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Diabetes mellitus is a pathology of the endocrine system, accompanied by insulin insufficiency and failure of carbohydrate metabolism in the body. High blood glucose concentration in diabetes worsens wound healing. This is a factor that previously prevented implantation in diabetics.

The impact of the disease on the condition of the teeth

With increasing blood sugar levels, the negative effect of glucose on the body increases – conditions for the development of a number of oral diseases appear:

  1. Hyposalivation (saliva deficiency). Dry mouth destroys the enamel layer – caries develops, pathogenic microflora spreads in the oral cavity.
  2. At high rates, acetone is released, increasing the demineralization of enamel.
  3. Inflammation of the gums. The root system of the tooth is destroyed. Wounds take a long time to heal, with the attachment of infection, purulent foci are formed.
  4. Infection of fungal type (Candida). With the reproduction of fungus, the entire oral cavity and nasopharynx is covered with a film – the infection affects healthy teeth.
  5. Bacterial infection. The accumulation of microbes in the mouth (in the cavities of the element and in the place of its former growth) leads to massive carious lesions.
  6. Failure of regenerative processes. Pathology is dangerous by slowing the rate of healing of wounds, ulcers and infected foci in the mouth.

Diabetes mellitus type 1 and 2 – at which implantation is possible

The type of diabetes mellitus determines the possibility of implantation for the patient:

  1. Type 1 (insulin-dependent) diabetes mellitus. More often diagnosed in children and young people due to viral pathology or genetic predisposition. It is characterized by sudden spikes in blood sugar. It refers to a complicated form of diabetes – dental implantation is not carried out.
  2. Diabetes mellitus type 2 (insulin-independent). Acquired pathology, develops due to incorrect nutrition. The cells of the body lose sensitivity to insulin – blood sugar rises. Implantation is carried out without the need for hormonal control of diabetes. The material of implants for diabetics is pure titanium or a bioinert alloy.

Possible risks

In patients with diabetes, metabolic processes are disturbed, the hormonal background is unstable, traumatized tissues regenerate slowly, blood supply to blood vessels is impeded. These factors explain the increased risk of complications after implantation. Among the likely consequences are:

  • Allergic reaction;
  • complicated engraftment;
  • implant rejection.

The risk of complications multiplies as the diabetic’s length of service increases – the longer the patient has been ill, the higher the risk of implant therapy.

When the installation of implants is prohibited

  • Diabetes mellitus type 1;
  • decompensated form (failure in carbohydrate metabolism, elevated blood glucose levels);
  • concomitant pathologies (diseases of the circulatory system, cardiovascular diseases);
  • inability to organize regular follow-up by the attending physician, endocrinologist;
  • bad habits (smoking, alcohol intake).

When surgery is possible

  • Diabetes mellitus type 2 (without hormonal regulation of diabetes);
  • compensated form (glucose level is stable – at 7-9 mol/l before surgery and during the period of engraftment);
  • the patient performs supportive therapy, takes hypoglycemic medications, follows a carbohydrate-free diet;
  • the process of tissue regeneration in the body is not disturbed (abrasions and bruises do not lead to complications);
  • refusal of bad habits (cigarettes, alcoholic beverages);
  • absence of concomitant pathologies (thyroid, cardiovascular and circulatory system diseases);
  • the possibility of organizing regular monitoring by an endocrinologist and attending physician.

Features of the procedure

Preparation

To guarantee the success of the operation and minimize the risk of complications, the patient should undergo preparatory measures:

  • take a test of urine, saliva, blood (including sugar levels), visit a therapist and endocrinologist;
  • undergo oral cavity sanation by a dentist, strengthen brushing of teeth a few weeks before the operation;
  • undergo jawbone diagnostics.

What methods can be used

Implantation in diabetics is carried out extremely carefully, with minimal trauma to the tissues in order for healing to take place without complications. The surgery can be performed using one of the following techniques:

  • One-stage with immediate loading

    An implant is implanted in place of the unit that has just been removed. The tissues are not re-traumatized and healing occurs naturally. A temporary prosthesis with immediate loading is fitted immediately, a permanent prosthesis as soon as the implants have healed.

  • One-stage (express implantation)

    The implant is implanted in place of the missing tooth when the hole is healed. A rod with a special thread is screwed into a puncture in the gum. Implants have good primary stability. A temporary denture can be fitted immediately.

  • Classic

    The prosthesis is fixed after the implants have completed the implant engraftment phase. The rod fuses with the tissue in a non-loaded state, it is covered by a gingival flap. Classic implantation for diabetics is rarely performed: the prolonged process increases the risk of complications.

Osteointegration of a titanium post with the bone in diabetes is a slow process and lasts at least six months. The probability of successful implant grafting is higher on the lower jaw than on the upper jaw.

Requirements for implants and dentures

Patients with diabetes mellitus are recommended to implant unadulterated titanium implants or products made of specially manufactured alloys. The length of the pins is average – 10-12 mm.

Prostheses for diabetics – designs with crowns made of an alloy of chromium with nickel or cobalt, zirconium metal-free crowns. When selecting a prosthesis, it is important to achieve an even distribution of masticatory load.

Postoperative period

The success of the implantation depends largely on the patient’s actions in the postoperative period. At this time, the diabetic adheres to the following recommendations:

  • takes prescribed antibiotics for 10-12 days after surgery;
  • Controls blood sugar levels;
  • maintain oral hygiene;
  • visits the attending physician every 2-3 days for a month. During the rehabilitation period (until the implant takes root) visits to the dentist can be reduced to once a month;
  • refuses from bad habits.

Guarantees

Since the patient is diagnosed with diabetes mellitus, it is impossible to guarantee 100% implant engraftment. The success of the operation depends on the professionalism of the implantologist and the patient’s diligence – taking prescribed medications, maintaining hygiene, careful attitude to health.

ROOTT Dental Clinic in Moscow employs highly qualified doctors with many years of experience who know how to work with complex clinical cases.

Alternative ways of restoring teeth in diabetes mellitus

If implantation of teeth for a patient with diabetes is undesirable or contraindicated, if the price of implantation is too high, one of the types of prosthetics is a justified alternative:

  • Removable prosthetics

    Complete removable prosthetics made of hypoallergenic materials (nylon or acrylic) are used even in uncompensated diabetes. The disadvantage of these products is the uneven distribution of masticatory load, which provokes accelerated bone loss.

  • Non-removable prosthetics

    Bridges, which are conveniently fixed and guarantee an even distribution of the load. It requires the presence of healthy teeth on the jaw for support. The material of the prosthesis is metal-ceramic, ceramic, zirconium dioxide.

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