Retrospective analysis of peri-implant tissue health and patient reported outcome measures in indirect sinus floor augmentation in diabetic and non-diabetic patients.

BACKGROUND

Implant therapy is a predictable solution for replacing missing teeth; however, the posterior maxilla presents challenges due to limited residual bone height and porous bone quality. The primary outcome of this retrospective study was to compare peri-implant tissue health—specifically total bone height (TBH) and marginal bone loss (MBL)—between well-controlled type 2 diabetes mellitus (T2DM) and non-diabetic patients over a 10-year period. Patient-reported outcome measures (PROMs) were evaluated as a secondary outcome.

METHODS

Seventy-six patients received 115 implants placed in the posterior maxilla with indirect sinus floor elevation. Based on metabolic status, patients were categorized into well-controlled T2DM (n = 31) and non-diabetic groups (n = 45). Clinical and radiographic parameters—gingival index (GI), residual bone height (RBH), sinus membrane elevation (SME), total bone height (TBH), marginal bone loss (MBL), sinus membrane thickness (SMT), and peri-implant soft tissue dehiscence (PSTD)—were assessed at baseline to 10 years follow up. PROMs were assessed using the OHIP-14 scale.

RESULTS

At 10-year follow-up, the mean total bone height was 14.05 ± 1.03 mm in the T2DM group and 14.65 ± 0.99 mm in the non-T2DM group, reflecting a mean difference of 0.60 mm (P = 0.002). Mean marginal bone loss was 1.21 ± 0.72 mm in T2DM patients vs. 0.56 ± 0.61 mm in non-diabetic patients, with a mean difference of 0.65 mm (P < 0.001). PROMs indicated similar patient satisfaction between groups, although esthetic and functional scores declined more in T2DM patients over time.

CONCLUSION

Both groups showed comparable long-term clinical outcomes, though lesser total bone height and greater mean marginal bone loss was observed in diabetic patients. Indirect sinus floor elevation with composite grafting demonstrated predictable success in both well-controlled T2DM and non-T2DM patients. CLINICAL TRIAL NUMBER: Not applicable.