Monday, 23 July 2012

Diabetes & Dental Implants

Dental Implants in Diabetic Patients
Dental implants have brought about a revolution in the treatment of missing teeth.However, not everybody makes the right candidate for dental implants, and diabetes is one common condition which makes the success of implants questionable.The use of implants in diabetic patients has been controversial .

Diabetes mellitus is one of the world's major chronic health problems. Diabetes is associated with a wide range of systemic complications including microvascular and macrovascular diseases, altered wound healing, and increased susceptibility to infection. These conditions may increase the risk of postsurgical complications following dental implant placement.

Placement of implants requires a minor surgical procedure, Surgical placement of the implants into the bone. After surgery, there is a healing period of approximately four months. During this time, the implants fuse to the bone by a process known as ‘osseointegration’.If the osseointegration is not proper due to any reason, the implant will stay loose in the bone, and eventually fail. dental implant failure rate in diabetic patients is much higher than that in non-diabetic patients.Though diabetes was considered a contradiction for dental implants till a few years back, recent studies have indicated that implants can be successfully placed in diabetic patients, if their blood sugar is kept under control.In general, glycemic control is evaluated clinically through use of the glycosylated hemoglobin assay, or HbA1c.A normal HbA1c is less than 6%.

American Diabetes Association (ADA) recommends that most people with diabetes try to control their blood glucose levels well enough to maintain an HbA1c below 7%.

However, it is very important for diabetic patients to not only keep a strict control over their blood sugar prior to the implant surgery, but also maintain that control throughout the entire implant process. Besides, a course of antibiotics can be given prior to the surgery, and continued for a few days after it, to bring down the risk of infection. Even healthy patients have a significant risk of infection after surgery, and diabetics, whose healing ability is already impaired, have it even worse.
 Also, the patient must maintain very good oral hygiene and cut down on other adverse oral habits, if he has any. The periodontal health of diabetics is also generally worse than healthy patients, which makes the implant surgery even more complicated. However, it is not absolutely impossible to manage an implant in a diabetic patient.

The success of an implant in diabetics depends a lot on the condition of the patient, and his commitment in maintaining the integrity of the implant.

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