Peri-implant evaluation of immediately loaded implants placed in esthetic zone in patients with diabetes mellitus type 2: A two-year study

Objectives: The aim of this study was to evaluate implant survival and primary stability parameters in patients with diabetes with different levels of glycosylated hemoglobin Alc (HbA1c) treated with immediate placement and provisionalization of implant-supported, single-tooth replacements over 2 years. Materials and methods: Eighty-five patients were divided into three groups according to their HbA1c levels: 33 patients in Group 1 (<6, control group); 30 patients in Group 2 (6.1-8); and 22 patients in Group 3 (8.1-10). Each patient received one-one-piece implant in the anterior zone of the upper maxillary. The implant survival rate was analyzed for each group, together with three variables to evaluate the general state of peri-implant health: probe depth, bleeding on probing, marginal bone loss. Results: Marginal bone loss increased in relation with higher HbA1c levels. For marginal bone loss in Group 1, mean resorption values ranged from 0.51 after 6 months to 0.72 after 2 years in comparison with respective values of 1.33 and 1.92 in Group 3. This pattern was repeated for bleeding on probing, both parameters showing significant differences between groups. For bleeding on probing, mean bleeding levels varied from 0.36 in Group I at 6 months after implant placement, to 0.59 in Group 3 (P = 0.041 between the three groups). Peri-implant pocket depth showed the same tendency to increase in relation to HbA1C but differences between groups did not reach statistical significance. Conclusions: Patients with diabetes can receive implant-based treatments with immediate loading safely, providing they present moderate HbA1c values.