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Clinical, microbiological, and salivary biomarker profiles of dental implant patients with type 2 diabetes

Authors

  • Nikolaos Tatarakis,

    1. Department of Periodontics and Oral Medicine, Michigan Center for Oral Health Research, University of Michigan School of Dentistry, Ann Arbor, MI, USA
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  • Janet S. Kinney,

    1. Department of Periodontics and Oral Medicine, Michigan Center for Oral Health Research, University of Michigan School of Dentistry, Ann Arbor, MI, USA
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  • Marita Inglehart,

    1. Department of Periodontics and Oral Medicine, Michigan Center for Oral Health Research, University of Michigan School of Dentistry, Ann Arbor, MI, USA
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  • Thomas M. Braun,

    1. Department of Periodontics and Oral Medicine, Michigan Center for Oral Health Research, University of Michigan School of Dentistry, Ann Arbor, MI, USA
    2. Department of Biostatistics, School of Public Health, University of Michigan, Ann Arbor, MI, USA
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  • Charles Shelburne,

    1. Department of Biologic and Material Sciences, University of Michigan School of Dentistry, Ann Arbor, MI, USA
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  • Niklaus P. Lang,

    1. Department of Oral Rehabilitation, Faculty of Dentistry, University of Hong Kong, Hong Kong, China
    2. Department of Biomedical Engineering, College of Engineering, University of Michigan, Ann Arbor, MI, USA
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  • William V. Giannobile,

    1. Department of Periodontics and Oral Medicine, Michigan Center for Oral Health Research, University of Michigan School of Dentistry, Ann Arbor, MI, USA
    2. Department of Biomedical Engineering, College of Engineering, University of Michigan, Ann Arbor, MI, USA
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  • Tae-Ju Oh

    Corresponding author
    1. Department of Periodontics and Oral Medicine, Michigan Center for Oral Health Research, University of Michigan School of Dentistry, Ann Arbor, MI, USA
    • Corresponding author:

      Tae-Ju Oh, DDS, MS

      Department of Periodontics and Oral Medicine

      University of Michigan School of Dentistry

      1101 N. University Ave

      Ann Arbor, MI 48109-1078, USA

      Tel.: 734 647 3320

      Fax: 734 763 5503

      e-mail: taejuoh@umich.edu

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  • Conflict of interest The authors report no conflict of interest.

Abstract

Objective

Regulators of peri-implant bone loss in patients with diabetes appear to involve multiple risk factors that have not been clearly elucidated. This study was conducted to explore putative local etiologic factors on implant bone loss in relation to type 2 diabetes mellitus, including clinical, microbial, salivary biomarker, and psychosocial factors.

Materials and methods

Thirty-two subjects (divided into type 2 diabetes mellitus and non-diabetic controls), having at least one functional implant and six teeth, were enrolled in a 1-year longitudinal investigation. Analyses of clinical measurements and standardized intra-oral radiographs, saliva and serum biomarkers (via protein arrays for 20 selected markers), and plaque biofilm (via qPCR for eight periodontal pathogens) were performed at baseline and 1 year. In addition, the subjects were asked to respond to questionnaires to assess behavioral and psychosocial variables.

Results

There was a significant increase from baseline to 1 year in the probing depth of implants in the diabetes group (1.95 mm to 2.35 mm, P = 0.015). The average radiographic bone loss during the study period marginally increased at dental implants compared to natural teeth over the study period (0.08 mm vs. 0.05 mm; P = 0.043). The control group harbored higher levels of Treponema denticola at their teeth at baseline (P = 0.046), and the levels of the pathogen increased significantly over time around the implants of the same group (P = 0.003). Salivary osteoprotegerin (OPG) levels were higher in the diabetes group than the control group at baseline only; in addition, the salivary levels of IL-4, IL-10, and OPG associated with host defense were significantly reduced in the diabetes group (P = 0.010, P = 0.019, and P = 0.024), while controls showed an increase in the salivary OPG levels (P = 0.005). For psychosocial factors, there were not many significant changes over the observation period, except for some findings related to coping behaviors at baseline.

Conclusions

The study suggests that the clinical, microbiological, salivary biomarker, and psychosocial profiles of dental implant patients with type 2 diabetes who are under good metabolic control and regular maintenance care are very similar to those of non-diabetic individuals. Future studies are warranted to validate the findings in longer-term and larger clinical trials (ClinicalTrials.gov # NCT00933491).

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