Date of Award

12-2024

Degree Type

Thesis

Degree Name

MS in Epidemiology & Biostatistics

First Advisor

Mr. Iqbal azam

Second Advisor

Dr.Farhan Raza Khan

Third Advisor

Dr. Rehana Siddiqui

Department

Community Health Sciences

Abstract

Introduction As per the World Health Organization, in 2022, 3.5 billion individuals worldwide were diagnosed with diabetes, 98% of whom suffer from type II. Diabetic individuals suffer from oral diseases, such as periodontal disease which may lead to loss of teeth. Diabetes also affects the density of the alveolar bone hence this can impact the tooth replacement options e.g. a dental implant. This also emphasizes the importance of pre-procedural radiographs such as CBCT which allow for better planning for implants. The aim of this study is to assess the difference in bone density and implant success among controlled type II diabetics and non-diabetics.
Methods The study was a retrospective cohort design, conducted in the dental clinics of Aga Khan University Hospital, Karachi, Pakistan, in a duration of two months. The sample population was all patients above the age of 18 years, who had at least one dental implant placed, utilizing an OPG and/or CBCT imaging, at dental clinics of The Aga Khan University Hospital, Karachi, Pakistan. Data was obtained from medical and dental records and pre-existing CBCT scans in the hospital database. The sample size was calculated to be 122 (41 in controlled type II diabetics and 81 in non-diabetics). The outcome was bone density, according to Misch’s classification, which was assessed in relation to other variables in both the groups. The secondary outcome was dental implant success. Bone Density was also measured in grey values (GV). ERC exemption was obtained for this study AKU-ERC# 2024-9854-29155.
Results A sample of 131 patients was taken, 45 were controlled type II diabetics, with HbA1c level of < 8% and 86 diabetics. 73 were males (22 were controlled type II diabetic) and 58 were females (23 were controlled type II diabetic). 45 patients were controlled diabetics (23 males and 22 females). A total of 210 dental implants were placed in these 131 patients between January 2018 and December 2023. The failed dental implants were v in the non-diabetic group only, no dental implants had failed in the controlled type II diabetic group. Bone density was greater in the diabetic group but difference from the non-diabetic group was statistically insignificant.
Conclusion Type II diabetes may affect bone density of the maxilla and mandible as compared to non[1]diabetics, however the difference in this study was not statistically significant. Pre[1]procedural dental implant planning, glycemic level and bone density assessment, can aid in prediction of better outcomes. Most dental implant failures occurred in areas of fine trabecular bone.

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1

Last Page

87

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