Gagik Hakobyan

Yeteavan STATE Medical University, Armenia

Title: Evaluation of the effectiveness sinus lift and implant prosthetic rehabilitation patients with type 2 diabetes mellitus

Time:

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Biography

Research Intrest

Abstract

Prosthetics rehabilitation of the posterior part of the upper jaw with implants is often difficult due to atrophy of the alveolar process and pneumatization of the maxillary sinus. Maxillary sinus floor augmentation with bone substitutes is considered a predictable procedure however in diabetic patients sinus lifting  associated with a higher risk of implant rejection due to increased susceptibility to infections, impaired wound healing, and associated microvascular complications compared to non-diabetic patients.

Objectives: To evaluate the effectiveness sinus lift and implant prosthetic rehabilitation patients with type 2 diabetes mellitus using UV-treated titanium implants, PRF and bone substitutes.

Material and Methods: The study included 82 patients, diagnosed type 2 diabetes mellitus in period 2018 - 2023 with partially or complete edentulous. 

All patients underwent a clinical, laborator examination and computed tomography. Patients underwent implantation with HbA1c levels <7.2% or less than 154 mg/dL.

Sinus lift was performed using PRF and bone substitutes

I-PRF 20 ml of peripheral venous blood was collected from the median cubital vein after thorough asepsis of the antecubital fossa using surgical spirit.PRF is prepared from immediate centrifugation of blood after collection in a glass tube in 3000 rotations per minute (RPM) for 10 minutes. With blood segregation, 3 compartments are formed: the upper one is platelet-poor plasma, the middle one is platelet-rich fibrin with a buffy coat, and the lower compartment is erythrocytes. The middle PRF contains a fibrin matrix in which the majority of platelets and leukocytes are entrapped along with circulating stem cells. A sterile insulin syringe of 30 gauge was used to aspirate the PRF. Received PRF mixed with Bio-Oss xenograft and filled the space under the sinus with a membrane and implants if they were installed simultaneously A membrane Bio-Gide was placed over the sinus bone window.

In  34 patients of 1st group one-stage sinus lifting was performed, 76 UV functionalization dental implants were installed after 5-6 months of sinus lifting, in 48 patients of 2st group 123 UV functionalization dental implants were installed simultaneous. Final dental prosthetics was performed after 4-5 months. Treatment  including systemic antibiotics (amoxicillin 500mg and metronidazole 200mg) with duration of 7-10 days.

Outcomes assessed included; implant survival, men MBL, PPD prosthetic success, Quality of life

Conclusion: This study confirmed that sinus lift and implant  therapy can be successfully used in patients diagnosed with diabetes using UV photofunctionalization implants, PRF, blood glucose levels should be maintained at normal levels at all times.