Platelet rich plasma as an adjunct for immediate implants supporting mandibular over dentures in diabetic patients

Abstract

Background: Diabetic patients are characterized by absolute or relative deficiency of insulin which is important for protein and collagen synthesis in bone. Therefore insulin deficiency is considered as one of the major systemic factors involved in the process of residual ridge resorption. Wound healing fails in diabetic patients unless diabetes is controlled. Platelet rich plasma (PRP) is an application of tissue engineering. It depends on stimulation and acceleration of bone and soft tissue healing. PRP delivers growth factors in high concentration to the required sites. These factors promote wound healing and tissue regeneration. Aim of the study was to evaluate the effect of platelet-rich plasma (PRP) as an adjunct for immediate implants supporting mandibular overdentures in diabetic patients (Clinically and radiographically). Materials& Methods; Ten controlled diabetic male patients were selected for this study. Each patient had a completely edentulous maxilla and a remaining mandibular canine or premolar on each side. The remaining teeth were extracted atraumatically then two implants were inserted immediately after extraction according to the non-submerged technique. One implant was inserted alone and the other one was inserted in conjunction with PRP. After four months, the implants were loaded using implant overdentures supported by ball and socket attachments. For each patient, both implants were evaluated clinically and radiographically for bone density and bone height around both implants before and after loading. Results & Conclusions: There was a statistically significant increase in the probing depth in the after loading period for both implants. There was insignificant change between the two sides. Radiographic evaluation revealed statistically significant increase in bone density for both implants before and after loading. In the preloading period, the bone density was significantly higher in implant with PRP than without PRP which provides better healing and better osseointegration especially for the diabetic patients. As regard bone height, there was a statistically significant loss of bone height around both implants before and after loading and there was no statistically significant difference between the two implants. PRP might have a role in regulation, promotion and enhancement in the process of bone regeneration around endosseous implants in controlled diabetic patients.