Retrospective analysis of peri-implant tissue health and patient reported outcome measures in indirect sinus floor augmentation in diabetic and non-diabetic patients

TL;DR

This study compared long-term dental implant outcomes in diabetic and non-diabetic patients, finding similar success but more bone loss in diabetics.

Contribution

A 10-year retrospective analysis of peri-implant tissue health and PROMs in T2DM and non-diabetic patients undergoing sinus floor augmentation.

Findings

Diabetic patients showed 0.60 mm less total bone height compared to non-diabetic patients after 10 years.

T2DM patients experienced 0.65 mm greater marginal bone loss than non-diabetic patients over the same period.

Patient satisfaction was similar, but esthetic and functional scores declined more in T2DM patients.

Abstract

Implant therapy is a predictable solution for replacing missing teeth; however, the posterior maxilla presents challenges due to limited residual bone height and porous bone quality. The primary outcome of this retrospective study was to compare peri-implant tissue health—specifically total bone height (TBH) and marginal bone loss (MBL)—between well-controlled type 2 diabetes mellitus (T2DM) and non-diabetic patients over a 10-year period. Patient-reported outcome measures (PROMs) were evaluated as a secondary outcome.

Seventy-six patients received 115 implants placed in the posterior maxilla with indirect sinus floor elevation. Based on metabolic status, patients were categorized into well-controlled T2DM (n = 31) and non-diabetic groups (n = 45). Clinical and radiographic parameters—gingival index (GI), residual bone height (RBH), sinus membrane elevation (SME), total bone height (TBH), marginal bone loss (MBL), sinus membrane thickness (SMT), and peri-implant soft tissue dehiscence (PSTD)—were assessed at baseline to 10 years follow up. PROMs were assessed using the OHIP-14 scale.

At 10-year follow-up, the mean total bone height was 14.05 ± 1.03 mm in the T2DM group and 14.65 ± 0.99 mm in the non-T2DM group, reflecting a mean difference of 0.60 mm (P = 0.002). Mean marginal bone loss was 1.21 ± 0.72 mm in T2DM patients vs. 0.56 ± 0.61 mm in non-diabetic patients, with a mean difference of 0.65 mm (P < 0.001). PROMs indicated similar patient satisfaction between groups, although esthetic and functional scores declined more in T2DM patients over time.

Both groups showed comparable long-term clinical outcomes, though lesser total bone height and greater mean marginal bone loss was observed in diabetic patients. Indirect sinus floor elevation with composite grafting demonstrated predictable success in both well-controlled T2DM and non-T2DM patients.

Not applicable.

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