Immunological Evaluation of Different Implant Abutment Interfaces for Complete Lower Implant Assisted Overdenture in Controlled Diabetic Patients

Immunological and inflammatory mechanisms perform a key role in the development and progression of type 2 diabetes mellitus. The objective of this study was to evaluate immunologically the effect of different implant abutment interface, the platform switched (PS) and platform matched (PM) implants for implant assisted complete mandibular overdenture in controlled type II diabetic patients.
Methodology: Ten edentulous controlled type II diabetic male patients were selected in a split- mouth study design, where group I represented the right side of the patient and restored with platform-switched implant while group II represented the left side of the patient and restored with platform matched implants. The patients received complete mandibular implant assisted overdenture with O-ring attachment. Saliva samples were collected to measure the level of salivary cytokines (TNF-α & IL-6) using ELISA technique. The recall visits for every patient was at the time of insertion, 3 and 6 months. The data of this study were collected, tabulated and statistically analyzed by IBM-SPSS statistics software.
Results: Comparing from denture insertion for group 1, both cytokines (TNF-α & IL-6) were significantly increased after 3 months and significantly decreased after six months, but there were insignificant differences in both cytokines from denture insertion up to 6 months. While for group 2, there a was significant increase from 0 to 3 months and from 0 to 6 months and significant decrease from 3 to 6 months. When comparing the two studied groups regarding the mean level of both pro inflammatory salivary cytokines (TNF-α& IL-6) after 3 and six months of the new denture delivery, group II levels were significantly higher than group I levels. There were significant differences between both groups. Group I implants represented less mean of TNF-α & IL-6 levels.
Conclusion: TNF-α and IL-6 can be used as a site specific marker in monitoring early inflammatory changes in peri-implant sulcular fluid. Platform-Switched dental implant is the implant of choice particularly in controlled type II diabetic patients to control inflammatory changes around implant and avoid progression of type 2 diabetes mellitus.