Dental implant sites in healthy versus diabetic subjects: A two-year clinical and bacteriological assessment

The aim of this study was to analyze by Real-Time Polymerase Chain Reaction (PCR) possible differences in periimplant microbiota of patients without significant systemic diseases versus patients affected by non-insulin-dependent diabetes mellitus (NIDDM), both treated with dental implants with the same implant-abutment system. Patients suffering from NIDDM, and those with no history of major systemic diseases, treated with dental implants at the Prosthodontics Operative Unit of "Sapienza" University of Rome in the period February 2009 - March 2010 were considered. Clinical parameters as well as microbiological profile were evaluated for each implant site at 3, 6, 12, and 24 month follow-up. Crevicular fluid was collected for microbial sampling and analyzed by Real-Time PCR in order to identify the possible presence of Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Tannerella forsythia, Treponema denticola, Fusobacterium nucleatum and Prevotella intermedia. Eight patients suffering from NIDDM and 22 with no history of major systemic diseases were included in the present investigation, each having received one to three dental implants. All the implants had been loaded 3 months after surgery, and the average follow-up after implant placement was 26.37±3.86. Clinical parameters showed no noticeable difference between the two groups, except for the Implant Stability Quotient (ISQ) that showed significantly lower values in NIDDM patients. A slightly higher amount of the considered pathogenic bacteria were retrieved in samples collected from patients with NIDDM (7.38x105) in comparison with those of healthy subjects (6.78x105), though the differences were below statistical significance. Within the limitations of the present study, a slight correlation was empirically detected between gene expression profiles of microbial populations and history of NIDDM, which however remained below the statistical significance. Further well-designed clinical studies may be useful to conclusively clarify the impact of subgingival microflora on the increased susceptibility of diabetic patients to periimplantitis.