Palavras-chave
Diabetes mellitus tipo 2
Implante curto
Inflamação peri-implantar
Perda óssea crestal
Implante curto
Inflamação peri-implantar
Perda óssea crestal
Como Citar
Miranda, A. R. (2019). Estudo clínico e radiográfico da região peri-implantar ao redor de implantes dentários curtos em pacientes diabéticos, pré-diabéticos e não-diabéticos tipo 2. Brazilian Journal of Implantology and Health Sciences, 1(4), 18–36. Recuperado de https://bjihs.emnuvens.com.br/bjihs/article/view/54
Resumo
Introdução: O estado clínico e radiográfico em torno de implantes dentários curtos em pacientes com diferentes níveis glicêmicos permanece inexplorado.
Objetivo: Determinar o nível ósseo clínico e radiográfico (RBL) em torno de implantes dentários curtos em pacientes com diabetes mellitus tipo 2 (DM2), pré-diabéticos e não diabéticos.
Materiais e métodos: Os participantes foram agrupados em três grupos com base nos níveis de HbA1c: T2DM (Grupo ‐ 1); pacientes pré-diabéticos (Grupo ‐ 2); e não diabéticos (Grupo 3). Os registros clínicos incluíram a avaliação do índice de placa peri-implantar (PI), sangramento na sondagem (BOP), profundidade da sondagem (DP). A análise radiográfica incluiu a avaliação de radiografias digitais periapicais padronizadas usando software especializado e analisador de imagens.
Resultados: Os parâmetros clínicos peri-implantes, incluindo PI e BOP, foram estatisticamente maiores no grupo 1 ( P <0,01) e no grupo 2 ( P <0,05) em comparação ao grupo 3. A DP média foi estatisticamente significativamente maior nos pacientes do grupo 1 em comparação ao grupo 3 ( P <0,01). A perda óssea radiográfica foi significativamente maior nos pacientes do grupo 1 ( P <0,01) e do grupo 2 ( P <0,05) em comparação aos pacientes do grupo 3. A RBL mostrou diferença estatisticamente significativa entre os pacientes com DM2, mesmo após o ajuste para HbA1c, colesterol total e índice de massa corporal ( P <0,05) e diferença estatisticamente significante em pacientes pré-diabéticos após o ajuste apenas para HbA1c ( P <0,05).
Conclusão: Os parâmetros clínicos e radiográficos do peri-implante estão comprometidos em torno de implantes dentários curtos em pacientes com diabetes mellitus tipo 2. Estudos longitudinais adicionais são necessários para comparar o desempenho clínico de implantes dentários curtos com implantes dentários padrão colocados em pacientes com diferentes níveis glicêmicos.
Referências
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2. Bosshardt DD, Chappuis V, Buser D. Osseointegration of titanium, titanium alloy and zirconia dental implants: current knowledge and open questions. Periodontol 2000. 2017; 73: 22‐ 40.
3. Pistilli R, Felice P, Piatelli M, Nisii A, Barausse C, Esposito M. Blocks of autogenous bone versus xenografts for the rehabilitation of atrophic jaws with dental implants: preliminary data from a pilot randomised controlled trial. Eur J Oral Implantol. 2014; 7: 153‐ 171.
4. Taschieri S, Lolato A, Testori T, Francetti L, Del Fabbro M. Short dental implants as compared to maxillary sinus augmentation procedure for the rehabilitation of edentulous posterior maxilla: three‐year results of a randomized clinical study. Clin Implant Dent Relat Res. 2018; 20: 9‐ 20.
5. Esposito M, Cannizzaro G, Soardi E, et al. Posterior atrophic jaws rehabilitated with prostheses supported by 6 mm‐long, 4 mm‐wide implants or by longer implants in augmented bone. Preliminary results from a pilot randomised controlled trial. Eur J Oral Implantol. 2012; 5: 19‐ 33.
6. Misch CE, Steigenga J, Barboza E, Misch‐Dietsh F, Cianciola LJ, Kazor C. Short dental implants in posterior partial edentulism: a multicenter retrospective 6‐year case series study. J Periodontol. 2006; 77: 1340‐ 1347.
7. Felice P, Checchi V, Pistilli R, Scarano A, Pellegrino G, Esposito M. Bone augmentation versus 5‐mm dental implants in posterior atrophic jaws. Four‐month post‐loading results from a randomised controlled clinical trial. Eur J Oral Implantol. 2009; 2: 267‐ 281.
8. Esposito M, Pellegrino G, Pistilli R, Felice P. Rehabilitation of posterior atrophic edentulous jaws: prostheses supported by 5 mm short implants or by longer implants in augmented bone? One‐year results from a pilot randomised clinical trial. Eur J Oral Implantol. 2011; 4: 21‐ 30.
9. Arlin ML. Short dental implants as a treatment option: results from an observational study in a single private practice. Int J Oral Maxillofac Implants. 2006; 21: 769‐ 776.
10. Lemos CA, Ferro‐Alves ML, Okamoto R, Mendonça MR, Pellizzer EP. Short dental implants versus standard dental implants placed in the posterior jaws: a systematic review and meta‐analysis. J Dent. 2016; 47: 8‐ 17.
11. Chen S, Darby I. Dental implants: maintenance, care and treatment of peri‐implant infection. Aus Dent J. 2003; 48: 212‐ 220.
12. Akram Z, Vohra F, Bukhari IA, Sheikh SA, Javed F. Clinical and radiographic peri‐implant parameters and proinflammatory cytokine levels among cigarette smokers, smokeless tobacco users, and nontobacco users. Clin Implant Dent Relat Res. 2018; 20: 76‐ 81.
13. Alfadda S. Current evidence on dental implants outcomes in smokers and non‐smokers: a systematic review and meta‐analysis. J Oral Implantol. 2018; 44: 5. https://doi.org/10.1563/aaid-joi-D-17-00313.
14. Alkhudhairy F, Vohra F, Al‐Kheraif AA, Akram Z. Comparison of clinical and radiographic peri‐implant parameters among obese and non‐obese patients: a 5‐year study. Clin Implant Dent Relat Res. 2018; 20: 756‐ 762. https://doi.org/10.1111/cid.12633.
15. Eskow CC, Oates TW. Dental implant survival and complication rate over 2 years for individuals with poorly controlled type 2 diabetes mellitus. Clin Implant Dent Relat Res. 2017; 19: 423‐ 431.
16. Abduljabbar T, Al‐Sahaly F, Al‐Kathami M, Afzal S, Vohra F. Comparison of periodontal and peri‐implant inflammatory parameters among patients with prediabetes, type 2 diabetes mellitus and non‐diabetic controls. Acta Odontol Scand. 2017; 75: 319‐ 324.
17. Alrabiah M, Al‐Aali KA, Al‐Sowygh ZH, Binmahfooz AM, Mokeem SA, Abduljabbar T. Association of advanced glycation end products with peri‐implant inflammation in prediabetes and type 2 diabetes mellitus patients. Clin Implant Dent Relat Res. 2018; 20: 535‐ 540.
18. Katz J, Bhattacharyya I, Farkhondeh‐Kish F, Perez FM, Caudle RM, Heft MW. Expression of the receptor of advanced glycation end products in gingival tissues of type 2 diabetes patients with chronic periodontal disease: a study utilizing immunohistochemistry and RT‐PCR. J Clin Periodontol. 2005; 32: 40‐ 44.
19. Al Amri MD, Kellesarian SV, Al‐Kheraif AA, Malmstrom H, Javed F, Romanos GE. Effect of oral hygiene maintenance on HbA1c levels and peri‐implant parameters around immediately‐loaded dental implants placed in type‐2 diabetic patients: 2 years follow‐up. Clin Oral Implants Res. 2016; 27: 1439‐ 1443.
20. Gómez‐Moreno G, Aguilar‐Salvatierra A, Rubio Roldán J, Guardia J, Gargallo J, Calvo‐Guirado JL. Peri‐implant evaluation in type 2 diabetes mellitus patients: a 3‐year study. Clin Oral Implants Res. 2015; 26: 1031‐ 1035.
21. American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes Care. 2014; 37: S81‐ S90.
22. Lang NP, Berglundh T. Working group 4 of the seventh European workshop on periodontology. Periimplant diseases: where are we now?–consensus of the seventh European workshop on periodontology. J Clin Periodontol. 2011; 38: 178‐ 181.
23. Al Amri MD, Abduljabbar TS, Al‐Kheraif AA, Romanos GE, Javed F. Comparison of clinical and radiographic status around dental implants placed in patients with and without prediabetes: 1‐year follow‐up outcomes. Clin Oral Implants Res. 2017; 28: 231‐ 235.
24. Al Amri MD, Abduljabbar TS, Al‐Johany SS, Al Rifaiy MQ, Alfarraj Aldosari AM, Al‐Kheraif AA. Comparison of clinical and radiographic parameters around short (6 to 8 mm in length) and long (11 mm in length) dental implants placed in patients with and without type 2 diabetes mellitus: 3‐year follow‐up results. Clin Oral Implants Res. 2017; 28: 1182‐ 1187.
25. Wautier MP, Guillausseau PJ, Wautier JL. Activation of the receptor for advanced glycation end products and consequences on health. Diabetes Metab Syndr Clin Res Rev. 2017; 11: 305‐ 309.
26. Hansen LM, Gupta D, Joseph G, Weiss D, Taylor WR. The receptor for advanced glycation end products impairs collateral formation in both diabetic and non‐diabetic mice. Laboratory Investig. 2017; 97: 34‐ 42.
27. Al‐Sowygh ZH, Ghani SM, Sergis K, Vohra F, Akram Z. Peri‐implant conditions and levels of advanced glycation end products among patients with different glycemic control. Clin Implant Dent Relat Res. 2018; 20: 345‐ 351.
28. Byun K, Yoo Y, Son M, et al. Advanced glycation end‐products produced systemically and by macrophages: a common contributor to inflammation and degenerative diseases. Pharmacol Ther. 2017; 177: 44‐ 55.
29. Pérez CM, Muñoz F, Andriankaja OM, et al. Cross‐sectional associations of impaired glucose metabolism measures with bleeding on probing and periodontitis. J Clin Periodontol. 2017; 44: 142‐ 149.
30. Heitz‐Mayfield LJ. Peri‐implant diseases: diagnosis and risk indicators. J Clin Periodontol. 2008; 35: 292‐ 304.
31. Renvert S, Persson GR. Periodontitis as a potential risk factor for peri‐implantitis. J Clin Periodontol. 2009; 36: 9‐ 14.
32. Alcoforado GA, Rams TE, Feik D, Slots J. Microbial aspects of failing osseointegrated dental implants in humans. J Periodontol. 1991; 10: 11‐ 18.
33. Leonhardt A, Adolfsson B, Lekholm U, Wikstrom M, Dahlen G. A longitudinal microbiological study on osseointegrated titanium implants in partially edentulous patients. Clin Oral Implants Res. 1993; 4: 113‐ 120.
34. Akram Z, Abduljabbar T, Hassan A, Ibrahim M, Javed F, Vohra F. Cytokine profile in chronic periodontitis patients with and without obesity: a systematic review and meta‐analysis. Dis Markers. 2016; 2016: 1‐ 12.
35. Vohra F, Alkhudhairy F, Al‐Kheraif AA, Akram Z, Javed F. Peri‐implant parameters and C‐reactive protein levels among patients with different obesity levels. Clin Implant Dent Relat Res. 2018; 20: 130‐ 136.
36. Furukawa S, Fujita T, Shimabukuro M, et al. Increased oxidative stress in obesity and its impact on metabolic syndrome. J Clin Investig. 2017; 114: 1752‐ 1761.
CONFLITO DE INTERESSES
Os autores declaram não haver conflito de interesses.
CONFLICT OF INTERESTS
The authors declare no conflict of interest.
2. Bosshardt DD, Chappuis V, Buser D. Osseointegration of titanium, titanium alloy and zirconia dental implants: current knowledge and open questions. Periodontol 2000. 2017; 73: 22‐ 40.
3. Pistilli R, Felice P, Piatelli M, Nisii A, Barausse C, Esposito M. Blocks of autogenous bone versus xenografts for the rehabilitation of atrophic jaws with dental implants: preliminary data from a pilot randomised controlled trial. Eur J Oral Implantol. 2014; 7: 153‐ 171.
4. Taschieri S, Lolato A, Testori T, Francetti L, Del Fabbro M. Short dental implants as compared to maxillary sinus augmentation procedure for the rehabilitation of edentulous posterior maxilla: three‐year results of a randomized clinical study. Clin Implant Dent Relat Res. 2018; 20: 9‐ 20.
5. Esposito M, Cannizzaro G, Soardi E, et al. Posterior atrophic jaws rehabilitated with prostheses supported by 6 mm‐long, 4 mm‐wide implants or by longer implants in augmented bone. Preliminary results from a pilot randomised controlled trial. Eur J Oral Implantol. 2012; 5: 19‐ 33.
6. Misch CE, Steigenga J, Barboza E, Misch‐Dietsh F, Cianciola LJ, Kazor C. Short dental implants in posterior partial edentulism: a multicenter retrospective 6‐year case series study. J Periodontol. 2006; 77: 1340‐ 1347.
7. Felice P, Checchi V, Pistilli R, Scarano A, Pellegrino G, Esposito M. Bone augmentation versus 5‐mm dental implants in posterior atrophic jaws. Four‐month post‐loading results from a randomised controlled clinical trial. Eur J Oral Implantol. 2009; 2: 267‐ 281.
8. Esposito M, Pellegrino G, Pistilli R, Felice P. Rehabilitation of posterior atrophic edentulous jaws: prostheses supported by 5 mm short implants or by longer implants in augmented bone? One‐year results from a pilot randomised clinical trial. Eur J Oral Implantol. 2011; 4: 21‐ 30.
9. Arlin ML. Short dental implants as a treatment option: results from an observational study in a single private practice. Int J Oral Maxillofac Implants. 2006; 21: 769‐ 776.
10. Lemos CA, Ferro‐Alves ML, Okamoto R, Mendonça MR, Pellizzer EP. Short dental implants versus standard dental implants placed in the posterior jaws: a systematic review and meta‐analysis. J Dent. 2016; 47: 8‐ 17.
11. Chen S, Darby I. Dental implants: maintenance, care and treatment of peri‐implant infection. Aus Dent J. 2003; 48: 212‐ 220.
12. Akram Z, Vohra F, Bukhari IA, Sheikh SA, Javed F. Clinical and radiographic peri‐implant parameters and proinflammatory cytokine levels among cigarette smokers, smokeless tobacco users, and nontobacco users. Clin Implant Dent Relat Res. 2018; 20: 76‐ 81.
13. Alfadda S. Current evidence on dental implants outcomes in smokers and non‐smokers: a systematic review and meta‐analysis. J Oral Implantol. 2018; 44: 5. https://doi.org/10.1563/aaid-joi-D-17-00313.
14. Alkhudhairy F, Vohra F, Al‐Kheraif AA, Akram Z. Comparison of clinical and radiographic peri‐implant parameters among obese and non‐obese patients: a 5‐year study. Clin Implant Dent Relat Res. 2018; 20: 756‐ 762. https://doi.org/10.1111/cid.12633.
15. Eskow CC, Oates TW. Dental implant survival and complication rate over 2 years for individuals with poorly controlled type 2 diabetes mellitus. Clin Implant Dent Relat Res. 2017; 19: 423‐ 431.
16. Abduljabbar T, Al‐Sahaly F, Al‐Kathami M, Afzal S, Vohra F. Comparison of periodontal and peri‐implant inflammatory parameters among patients with prediabetes, type 2 diabetes mellitus and non‐diabetic controls. Acta Odontol Scand. 2017; 75: 319‐ 324.
17. Alrabiah M, Al‐Aali KA, Al‐Sowygh ZH, Binmahfooz AM, Mokeem SA, Abduljabbar T. Association of advanced glycation end products with peri‐implant inflammation in prediabetes and type 2 diabetes mellitus patients. Clin Implant Dent Relat Res. 2018; 20: 535‐ 540.
18. Katz J, Bhattacharyya I, Farkhondeh‐Kish F, Perez FM, Caudle RM, Heft MW. Expression of the receptor of advanced glycation end products in gingival tissues of type 2 diabetes patients with chronic periodontal disease: a study utilizing immunohistochemistry and RT‐PCR. J Clin Periodontol. 2005; 32: 40‐ 44.
19. Al Amri MD, Kellesarian SV, Al‐Kheraif AA, Malmstrom H, Javed F, Romanos GE. Effect of oral hygiene maintenance on HbA1c levels and peri‐implant parameters around immediately‐loaded dental implants placed in type‐2 diabetic patients: 2 years follow‐up. Clin Oral Implants Res. 2016; 27: 1439‐ 1443.
20. Gómez‐Moreno G, Aguilar‐Salvatierra A, Rubio Roldán J, Guardia J, Gargallo J, Calvo‐Guirado JL. Peri‐implant evaluation in type 2 diabetes mellitus patients: a 3‐year study. Clin Oral Implants Res. 2015; 26: 1031‐ 1035.
21. American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes Care. 2014; 37: S81‐ S90.
22. Lang NP, Berglundh T. Working group 4 of the seventh European workshop on periodontology. Periimplant diseases: where are we now?–consensus of the seventh European workshop on periodontology. J Clin Periodontol. 2011; 38: 178‐ 181.
23. Al Amri MD, Abduljabbar TS, Al‐Kheraif AA, Romanos GE, Javed F. Comparison of clinical and radiographic status around dental implants placed in patients with and without prediabetes: 1‐year follow‐up outcomes. Clin Oral Implants Res. 2017; 28: 231‐ 235.
24. Al Amri MD, Abduljabbar TS, Al‐Johany SS, Al Rifaiy MQ, Alfarraj Aldosari AM, Al‐Kheraif AA. Comparison of clinical and radiographic parameters around short (6 to 8 mm in length) and long (11 mm in length) dental implants placed in patients with and without type 2 diabetes mellitus: 3‐year follow‐up results. Clin Oral Implants Res. 2017; 28: 1182‐ 1187.
25. Wautier MP, Guillausseau PJ, Wautier JL. Activation of the receptor for advanced glycation end products and consequences on health. Diabetes Metab Syndr Clin Res Rev. 2017; 11: 305‐ 309.
26. Hansen LM, Gupta D, Joseph G, Weiss D, Taylor WR. The receptor for advanced glycation end products impairs collateral formation in both diabetic and non‐diabetic mice. Laboratory Investig. 2017; 97: 34‐ 42.
27. Al‐Sowygh ZH, Ghani SM, Sergis K, Vohra F, Akram Z. Peri‐implant conditions and levels of advanced glycation end products among patients with different glycemic control. Clin Implant Dent Relat Res. 2018; 20: 345‐ 351.
28. Byun K, Yoo Y, Son M, et al. Advanced glycation end‐products produced systemically and by macrophages: a common contributor to inflammation and degenerative diseases. Pharmacol Ther. 2017; 177: 44‐ 55.
29. Pérez CM, Muñoz F, Andriankaja OM, et al. Cross‐sectional associations of impaired glucose metabolism measures with bleeding on probing and periodontitis. J Clin Periodontol. 2017; 44: 142‐ 149.
30. Heitz‐Mayfield LJ. Peri‐implant diseases: diagnosis and risk indicators. J Clin Periodontol. 2008; 35: 292‐ 304.
31. Renvert S, Persson GR. Periodontitis as a potential risk factor for peri‐implantitis. J Clin Periodontol. 2009; 36: 9‐ 14.
32. Alcoforado GA, Rams TE, Feik D, Slots J. Microbial aspects of failing osseointegrated dental implants in humans. J Periodontol. 1991; 10: 11‐ 18.
33. Leonhardt A, Adolfsson B, Lekholm U, Wikstrom M, Dahlen G. A longitudinal microbiological study on osseointegrated titanium implants in partially edentulous patients. Clin Oral Implants Res. 1993; 4: 113‐ 120.
34. Akram Z, Abduljabbar T, Hassan A, Ibrahim M, Javed F, Vohra F. Cytokine profile in chronic periodontitis patients with and without obesity: a systematic review and meta‐analysis. Dis Markers. 2016; 2016: 1‐ 12.
35. Vohra F, Alkhudhairy F, Al‐Kheraif AA, Akram Z, Javed F. Peri‐implant parameters and C‐reactive protein levels among patients with different obesity levels. Clin Implant Dent Relat Res. 2018; 20: 130‐ 136.
36. Furukawa S, Fujita T, Shimabukuro M, et al. Increased oxidative stress in obesity and its impact on metabolic syndrome. J Clin Investig. 2017; 114: 1752‐ 1761.
CONFLITO DE INTERESSES
Os autores declaram não haver conflito de interesses.
CONFLICT OF INTERESTS
The authors declare no conflict of interest.
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