Methods for studying the state of bone metabolism in patients with diabetes who require comprehensive total rehabilitation of the oral cavity through dental implantation

Анотація

Replacement of dentition defects using the dental implantation method is today one of the most common operations in the practice of a dentist-surgeon. The purpose of the study is to substantiate the choice of diagnostic methods for patients with type 2 diabetes mellitus, complicated by generalized periodontitis and diabetic osteopathy, who require dental implantation for total replacement of dentition defects. An electronic search was performed in PubMed and Google Scholar in the time interval 2003-2023. The study found 3728, selected 1170 and analyzed 24 sources, according to which the most optimal and expediently recommended research methods for the above group of patients were established. When processing information, the inclusion criteria were the study design, which included books and documents, clinical studies, meta-analysis, randomized controlled trial, review, systematic review, etc. The exclusion criteria were publications that did not meet the purpose of this review. The keywords used were “periodontitis”, “periodontal pathology”, “diabetes mel­litus”, “bone metabolism markers”, “dental implantation”, “bone metabolism”, “surgical dentistry”, “maxillofacial surgery”. In patients without general somatic pathology, the results of implant treatment are quite predictable, however, the treatment of patients with type 2 diabetes mellitus may be compromised by a large number of complications, especially if they have generalized periodontitis and diabetic osteopathy. There is no consensus in the literature among researchers regarding the nature of the combined effect of the above pathology and various variants of generalized periodontitis on the features of bone metabolism and the results of dental implantation, especially in those patients who require total rehabilitation, which in turn requires a more detailed study of their effect on the osseointegration of implants. This is of particular importance for the development of new approaches to preoperative diagnostics of personalized determination of indications and contraindications for dental implantation in this category of patients. In contrast to X-ray studies, cone-beam computed tomography and dual-energy X-ray absorptiometry have a more sensitive response to changes in the rate of balance between the processes of bone resorption and osteosynthesis, which makes their clinical use valuable for monitoring in the preoperative period and predicting osseointegration after dental implantation, as well as for assessing the response to the prescribed treatment. Diagnostics and planning of surgical interventions in patients with type 2 diabetes mellitus cannot be similar to those used in somatically healthy patients.