Influence of Glycemic Control on Peri-Implant Bone Healing: 12-Month Outcomes of Local Release of Bone-Related Factors and Implant Stabilization in Type 2 Diabetics

Background: The poor glycemic status seems to be an important factor affecting implant complication rates, including peri-implant bone loss. Purpose: This trial evaluated the influence of glycemic control of type 2 diabetes mellitus (T2DM) patients on implant stabilization and on the levels of bone markers in peri-implant fluid during the healing. Materials and Methods: Systemically healthy patients (SH, n = 19), better-controlled T2DM (BCDM, n = 16), and poorly controlled T2DM (PCDM, n = 16) indicated for implant therapy were recruited. The implant stability quotient (ISQ) was determined at implant placement, 3, 6, and 12 months. Levels of transforming growth factor-beta (TGF-beta), fibroblast growth factor (FGF), osteopontin (OPN), osteocalcin (OC), and osteoprotegerin (OPG) in the peri-implant fluid were quantified at 15 days, and 3, 6, and 12 months, using the Luminex assay. Results: OPG and OPN levels were higher in SH at 12 months than at15 days (p < .05), whereas OC and TGF-beta were lower in PCDM at 12 months compared with the 15-day and 3-month follow-ups, respectively (p < .05). Inter-group analyses showed lower OPN levels in PCDM compared with SH at 12 months (p < .05). The ISQ was higher at 12 months when compared with baseline and 3 months in SH (p < .05), whereas no differences were observed during follow-up in diabetics, regardless of glycemic control (p > .05). No difference in ISQ was observed among groups over time (p > .05). Conclusion: Poor glycemic control negatively modulated the bone factors during healing, although T2DM, regardless of glycemic status, had no effect on implant stabilization.