Assessment of osteoblastic activity around dental implants following Low-Intensity Pulsed Ultrasound (LIPUS) therapy in patients with type 2 Diabetes Mellitus: A split-mouth randomised controlled trial

Diabetes mellitus was once considered a contraindication to the use of dental implant therapy, as it has been associated with comorbidities, including increased susceptibility to infection, impaired wound healing, and periodontitis. Since dental implants and techniques for controlling diabetes have evolved, dental implant therapy has become increasingly common among patients with Type 2 Diabetes Mellitus. The rising success of dental implants in prosthodontic rehabilitation has shifted current trends to accommodate Dental Implant placement in patients with controlled Type 2 Diabetes Mellitus. With advancements in implant surface treatment technology, Type 2 Diabetes Mellitus with well-controlled blood glucose levels is no longer considered an absolute contraindication for implant surgery. However, several studies have reported that patients with these diseases still pose a potentially high risk of implant failure. Various studies have indicated that patients with Type 2 diabetes mellitus exhibit diminished proliferation and osteogenic differentiation capabilities of osteoblasts compared to individuals without Type 2 diabetes mellitus. Also, elevated blood glucose levels can significantly impact bone tissue remodeling and interfere with the bonding between implants and bone, particularly within the first three weeks following implant placement. Literature suggests various methods to improve osseointegration around Dental Implants in patients with Type 2 Diabetes Mellitus, however effective and simple methods to enhance the osseointegration around Dental Implants are yet to be found. Abdulhameed et al. suggested a simple and effective method known as Low-Intensity Pulsed Ultrasound (LIPUS) therapy for effectively enhancing implant osseointegration and reduced healing duration. Low-Intensity Pulsed Ultrasound (LIPUS) is a noninvasive therapy that harnesses acoustic pulsed energy to provide physical stimulation. The use of LIPUS (Low-Intensity Pulsed Ultrasound Stimulation) has been shown to have a stimulatory effect on bone regeneration and osseointegration around dental implants.