One of the more subtle complications of diabetes mellitus is a decrease in the patient's quality of life due to tooth loss and compromised function. While implant therapy has shown promise in patients with well- managed diabetes, questions remain as to the influence of this systemic condition on dental implant therapy. In fact, it may be those patients with inadequate glycemic control that have the most to gain by improvements in dietary control through implant therapy. Purpose: Our long-term goal is to develop the scientific rationale for the development of patient-specific, therapeutic protocols for implant care in diabetic patients. This study seeks to address the following aims: 1) Determine the impact of type 2 diabetes and glycemic control on dental implant integration, complications, and success both before and after functional loading. 2) Identify the impact of type 2 diabetes and glycemic control on oral health-related quality of life associated with the addition of implant-support to mandibular complete dentures. Methods: A parallel design, prospective study will assess dental implant integration, success, complications, oral health-related quality of life and satisfaction for edentulous patients with conventional dentures, and through 1 to 3.5 years after converting the denture to a 2-implant supported mandibular overdenture. Patients will be recruited (45 subjects/group) from well-controlled (HbA1c<8.0%) or poorly-controlled (HbA1c 8.1-12%) type 2 diabetic patients, and non-diabetic, healthy control subjects. All patients (n=135) will be recruited from the San Antonio/south Texas area. This study looks to capitalize on the high prevalence of diabetes. in this area. Outcomes: Assessments include implant failures (removal or non-restored), clinical complications, resonance frequency analysis (RFA) as a measure of implant integration, oral health-related quality of life, satisfaction, and diet. Implications: This proposal challenges existing paradigms regarding the utilization of dental implant therapy for diabetic patients lacking good glycemic control by examining the specific relationship between glycemic control and implant therapy. It explores the potential for implant therapy to provide important functional, nutritional, and quality of life benefits to diabetes patients with poorer glycemic control. Ultimately, this information will contribute to the establishment of evidence-based guidelines for the assessment and application of dental implant therapy for patients with diabetes.
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