Mohammad D. Al Amri Tariq S. Abduljabbar Abdulaziz A. Al-Kheraif Georgios E. Romanos Fawad Javed Comparison of clinical and radiographic status around dental implants placed in patients with and without prediabetes: 1-year follow-up outcomes Authors’ affiliations: Mohammad D. Al Amri, Tariq S. Abduljabbar, Department of Prosthetic Dental Sciences, College of Dentistry, King Saud University, Riyadh, Saudi Arabia Abdulaziz A. Al-Kheraif, Dental Health Department, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia Georgios E. Romanos, Department of Periodontology, School of Dental Medicine, Stony Brook University, Stony Brook, NY, USA and; Department of Oral Surgery and Implant Dentistry, Johann Wolfgang University, Frankfurt, Germany Fawad Javed, Department of General Dentistry, Eastman Institute for Oral Health, University of Rochester, Rochester, NY, USA Corresponding author: Dr Mohammad D. Al Amri Department of Prosthetic Dental Sciences College of Dentistry King Saud University P.O. Box 60169, Riyadh 11545, Saudi Arabia Tel.: +966 11 467 7325 Fax: +966 11 467 8548 e-mail: dramri@yahoo.com Key words: clinical parameters, dental implant, marginal bone loss, prediabetes, success rate Abstract Objective: We hypothesized that peri-implant soft tissue inflammation is worse and peri-implant marginal bone loss (MBL) is higher around dental implants placed in patients with prediabetes compared to healthy subjects. The aim of the present 12-month follow-up study was to compare the clinical and radiographic status around dental implants placed in patients with and without prediabetes. Material and methods: Twelve patients with medically diagnosed prediabetes (Group-1) and 12 controls (Group-2) were included. All patients were indicated for single tooth maxillary or mandibular premolar replacement with the adjacent teeth intact. Success of the restored implants was assessed by comparing clinical (peri-implant bleeding on probing [BOP], and probing pocket depth [PPD]) and radiographic (peri-implant MBL) parameters at baseline and at 12-months follow- up. Statistical analysis was performed using one-way analysis of variance, and P-values <0.05 were considered statistically significant. Results: At 12 months of follow-up, there was no clinical evidence for the presence of plaque, BOP and peri-implant pockets with PPD ≥ 4 mm in both groups. At 12-month follow-up, the mean MBL among implants placed in groups 1 and 2 were 0.2 Æ 0.1 mm and 0.1 Æ 0.01 mm, respectively. Overall, the periodontal status (PI, BOP and PPD ≥ 4 mm) at 12-month follow-up was comparable among patients in both groups. Conclusion: Within the limitations of this study, it is concluded that dental implants inserted in prediabetic and healthy patients have similar success rates and remain clinically and radiographically stable after 1-year follow-up. It is known that chronic hyperglycemia nega- tively influences osseointegration of dental implants, and implant failure is a common manifestation in such patients (Alsaadi et al. 2008; Daubert et al. 2015). Chronic hyper- glycemia has also been associated with the delayed cell proliferation and osteoblast dif- ferentiation (Colombo et al. 2011). In addi- tion, chronic hyperglycemia has been associated with the dysregulation of bone fac- tors such as transforming growth factor-beta, fibroblast growth factor, osteopontin, osteo- calcin and osteoprotegerin in the peri-implant crevicular fluid (Ghiraldini et al. 2015). Although optimal glycemic control in patients with diabetes has been reported to enhance osseointegration (Javed & Romanos 2009), results from a recent clinical trial showed that elevated hemoglobin A1c (HbA1c) levels in patients with type 2 diabetes mellitus (T2DM) were not associ- ated with altered implant success after 1 year of loading (Oates et al. 2014). However, alter- ations in early bone healing and implant sta- bility were associated with chronic hyperglycemia (Oates et al. 2014). Similar results were reported in another clinical study (Ghiraldini et al. 2015). Prediabetes, a state of abnormal glucose homeostasis, is characterized by the presence of impaired fasting glucose, impaired glucose tolerance, or both (American Diabetes Asso- ciation 2015a). Prediabetes designations have been defined by fasting glucose levels of 100– 125 milligrams per deciliter (mg/dl), hemo- globin A1c (HbA1c) levels between 5.7% and 6.4% and postglucose challenge levels of 140–199 mg/dl (Olson et al. 2010; American Diabetes Association 2015b). Studies (Javed et al. 2012a,b, 2013, 2014a,b, 2015; Alshehri Date: Accepted 30 December 2015 To cite this article: Al Amri MD, Abduljabbar TS, Al-Kheraif AA, Romanos GE, Javed F. Comparison of clinical and radiographic status around dental implants placed in patients with and without prediabetes: 1-year follow-up outcomes. Clin. Oral Impl. Res. 00, 2016, 1–5 doi: 10.1111/clr.12788 © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd 1