SAN ANTONIO (Jan. 20, 2015) – For some 20 years, dentists have been reluctant to place dental implants on patients with diabetes because of problems they often have with slow healing and high infection rates.
A new study by researchers at The University of Texas Health Science Center at San Antonio shows that, with some accommodations, diabetic patients ― even those with poorly controlled diabetes ― had as high a success rate with implants after one year as patients with no high-blood-sugar issues.
The study, which appears in the December edition of the Journal of the American Dental Association, was led by Thomas Oates, D.M.D., Ph.D. Dr. Oates is interim associate dean for research and assistant dean for clinical research in the School of Dentistry. He also is a professor and vice chair of the Department of Periodontics at the UT Health Science Center.
Periodontics is the study of the underlying bone and gums that provide the structure for teeth. When a tooth is lost, a dental implant, usually made of metal or another material, can be permanently implanted in the jawbone to become the base for a false tooth.
“The most striking thing to me about the study is that we are not only able to see that dental implants can be successful for patients with diabetes, but that the patients are truly benefitting from them,” Dr. Oates said. “We were seeing dramatic results.”
The 110 patients who completed the study were divided into three groups:
• Patients without diabetes, who were defined as having an A1C glycemic blood test score of less than 6 percent.
• A group with controlled diabetes, which had a glycemic blood score between 6 percent and 8 percent.
• And a third group that had poorly controlled diabetes, defined as a score of 8 percent or higher on the A1C blood glycemic blood test.
Each patient had two implants placed in the lower jaw followed later by placement of a full set of dentures anchored to the implants. After the implants were placed, patients were followed for at least one year. Diabetics, like nondiabetic patients, had nearly 100 percent implant success rates.
“The study findings showed no significant differences between the nondiabetic and well-controlled diabetic groups. The group with poorly controlled diabetes required a longer time for the implant to heal before placing the dentures,” Dr. Oates said. For this reason, there was a four-month healing time following implantation for all groups instead of the usual two months. All patients were prescribed antibiotics and a chlorhexidine gluconate mouth rise following implantation to guard against infection.
Two patients had failed implants early in the study, but were able to receive new implants that healed and were successful at one year. Only seven patients did not complete the study of the original 117 who were screened.
The study was supported by two grants from the National Institute of Dental and Craniofacial Research, part of the National Institutes of Health. Additional funding from the NIDCR is supporting an extension of the study that will allow researchers to follow the patients through five or more years to see if the implants continue to be successful.
Dr. Oates said more investigation is needed before drawing major conclusions. For example, he wants to investigate which variables in the study will produce the best result, as well as how patients will deal with the potential for infections over the long term.
For more information about the study, call (210) 567-5076.
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