourteen implants were placed in seven well-controlled diabetic subjects as determined by Glycosylated hemoglobin (HbA1c) values before implant placement (baseline) and throughout the follow-up period. Each patient received two implants; one implant in healed canine site and the other was immediately inserted following the extraction of an existing periodontally hopeless canine. The implants were uncovered approximately 3 months after place- ment and restored with bar-retained overdenture. The patients were scheduled for regular follow-up appointments and for data collection. Kaplan-Meier analysis was used to calculate implant survival from time of prosthesis placement through 24-month follow-up period. Results: No implant failed in the delayed placement group within the 2 years study period, whereas in the immediate group two implants failed in two patients following the prosthetic loading at one-year follow-up period resulting in 71.2% implant survival rate. HbA1c levels ranging from 7.4 to 8.0 percent were identified in two patients with implant failures. There was no statistically significant difference in survival rate between immediate and delayed implants in type 2 Diabetic subjects rehabilitated with MIOD s (P=0.141). Conclusions: Within the limitations of this study, insufficient evidence exists to recommend immediate implant placement in type 2 diabetic subjects rehabilitated with MIODs.