An in Vivo Evaluation of Correlations of Open and Closed Tray Implant Impressions with Implant Longevity in Uncontrolled Diabetes Mellitus of Middle Aged Patients: An Original Research Study

Abstract

Aim: This study aims to evaluate the correlation between open and closed tray implant impressions and implant longevity in middle-aged patients with uncontrolled diabetes mellitus.

Materials and Methods: Fifty patients reported the absence of their right mandibular first molar, with 40 choosing dental implants. Participants aged 35 to 60, including both genders with a diabetes history, were assessed before treatment with clinical evaluations and cone beam computed tomography (CBCT). Exclusions included those with mental instability, smokers, or pregnant women. After informed consent, chlorhexidine rinses were used to reduce infection risk, and pain management was achieved with an inferior alveolar nerve block. A flap was created for implant placement, followed by suturing. Two months later, a healing abutment was fitted, and custom implant-supported prostheses were created using both open and closed tray impression techniques. The study specifically focused on 40 patients with uncontrolled diabetes, divided into two groups: Group 1 (20 patients) used the open tray technique, while Group 2 (20 patients) used the closed tray method. Microcomputed Tomography (Micro-CT) assessed osseointegration and healing, evaluating the impact of impression techniques on implant longevity in this population.

Statistical Analysis and Results: The study examined 40 patients missing their right mandibular first molar who sought dental implants. Aged 35 to 60, participants included 23 males and 17 females, as shown in Table 1. They were divided into two groups: Group 1 had 20 patients using the open tray technique, and Group 2 had 20 patients using the closed tray technique. Both methods were assessed with Microcomputed Tomography (Micro-CT) to evaluate osseointegration and potential complications. In Group 1, 8 out of 20 patients with uncontrolled diabetes showed significant implant longevity, while 5 out of 20 patients in Group 2 demonstrated notable longevity. The results indicated that Group 1 had better impression accuracy and implant longevity than Group 2. Table 4 summarises these findings, which were analysed using one-way ANOVA to evaluate the impression techniques' effectiveness.

Conclusion: The study found both impression methods viable but noted that implant durability can suffer from compromised wound healing and an increased risk of peri-implant diseases. Strict glycemic control and good oral hygiene are crucial. The open-tray technique provides better accuracy and implant longevity while the closed-tray method may lead to misalignment. The micro-CT technique is identified as a simpler, non-invasive evaluation method, highlighting the need for further research to improve clinical practice.