DYNAMICS OF CHANGES IN OSSEOINTEGRATION OF DENTAL IMPLANTS IN PATIENTS WITH RAPIDLY PROGRESSIVE GENERALIZED PERIODONTITIS ON THE BACKGROUND OF DIABETIC OSTEOPATHY
DOI:
https://doi.org/10.35220/2078-8916-2023-49-3.9Keywords:
periodontitis, periodontal pathology, rapidly progressive generalized periodontitis, diabetes, bone morphogenetic protein 2 (BMP-2), ossein-hydroxyapatite complexAbstract
The purpose of the study is to increase the effectiveness of dental implant osseointegration in patients with rapidly progressive generalized periodontitis in combination with diabetic osteopathy by achieving through a comprehensive investigation of the dynamics of changes in bone tissue density and the development of medical correction methods for bone tissue remodeling. Research material and methods. The comparative effectiveness of dental implantation was studied in 52 patients with rapidly progressive generalized periodontitis and type 2 diabetes, complicated by systemic osteoporosis and periodontal bone destruction, who were divided into 2 groups (26 patients in each) and differed only by prescribed treatment complex, and also in 32 patients with the established diagnosis of rapidly progressive generalized periodontitis without general somatic pathology, who were treated with identical to II group therapeutic complex. There were 56 (66.7 %) women and 28(33.3%) men were observed among them. The average age was 41.9±2.36 years. All patients of I, II and III groups were installed dental implants – totally – 282. While we aimed for the number of surgical operations in each groups were approximately the same. Research results. The conducted studies showed that after the installation of dental implants in response to surgical intervention, there were changes in the alveolar bone, which led to a significant decrease in the density of bone tissue and were more essential in patients of groups I and II than in representatives of group III. The use for pharmacological correction of bone remodeling of ossein-hydroxyapatite complex in combination with morphogenetic protein (rhBMP-2) after the installation of dental implants in patients with rapidly progressive generalized periodontitis for 1.5 months causes increased effect of osteoregeneration, rapid and essential restoration of bone density and faster completion of osseointegration in at least 95 % of cases. Prescribing just osseinhydroxyapatite complex during dental implantation to patients with rapidly progressed generalized periodontitis complicated with diabetic osteopathy turned out to be ineffective. Using this method for bone remodeling correction led lower rates of bone density repair were observed, which was reflected in delayed osseointegration of dental implants and their loss. Conclusions. The initial low density of bone tissue and disturbances in the bone regulation system in combination with increased bone resorption and decreased osteogenesis activity are a risk factor for dental implantation in patients with generalized periodontitis on the background of diabetic osteopenia, which requires complex antiresorptive and osteotropic therapy.
References
Zhu L., Zhou C., Chen S., Huang D., Jiang Y., Lan Y., Zou S., Li Y. Osteoporosis and Alveolar Bone Health in Periodontitis Niche: A Predisposing Factors-Centered Review. Cells/ 2022. № 11. Р. 3380. doi: 10.3390/cells11213380.
Yu B., Wang C.Y. Osteoporosis and periodontal diseases–An update on their association and mechanistic links. Periodontol. 2000. 2022. № 89. Р. 99–113.
Гудар’ян О.О., Мащенко І.С., Кучеренко Т.О. Лікування агресивного (швидкопрогресуючого) генералізованого пародонтиту з викориcтанням системної ензимотерапії в комбінації із остеоіндуктивними засобами. Медичні перспективи. 2020. Т. 25, № 3. С. 144-152 doi: https://doi.org/10.26641/2307-0404.2020.3.214852.
Simpson T.C. et al. Treatment of periodontal disease for glycaemic control in people with diabetes mellitus. Cochrane Database Syst Rev. 2015. V. 4. P. 221-227
Hayashi J. et al. Effects of periodontal treatment on the medical status of patients with type 2 diabetes mellitus: a pilot study. BMC Oral Health. 2017. V.17(1). № 77. Р. 1-6 DOI 10.1186/s12903-017-0369-2.
Мащенко І.С., Гудар’ян О.О., Кучеренко T.O Клінічні, імунологічні та метаболічні особливості загостреного і швидко прогресуючого варіантів генералізованого пародонтита. Сучасна стоматологія. 2020. Том 4. С. 26-32. doi: https://doi.org/10.33295/1992-576X-2020-4-26.
Гудар’ян О. О., Кучеренко Т. О. Стан кісткового метаболізму у хворих з різними варіантами течії генералізованого пародонтиту. Вісник проблем біології і медицини. 2020. Вип. 3. С. 314-318. Режим доступу: http://nbuv.gov.ua/UJRN/Vpbm_2020_3_73.
Chapple I.L., Genco R. Diabetes and periodontal diseases: consensus report of the joint EFP/AAP workshop on periodontitis and systemic diseases. J Periodontol. 2013. № 84(4). Р. 106–12.
Chen H., Liu N., Xu X., Qu X., Lu E. Smoking, radiotherapy, diabetes and osteoporosis as risk factors for dental implant failure: a meta-analysis. PLoS One. 2013. № 8(8). e71955. doi: 10.1371/journal.pone.0071955. PMID: 23940794.
Jiang X., Zhu Y., Liu Z., Tian Z., Zhu S. Association between diabetes and dental implant complications: a systematic review and meta-analysis. Acta Odontol Scand. 2021. № 79(1). Р. 9-18 doi: 10.1080/00016357.2020.1761031.
Sbricoli L., Bazzi E., Stellini E., Bacci C. Systemic Diseases and Biological Dental Implant Complications: A Narrative Review. Dent J (Basel). 2022. № 11(1). Р. 10 doi: 10.3390/dj11010010.
Германчук С. М. Морфобіохімічні зміни у тканинах пародонта при експериментальному цукровому діабеті. Український журнал медицини, біології та спорту. 2018. Т. 3, № 4. С. 13-19.
Liu W., Yu M., Chen F., Wang L., Ye C., Chen Q., Zhu Q., Xie D., Shao M., Yang L. A novel delivery nanobiotechnology: engineered miR-181b exosomes improved osteointegration by regulating macrophage polarization. J Nanobiotechnology. 2021. № 19(1). Р. 269 doi: 10.1186/s12951-021-01015-y.
Kohli N., Ho S., Brown S.J., Sawadkar P., Sharma V., Snow M., García-Gareta E. Bone remodelling in vitro: Where are we headed?: – A review on the current understanding of physiological bone remodelling and inflammation and the strategies for testing biomaterials in vitro. Bone. 2018. № 110. Р. 38-46 doi: 10.1016/j.bone.2018.01.015.
Johnson T.B., Siderits B., Nye S., Jeong Y.H., Han S.H., Rhyu I.C., Han J.S., Deguchi T., Beck F.M., Kim D.G. Effect of guided bone regeneration on bone quality surrounding dental implants. J Biomech. 2018. № 80. Р. 166-170 doi: 10.1016/j.jbiomech.2018.08.011.
Castelo-Branco C., Dávila Guardia J. Use of ossein-hydroxyapatite complex in the prevention of bone loss: a review. Climacteric. 2015. № 18(1). Р. 29-37. doi: 10.3109/13697137.2014.929107.
Kishchuk V., Bondarchuk O., Dmitrenko I., Bartsihovskyiy A., Lobko K., Grytsun Y., Isniuk A Morphological dynamics of bone tissue reparative regeneration during the implantation of biocomposite "syntekost" into the cavity of the traumatic defect of the iliac crest of a rabbit in the experiment. Wiad Lek. 2018. № 71(7). Р. 1281-1288.
Mitra S. Multiple Data Analyses and Statistical Approaches for Analyzing Data from Metagenomic Studies and Clinical Trials. Methods Mol Biol. 2019. № 1910. Р. 605-634. doi: 10.1007/978-1-4939-9074-0_20.
Kour A., Kumar A., Puri K., Khatri M., Bansal M., Gupta G. Comparative evaluation of probing depth and clinical attachment level using a manual probe and Florida probe. Journal of Indian Society of Periodontology, 2016. № 20(3). Р. 299–306 https://doi.org/10.4103/0972-124X.181241.
Різник Ю. Б., Різник С. С. Індексна оцінка стану тканин пародонта у хворих на цукровий діабет II типу. Сучасна стоматологія. 2019. № (5). С. 42-42.
Skalerič E., Petelin M., Gašpirc B. Antimicrobial photodynamic therapy in treatment of aggressive periodontitis (stage III, grade C periodontitis): A comparison between photodynamic therapy and antibiotictherapy as an adjunct to non-surgical periodontal treatment. Photodiagnosis and photodynamic therapy. 2023. № 41. Р. 103251. https://doi.org/10.1016/j.pdpdt.2022.103251
