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Clinical, microbiological, and salivary biomarker profiles of dental implant patients with type 2 Diabetes

Identifieur interne : 002763 ( Pmc/Curation ); précédent : 002762; suivant : 002764

Clinical, microbiological, and salivary biomarker profiles of dental implant patients with type 2 Diabetes

Auteurs : Nikolaos Tatarakis [États-Unis] ; Janet S. Kinney [États-Unis] ; Marita Inglehart [États-Unis] ; Thomas M. Braun [États-Unis] ; Charles Shelburne [États-Unis] ; Niklaus P. Lang ; William V. Giannobile [États-Unis] ; Tae-Ju Oh [États-Unis]

Source :

RBID : PMC:4295063

Abstract

Objective

Regulators of peri-implant bone loss in diabetic patients appears to involve multiple risk factors that have not been clearly elucidated. This study was conducted to explore putative local etiologic factors on implant bone loss in relation to type 2 diabetes mellitus, including clinical, microbial, salivary biomarker, and psychosocial factors.

Materials and Methods

Thirty-two subjects (divided into type 2 diabetes mellitus and non-diabetic controls), having at least one functional implant and 6 teeth, were enrolled in a one-year longitudinal investigation. Analyses of clinical measurements and standardized intra-oral radiographs, saliva and serum biomarkers (via protein arrays for 20 selected markers) and plaque biofilm (via qPCR for 8 periodontal pathogens) were performed at baseline and 1 year. In addition, the subjects were asked to respond to questionnaires to assess behavioral and psychosocial variables.

Results

There was a significant increase from baseline to 1 year in the probing depth of implants in the diabetes group (1.95mm to 2.35mm, p=0.015). The average radiographic bone loss during the study period marginally increased at dental implants compared to natural teeth over the study period (0.08mm vs. 0.05mm; p=0.043). The control group harbored higher levels of T. denticola at their teeth at baseline (p=0.046) and the levels of the pathogen increased significantly over time around the implants of the same group (p=0.003). Salivary osteoprotegerin (OPG) levels were higher in the diabetes group than the control group at baseline only; in addition, the salivary levels of IL-4, IL-10, and OPG associated with host defense were significantly reduced in the diabetes group (p=0.010, p=0.019, and p=0.024) while controls showed an increase in the salivary OPG levels (p=0.005). For psychosocial factors, there were not many significant changes over the observation period, except for some findings related to coping behaviors at baseline.

Conclusions

The study suggests that the clinical, microbiological, salivary biomarker, and psychosocial profiles of dental implant patients with type 2 diabetes who are under good metabolic control and regular maintenance care are very similar to those of non-diabetic individuals. Future studies are warranted to validate the findings in longer-term and larger clinical trials (ClinicalTrials.gov # NCT00933491).


Url:
DOI: 10.1111/clr.12139
PubMed: 23445216
PubMed Central: 4295063

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Niklaus P. Lang
<affiliation>
<nlm:aff id="A4"> Department of Oral Rehabilitation, Faculty of Dentistry, University of Hong-Kong</nlm:aff>
<wicri:noCountry code="subfield">University of Hong-Kong</wicri:noCountry>
</affiliation>
William V. Giannobile
<affiliation>
<nlm:aff id="A5"> Department of Biomedical Engineering, College of Engineering, University of Michigan</nlm:aff>
<wicri:noCountry code="subfield">University of Michigan</wicri:noCountry>
</affiliation>

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<wicri:noCountry code="subfield">University of Hong-Kong</wicri:noCountry>
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<wicri:noCountry code="subfield">University of Michigan</wicri:noCountry>
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<name sortKey="Oh, Tae Ju" sort="Oh, Tae Ju" uniqKey="Oh T" first="Tae-Ju" last="Oh">Tae-Ju Oh</name>
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<sec id="S1">
<title>Objective</title>
<p id="P1">Regulators of peri-implant bone loss in diabetic patients appears to involve multiple risk factors that have not been clearly elucidated. This study was conducted to explore putative local etiologic factors on implant bone loss in relation to type 2 diabetes mellitus, including clinical, microbial, salivary biomarker, and psychosocial factors.</p>
</sec>
<sec id="S2">
<title>Materials and Methods</title>
<p id="P2">Thirty-two subjects (divided into type 2 diabetes mellitus and non-diabetic controls), having at least one functional implant and 6 teeth, were enrolled in a one-year longitudinal investigation. Analyses of clinical measurements and standardized intra-oral radiographs, saliva and serum biomarkers (via protein arrays for 20 selected markers) and plaque biofilm (via qPCR for 8 periodontal pathogens) were performed at baseline and 1 year. In addition, the subjects were asked to respond to questionnaires to assess behavioral and psychosocial variables.</p>
</sec>
<sec id="S3">
<title>Results</title>
<p id="P3">There was a significant increase from baseline to 1 year in the probing depth of implants in the diabetes group (1.95mm to 2.35mm, p=0.015). The average radiographic bone loss during the study period marginally increased at dental implants compared to natural teeth over the study period (0.08mm vs. 0.05mm; p=0.043). The control group harbored higher levels of
<italic>T. denticola</italic>
at their teeth at baseline (p=0.046) and the levels of the pathogen increased significantly over time around the implants of the same group (p=0.003). Salivary osteoprotegerin (OPG) levels were higher in the diabetes group than the control group at baseline only; in addition, the salivary levels of IL-4, IL-10, and OPG associated with host defense were significantly reduced in the diabetes group (p=0.010, p=0.019, and p=0.024) while controls showed an increase in the salivary OPG levels (p=0.005). For psychosocial factors, there were not many significant changes over the observation period, except for some findings related to coping behaviors at baseline.</p>
</sec>
<sec id="S4">
<title>Conclusions</title>
<p id="P4">The study suggests that the clinical, microbiological, salivary biomarker, and psychosocial profiles of dental implant patients with type 2 diabetes who are under good metabolic control and regular maintenance care are very similar to those of non-diabetic individuals. Future studies are warranted to validate the findings in longer-term and larger clinical trials (
<ext-link ext-link-type="uri" xlink:href="http://ClinicalTrials.gov">ClinicalTrials.gov</ext-link>
# NCT00933491).</p>
</sec>
</div>
</front>
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<journal-meta>
<journal-id journal-id-type="nlm-journal-id">9105713</journal-id>
<journal-id journal-id-type="pubmed-jr-id">1142</journal-id>
<journal-id journal-id-type="nlm-ta">Clin Oral Implants Res</journal-id>
<journal-id journal-id-type="iso-abbrev">Clin Oral Implants Res</journal-id>
<journal-title-group>
<journal-title>Clinical oral implants research</journal-title>
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<issn pub-type="epub">1600-0501</issn>
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<article-id pub-id-type="pmc">4295063</article-id>
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<article-id pub-id-type="manuscript">NIHMS438767</article-id>
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<title-group>
<article-title>Clinical, microbiological, and salivary biomarker profiles of dental implant patients with type 2 Diabetes</article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname>Tatarakis</surname>
<given-names>Nikolaos</given-names>
</name>
<xref ref-type="aff" rid="A1">*</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Kinney</surname>
<given-names>Janet S.</given-names>
</name>
<xref ref-type="aff" rid="A1">*</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Inglehart</surname>
<given-names>Marita</given-names>
</name>
<xref ref-type="aff" rid="A1">*</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Braun</surname>
<given-names>Thomas M.</given-names>
</name>
<xref ref-type="aff" rid="A1">*</xref>
<xref ref-type="aff" rid="A2">§</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Shelburne</surname>
<given-names>Charles</given-names>
</name>
<xref ref-type="aff" rid="A3"></xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Lang</surname>
<given-names>Niklaus P.</given-names>
</name>
<xref ref-type="aff" rid="A4"></xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Giannobile</surname>
<given-names>William V.</given-names>
</name>
<xref ref-type="aff" rid="A1">*</xref>
<xref ref-type="aff" rid="A5">#</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Oh</surname>
<given-names>Tae-Ju</given-names>
</name>
<xref ref-type="aff" rid="A1">*</xref>
</contrib>
</contrib-group>
<aff id="A1">
<label>*</label>
Department of Periodontics and Oral Medicine & Michigan Center for Oral Health Research, University of Michigan School of Dentistry, Ann Arbor, MI</aff>
<aff id="A2">
<label>§</label>
Biostatistics Department, School of Public Health, University of Michigan, Ann Arbor, MI</aff>
<aff id="A3">
<label></label>
Department of Biologic and Material Sciences, University of Michigan School of Dentistry, Ann Arbor, MI</aff>
<aff id="A4">
<label></label>
Department of Oral Rehabilitation, Faculty of Dentistry, University of Hong-Kong</aff>
<aff id="A5">
<label>#</label>
Department of Biomedical Engineering, College of Engineering, University of Michigan</aff>
<author-notes>
<corresp id="CR1">
<bold>Correspondence to:</bold>
Tae-Ju Oh, D.D.S., M.S. Department of Periodontics and Oral Medicine University of Michigan School of Dentistry 1101 N. University Ave Ann Arbor, MI 48109-1078 Phone: 734-647-3320 Fax: 734-763-5503
<email>taejuoh@umich.edu</email>
</corresp>
</author-notes>
<pub-date pub-type="nihms-submitted">
<day>10</day>
<month>1</month>
<year>2015</year>
</pub-date>
<pub-date pub-type="epub">
<day>27</day>
<month>2</month>
<year>2013</year>
</pub-date>
<pub-date pub-type="ppub">
<month>7</month>
<year>2014</year>
</pub-date>
<pub-date pub-type="pmc-release">
<day>01</day>
<month>7</month>
<year>2015</year>
</pub-date>
<volume>25</volume>
<issue>7</issue>
<fpage>803</fpage>
<lpage>812</lpage>
<pmc-comment>elocation-id from pubmed: 10.1111/clr.12139</pmc-comment>
<abstract>
<sec id="S1">
<title>Objective</title>
<p id="P1">Regulators of peri-implant bone loss in diabetic patients appears to involve multiple risk factors that have not been clearly elucidated. This study was conducted to explore putative local etiologic factors on implant bone loss in relation to type 2 diabetes mellitus, including clinical, microbial, salivary biomarker, and psychosocial factors.</p>
</sec>
<sec id="S2">
<title>Materials and Methods</title>
<p id="P2">Thirty-two subjects (divided into type 2 diabetes mellitus and non-diabetic controls), having at least one functional implant and 6 teeth, were enrolled in a one-year longitudinal investigation. Analyses of clinical measurements and standardized intra-oral radiographs, saliva and serum biomarkers (via protein arrays for 20 selected markers) and plaque biofilm (via qPCR for 8 periodontal pathogens) were performed at baseline and 1 year. In addition, the subjects were asked to respond to questionnaires to assess behavioral and psychosocial variables.</p>
</sec>
<sec id="S3">
<title>Results</title>
<p id="P3">There was a significant increase from baseline to 1 year in the probing depth of implants in the diabetes group (1.95mm to 2.35mm, p=0.015). The average radiographic bone loss during the study period marginally increased at dental implants compared to natural teeth over the study period (0.08mm vs. 0.05mm; p=0.043). The control group harbored higher levels of
<italic>T. denticola</italic>
at their teeth at baseline (p=0.046) and the levels of the pathogen increased significantly over time around the implants of the same group (p=0.003). Salivary osteoprotegerin (OPG) levels were higher in the diabetes group than the control group at baseline only; in addition, the salivary levels of IL-4, IL-10, and OPG associated with host defense were significantly reduced in the diabetes group (p=0.010, p=0.019, and p=0.024) while controls showed an increase in the salivary OPG levels (p=0.005). For psychosocial factors, there were not many significant changes over the observation period, except for some findings related to coping behaviors at baseline.</p>
</sec>
<sec id="S4">
<title>Conclusions</title>
<p id="P4">The study suggests that the clinical, microbiological, salivary biomarker, and psychosocial profiles of dental implant patients with type 2 diabetes who are under good metabolic control and regular maintenance care are very similar to those of non-diabetic individuals. Future studies are warranted to validate the findings in longer-term and larger clinical trials (
<ext-link ext-link-type="uri" xlink:href="http://ClinicalTrials.gov">ClinicalTrials.gov</ext-link>
# NCT00933491).</p>
</sec>
</abstract>
<kwd-group>
<kwd>diabetes mellitus</kwd>
<kwd>dental implants</kwd>
<kwd>microbiology</kwd>
<kwd>salivary diagnostics</kwd>
<kwd>psychosocial indicator</kwd>
<kwd>alveolar bone loss</kwd>
</kwd-group>
</article-meta>
</front>
</pmc>
</record>

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