Radiographic and clinical assessments of platform switching implant assisted mandibular overdenture in controlled diabetic patients

Background: Currently platform switching concept is widely used in implant dentistry; however, its influence on the health of
surrounding soft tissue and marginal bone level alterations in implant assisted overdentures and especially in controlled diabetic
patients, remains inconclusive.
Objective: The purpose of this research was to assess the viability of platform-switched implants for improvement of osseous
and soft tissue response in implant-assisted mandibular overdentures in completely edentulous controlled diabetic patients
having type 2 diabetes mellitus (T2DM) and compare it with non diabetic patients as control group.
Material and method: Fourteen completely edentulous patients were included in this study, two groups were formed; Group
I patients who are non diabetic (as control group) and group II patients medically diagnosed T2DM and controlled. New
upper and lower complete dentures were constructed following the conventional steps. For all participants, two platformswitching
implants were inserted in the mandibular canine area following flapless technique guided by 3D printed surgical
guide constructed according to the planned CBCT data evaluation. Immediate loading protocol was applied as pick up of the
metal housing of the attachment was done in the day of implant placement. Gingival index and pocket depth were measured
at one week after implant placement, 3, 6 and 12 months follow-up. While peri-implant marginal bone level was measured at
loading time, 6 and 12 months follow-up. For diabetic patients (group II) hemoglobin A1c test was done every three month for
monitoring their medical condition. Data collected were statistically analyzed.
Results:Peri-implant bone loss of higher values was found in diabetic patients (group II) compared to non diabetic patients
(group I) but with no statistical significance along the study period follow up records. Peri-implant gingival index and pocket
depth showed no statistical significance along the study period with better value for non diabetic patients compared to diabetic
patients.
Conclusions: Within the limitations of this study, it was revealed that using two platform switching implants in assisting
mandibular overdenture is a successful and predictable treatment option for type2 controlled diabetic patients as non diabetic
patients. Peri-implant bone loss was found in type2 controlled diabetic patients higher but insignificantly when compared to
non diabetic patients during one year follow up period. Regarding the clinical assessment there was no significant difference in
both groups with consideration of continuous glycemic control and optimum oral hygiene measures.