Diabetes Mellitus And Dental Implantation

Diabetes Mellitus And Dental Implantation

Zhartybayev R. Director of Specialized Center for Rendering of Dental Aid to the Patients Suffering from Diabetes Mellitus The President of Kazakhstan Implantologists association Doctor of Medicine, Professor. Kazakhstan, Almaty

The dental implantation became customary for dental clinical practice on a strong basis. With all its attractiveness the dental implantation has a whole number of absolute and relative contraindications.
Insertion of dental implants for treatment of patients suffering from diabetes mellitus is one of the most widespread problems of dental practice.
However the opportunities for revision of existing positions and reduction of restrictions appear simultaneously with improvement of techniques of dental implantation and achievements of endocrinology.
 
The techniques of dental implantation stipulate carrying out the surgeries. Their permissible scope for each patient should be determined as exactly as possible. And at the same time, the clinical approach selected by a dentist should make it possible to eliminate or minimize the probability of development of sequelae both of underlying disease and the dental implantation.
When decision-making as regards insertion of dental implants for treatment of patients suffering from diabetes, the dentist should observe a methodological sequence.
 
The factors exerting influence upon the result of making use of dental implantation for treatment of patients suffering from diabetes mellitus are as follows:
 
• Dental implantation to patients ill with diabetes mellitus is directly dependent upon specificity of clinical treatment of diabetes mellitus. The diabetes mellitus is characterized by a chronic recurrent course alternating with the periods of compensation and decompensation of the disease.
 
• The great importance is attached to the duration of disease. Decompensation of diabetes mellitus is more frequently occurred in patients suffering from diabetes mellitus for more than 10 years.
 
• Decompensation of diabetes course raises the risk of development of the inflammatory sequelae exerting influence upon implant viability. The terms compensation and decompensation conventionally correlate with the concepts of controlled and uncontrolled diabetes which a customary in the literature.
 
• Insertion of implant is a surgery, a surgical stress in its turn capable to result in development of pressing states. Availability of hyperglycemia and hypoglycemia in a patient’s antecedent anamnesis increases the probability of arising of such situation. That’s why a dentist should be ready to render emergency medical aid.
 
When planning, the dentist should keep to the following rules:
• minimum invasiveness, sparing treatment of soft and osseous tissues in the area of implantation;
• prescription of antibiotics a day before the surgery;
• prophylaxis of pressing states;
• active role played by a patient in questions of diabetes self-testing and personal oral hygiene.
 
Photo 1.Partial maxillary and mandibular adentia in a 52-year-old patient suffering from type 2 diabetes mellitus for more than 12 years.
Photo 2.Application of sparing techniques without sinus lift (subantral augmentation) and osteoplasty with the account taken of disease length and available sequel (microangiopathy). State after insertion of 5 Alpha Dent Implants into the maxilla.
Photo 3.There was made a conditionally removable tapered-crown dental prosthesis (milling technique).

 

Photo 4. There was made a conditionally removable tapered-crown dental prosthesis (milling technique).
Photo 5. Stages of manufacture of double-tapered crowns on the mandible.
Photo 6. Stages of manufacture of double-tapered crowns on the mandible.

 

Photo 7. The final result.
Photo 8. The final result.

 

May 25, 2018
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