Pre-implant Assessment of Mandibular Bone Density in Diabetic Type II Patients using Cone Beam Computed Tomography

Abstract

Dental implant success is highly dependent on the quality and density of the supporting bone, particularly in medically compromised patients such as those with type 2 diabetes mellitus (T2DM). This study aimed to evaluate mandibular bone density (MBD) in T2DM patients using cone beam computed tomography (CBCT), with a focus on the influence of glycemic control and gender in a Yemeni population. A retrospective comparative cross-sectional observational study was conducted on 45 patients diagnosed with T2DM (24 males and 21 females), comprising 146 posterior mandibular implant sites. Glycemic control was assessed using HbA1c levels and categorized into controlled (<7%) and uncontrolled (≥7%) groups. MBD was measured using CBCT grayscale values at premolar and molar regions under standardized imaging protocols. The results demonstrated no statistically significant differences in MBD between controlled and uncontrolled glycemic groups in both premolar (p = 0.206) and molar regions (p = 0.650). A weak negative, non-significant correlation was observed between HbA1c levels and MBD. Additionally, no significant differences were found between the right and left sides of the mandible, indicating symmetrical bone distribution. However, a statistically significant difference was identified between genders, with males exhibiting higher bone density than females in both premolar (p = 0.001) and molar regions (p = 0.002). In conclusion, glycemic control, as measured by HbA1c, does not appear to significantly influence MBD in posterior regions. Conversely, gender plays a significant role in MBD variations. CBCT proved to be a reliable tool for pre-implant bone assessment.