Crafting a comprehensive literature review on dental implants is a challenging endeavor that requires

meticulous attention to detail, extensive research, and proficient writing skills. This critical
component of academic and professional research serves to summarize, evaluate, and synthesize
existing literature relevant to dental implantology, providing valuable insights into the current state
of knowledge in the field.

Navigating through the vast expanse of scholarly articles, journals, textbooks, and other sources to
identify relevant studies and extract pertinent information can be a daunting task. Moreover,
synthesizing this information in a coherent and structured manner while maintaining objectivity and
academic rigor presents its own set of challenges.

Effective literature reviews require a deep understanding of the subject matter, familiarity with
research methodologies, and the ability to critically analyze and interpret findings. Researchers must
meticulously evaluate the quality and credibility of each source, assess the relevance of the
information presented, and identify gaps or inconsistencies in the existing literature.

Furthermore, crafting a literature review that adheres to academic standards and guidelines, such as
APA or MLA formatting, adds another layer of complexity to the writing process. Ensuring proper
citation and referencing of sources is essential to avoid plagiarism and maintain academic integrity.

Given the intricacies involved in writing a literature review on dental implants, many individuals
may find themselves overwhelmed or struggling to produce a high-quality document that meets the
required standards. In such cases, seeking assistance from professional writing services can be
invaluable.

⇒ StudyHub.vip ⇔ offers specialized academic writing services tailored to the needs of researchers
and scholars in the field of dentistry. Our team of experienced writers possesses the expertise and
proficiency required to conduct thorough literature reviews on dental implants, delivering
meticulously researched and impeccably written documents that meet the highest academic
standards.

By entrusting your literature review to ⇒ StudyHub.vip ⇔, you can alleviate the stress and burden
associated with this demanding task, allowing you to focus on other aspects of your research or
academic pursuits. Our commitment to excellence ensures that you receive a well-crafted literature
review that not only showcases your understanding of the subject matter but also makes a
meaningful contribution to the advancement of dental implantology.

Don't let the challenges of writing a literature review impede your research progress. Order from ⇒
StudyHub.vip ⇔ today and take the first step towards achieving your academic and professional
goals in the field of dental implants.
Many case series analyzing the trigger factors for BP-ONJ describe dentures as one of the main
causes. Taken together, cardiovascular and chronic respiratory diseases, cancer and diabetes are
responsible for almost 75% of deaths in Europe as a whole, and the principal cause of death in the
53 member states of the WHO European Region. Dental and periodontal history of oncologic
patients on parenteral bisphosphonates with or without osteonecrosis of the jaws: a pilot study. The
information provided above is for reference purposes only. Perioperative antimicrobial prophylaxis
has a benefit in the prevention of BP-ONJ development. Journal of Manufacturing and Materials
Processing (JMMP). You can download the paper by clicking the button above. Tooth-implant
connection: some biomechanical aspects based on finite element analyses. Implant therapy in these
patients can be a successful outcome as long as the tissues are kept healthy from a microbiologic
viewpoint. A systematic review of the survival and complication rates of fixed partial dentures
(FPDs) after an observation period of at least 5 years. No implants were lost, and no differences in
marginal bone loss were observed between the treatment groups. This deduction is based on almost
every study that addressed this issue and found the survival rates were similar when TISPs and ISPs
were compared. Implant versus tooth-implant supported prostheses in the posterior maxilla: a 2-year
report. For each topic the search terms (ST) are given Full size table. European Journal of
Investigation in Health, Psychology and Education (EJIHPE). In cases of obesity, the adipocytes
secrete pro-inflammatory cytokines such as TNF-. Once you complete your order, you will receive a
separate email acknowledgment that provides information about your purchase. Maintenance of
implant is more difficult than maintenance of teeth. There is still no accepted range of glycated
hemoglobin (HbA1c) levels to indicate when diabetes is not controlled, however. American
Association of Oral and Maxillofacial Surgeons position paper on medication-related osteonecrosis
of the jaw--2014 update. In most studies, analyzing osteoporosis patients only, no cases of BP-ONJ
were observed in patients with implant therapy in the time span observed. Clarification of risk
factors or indicators leading to peri-implant disease is necessary to provide clinicians more effective
strategies for prevention and treatment. It was believed differences in mobility patterns of a tooth
and an implant would result in the prosthesis being cantilevered off the implant, thereby stressing the
implant. The flowchart illustrates the decision-making process for the selection of the articles eligible
for review ( Figure 1 ). 4. Types of Study Examined Considering the articles by study design, 20
were prospective, 32 were retrospective, 13 were cross-sectional and for 5, the study design was not
specified. We use cookies on our website to ensure you get the best experience. Patient evaluation of
treatment with fixed prostheses supported by implants or a combination of teeth and implants. Oral
rehabilitation with dental implants in irradiated patients: a meta-analysis on implant survival.
Prevalence of bisphosphonate associated osteonecrosis of the jaw within the field of osteonecrosis.
However, extrapolating information from FEA studies to humans with re spect to stress distribution
is difficult because many as sumptions are needed concerning biologic factors, such as bone
properties, response to applied mechanical force, and stress distribution after force transmission. 19-
21 Furthermore, as will be discussed in this article, clinical trials that assessed po tential problems
associated with TISPs did not usually dem onstrate the extent of problems predicted by FEA. This
will include considerations to class size, the wearing of masks by all, and any other measures that
promote safety.
Int J Oral Maxillofac Implants. 1988;3(4):281-286. Despite heterogenous study designs,
epidemiologic studies demonstrate using both direct and indirect measures that individuals with a
history of periodontitis are at greater risk for biologic implant complications. Int J Oral Maxillofac
Implants. 1994;9(2):230-234. Int J Oral Maxillofac Implants. 2004;19(2): 247-259. Finally, as
concerns the five studies of unspecified design, three analyzed diabetes as a risk factor, one
considered only prediabetes and one investigated both diabetes and prediabetes. All payments
received prior to Session III are non-refundable regardless of participation during sessions III and IV.
European Journal of Investigation in Health, Psychology and Education (EJIHPE). Feature papers
are submitted upon individual invitation or recommendation by the scientific editors and must
receive. It is recommended that customers who elect to incur travel costs for a training course,
schedule and purchase airfare and hotel accommodations with this in mind. But there is one
importance difference- the inflammation of the peri-implant tissues develops faster than that of the
periodontal. Systemic Diseases and Biological Dental Implant Complications: A Narrative Review.
Dent. J. 2023, 11, 10. However, after 10 years, TISPs had more failures than ISPs. Implant
placement in patients with oral bisphosphonate therapy: a case series. DevGAMM Conference
Barbie - Brand Strategy Presentation Barbie - Brand Strategy Presentation Erica Santiago Good
Stuff Happens in 1:1 Meetings: Why you need them and how to do them well Good Stuff Happens
in 1:1 Meetings: Why you need them and how to do them well Saba Software Introduction to C
Programming Language Introduction to C Programming Language Simplilearn The Pixar Way: 37
Quotes on Developing and Maintaining a Creative Company (fr. Analyzing blood levels of
inflammatory molecules could help to identify a possible causal relationship between obesity and
peri-implantitis. At present, there are no large long-term studies that assessed textured surface im
plants as an integral part of a TISP. Note that from the first issue of 2016, this journal uses article
numbers instead of page numbers. The loading time for TISP was 1.5 years to 15 years (mean 6.5
years) and ISP was 1.3 years to 14.5 years (mean 6.2 years). The cumulative success rates of the
implants for ISPs and TISPs were 98.5% and 95%, respectively. You have no obligation to purchase
the product once you know the price. You have no obligation to purchase the product once you know
the price. Published findings concerning any link between glycemic control and peri-implant disease
are very mixed, but diabetes has been widely recognized as a factor capable of interfering with the
postoperative healing process after the insertion of a dental implant. The results of the present review
are similar to those obtained for diabetes in the systematic review conducted by Guobis et al. Journal
of Experimental and Theoretical Analyses (JETA). There fore, this article assesses the literature to
determine if evidence-based decisions could be made concerning the utility of connecting teeth to
dental implants. Quality assessment of selected studies Due to the available data, an explicit quality
assessment was not performed. We use cookies on our website to ensure you get the best experience.
Initial deposit and 1st installment payment are non-refundable after Session I. Patients with a history
of periodontitis represent a unique group of individuals who previously succumbed to a bacterial
challenge. This was a small study and lacked adequate power to find small differences between the
test and control groups. 1 Data related to this one cohort of patients were published at three different
times: 3 years, 63 5 years, 46 and 10 years. 49. Biological factors contributing to failures of
osseointegrated oral implants. (II). Etiopathogenesis. Eur J Oral Sci. 1998;106(3):721-764.
A drawback of previous research on the relationship between systemic diseases and peri-implantitis
could lie in the scarcely consistent definition of peri-implantitis and its clinical indicators. It is
recommended that customers who elect to incur travel costs for a training course, schedule and
purchase airfare and hotel accommodations with this in mind. Unfortunately there is only little data
on how to proceed with implant therapy in patients with bisphosphonate treatment. This might
explain why such patients have worse peri-implant clinical values, though long-term controlled
clinical trials would be needed to support these findings (obtained in a retrospective cross-sectional
study). Int J Oral Maxillofac Implants. 2002;17(2):212-219. American Association of Oral and
Maxillofacial Surgeons position paper on medication-related osteonecrosis of the jaw--2014 update.
Journal of Experimental and Theoretical Analyses (JETA). Hopefully, future research will shed more
light on the role of obesity in dental implant rehabilitation. 5.3. Cardiovascular Disease Out of 13
studies selected for review, 11 did not identify cardiovascular disease as a risk factor for dental
implant failure or implant-related complications. Tropical Medicine and Infectious Disease
(TropicalMed). The use of a dental im plant as an abutment in three unit implant-tooth supported
fixed partial denture: a case report and 32 month follow-up. Int J Oral Maxillofac Implants.
1998;13(2):227-231. Bei welchen Bisphosphonat-Patienten darf ich eigentlich implantieren.
Systematic reviews often are cited in this article, because they provide a high level of evidence and
facilitate reviewing a vast amount of information in a succinct manner. Products from opened
packages will only be exchanged if deemed defective. Finite element stress analysis of tooth-to-
implant fixed partial denture designs. The distribution clearly illustrates the necessity for an
individual risk assessment as it is recommended by most guidelines and the importance of explaining
the possibility of BP-ONJ development to the patient. Therefore, it is important to address the
management and survival rate of implants in these patients. Further longitudinal studies are needed
to better understand the effects of systemic diseases on rehabilitation with dental implants. Outcome
quality of life (QoL) There is nearly no literature available on the change of the quality of life due to
implants in patients with antiresorptive therapy. Finally, as concerns the five studies of unspecified
design, three analyzed diabetes as a risk factor, one considered only prediabetes and one investigated
both diabetes and prediabetes. There were no significant differences with regard to loss of im plants
even though more implants were lost with TISP (10 out of 339 TISPs vs one out of 329 ISPs).
Prevalence of osteonecrosis of the jaw in patients with oral bisphosphonate exposure. They reported
root in trusion was a problem when nonrigid connectors were used and cited numerous studies that
monitored patients with successful TISPs. 24,44,62,67 Table 3 includes an additional 11 studies
addressing successful splinting of teeth to im plants not mentioned by Gross and Laufer 45 or
published after their review. 24,31,36,37,39,47,51,52,54,58,60. Retrospective study of two
biochemical markers for the risk assessment of oral bisphosphonate-related osteonecrosis of the jaws:
can they be utilized as risk markers. Periodontal as pects of osseointegrated fixtures supporting a
partial bridge. Clinically, the inflammatory process in peri-implantitis and in chronic periodontitis can
be presented as bleeding on probing, deepened periodontal pockets and periodontal suppuration.
Studies that had less than five patients or cases were excluded as well as studies whose cases lacked
data or were not clearly defined. Photoelastic stress analysis of load transfer to implants and natural
teeth comparing rigid and semirigid connectors. Prospective evaluation of implants connected to
teeth. Articles not conducted on human beings, those without an abstract and those with titles or
abstracts judged inconsistent with the aims of the present review were also omitted; the final step
was to remove the items with full text unavailable, single case reports, narrative reviews, systematic
reviews, and meta-analyses.
To assess the prevalence of this occurrence, issues need to be discussed from four different points of
view: con ceptual effect of occlusal load on bone loss, usual amount of osseous resorption around
freestanding implants, bone loss around implants in an ISP, and bone loss around natural tooth
abutments in a TISP. If the transmission is interrupted in any way, you can use your gIDE account
and password to begin the process again. Finally, as concerns the five studies of unspecified design,
three analyzed diabetes as a risk factor, one considered only prediabetes and one investigated both
diabetes and prediabetes. Dental plaque biofilm induced inflammation and associated tissue
destruction endanger the success and survival of dental implants more than the way it affects natural
teeth. Subscribe to receive issue release notifications and newsletters from MDPI journals. Among
the TISPs with rigid connections, only three out of 56 prostheses had technical problems. The
authors concluded TISPs with rigid connection provided a high success rate. Regarding the topics
augmentation, masticatory efficiency, TMJ and the impact on the remaining dentition no literature
met the inclusion criteria or no literature was available at all. Filters were used to select only studies
in the English language, published until 1 March 2022. The risk in patients with malignant diseases is
hard to describe since mostly negative examples are published but not the total number of patients
receiving implant therapy. Different prostheses sizes were fabricated depending on patients’ needs.
Systemic Diseases and Biological Dental Implant Complications: A Narrative Review. Dent. J. 2023,
11, 10. In addition, patients with nonrigid connections needed more maintenance visits. Implant
therapy in these patients can be a successful outcome as long as the tissues are kept healthy from a
microbiologic viewpoint. A survey of natural tooth abutment in trusion with implant-connected fixed
partial dentures. Please note that many of the page functionalities won't work as expected without
javascript enabled. An individual risk assessment is essential, taking the primary disease with the
medication and further wound-healing-compromising diseases and medications into account. As a
methodology, Scopus, Web of Science and Google Scholar indexing portals were scanned with the
terms implantodontics, periodon. Effect of oc clusal wear on bone loss and Periotest value of dental
implants. Patient evaluation of treatment with fixed prostheses supported by implants or a
combination of teeth and implants. Most of the literature concludes for no association between
diabetes, cardiovascular disease, hypertension or osteoporosis and the risk of peri-implantitis. A
database search initially yielded 2787 studies of potential interest published up to 1 March 2022
(993 in PubMed; 908 in Web of Science; and 886 in Scopus). Chronic inflammation also induces
oxidative stress, which could contribute to the onset of insulin resistance. Therefore, the use of
nonrigid connector or telescopic crowns was advocated to reduce the bending mo ments on the
implant. 22-35 However, this could result in oth er problems, namely tooth intrusion. The nature and
frequency of bisphosphonate-associated osteonecrosis of the jaws in dental implant patients: a South
Australian case series. In fact, the healthy people in their sample revealed more severe inflammation
in the oral cavity than patients suffering from diabetes or hypertension. A systematic review of the
survival and complication rates of fixed partial dentures (FPDs) after an observation period of at
least 5 years. Studies that had less than five patients or cases were excluded as well as studies whose
cases lacked data or were not clearly defined. Download citation Received: 26 September 2015
Accepted: 23 March 2016 Published: 04 April 2016 DOI: Share this article Anyone you share the
following link with will be able to read this content: Get shareable link Sorry, a shareable link is not
currently available for this article. Systemic Diseases and Biological Dental Implant Complications: A
Narrative Review. An individual risk assessment is essential, taking the primary disease with the
medication and further wound-healing-compromising diseases and medications into account.
BP-ONJ can be triggered by dental implants and by dentures in patients with benign and malignant
primary diseases. There is no literature on patients with antiresorptive medications other than
bisphosphonates, and so the recommendation is to proceed with these patients similarly to patients
on bisphosphonates. Therefore, the use of nonrigid connector or telescopic crowns was advocated to
reduce the bending mo ments on the implant. 22-35 However, this could result in oth er problems,
namely tooth intrusion. The results of the present review are similar to those obtained for diabetes in
the systematic review conducted by Guobis et al. Effect of oc clusal wear on bone loss and Periotest
value of dental implants. Lopez-Cedrun exclusively found patients with benign diseases: 8
osteoporosis and 1 polymyalgia rheumatic. This might explain why such patients have worse peri-
implant clinical values, though long-term controlled clinical trials would be needed to support these
findings (obtained in a retrospective cross-sectional study). ISPRS International Journal of Geo-
Information (IJGI). Denture The literature dealing with this topic can be separated into two groups.
However, with additional tooth or implant support or cross-arch stabilization, additional pontics can
be used. This increased stress could lead to a decreased success rate for a tooth-implant supported
prosthesis (TISP) compared with implant-only supported prosthesis (ISP). 1-7 However, potential
problems associated with TISPs may have been overstated. Once you complete your order, you will
receive a separate email acknowledgment that provides information about your purchase. Taken
together, cardiovascular and chronic respiratory diseases, cancer and diabetes are responsible for
almost 75% of deaths in Europe as a whole, and the principal cause of death in the 53 member states
of the WHO European Region. Different types of studies have been conducted: a limited number of
clinical trials compared same-sized TISP and ISP intraindividually, comparisons of dissimilarly sized
TISP and ISP intraindividually, comparisons of different-sized ISPs and TISPs in various patient
populations, and case reports assessing various combinations of im plants and teeth. Radiographic
findings in bisphosphonate-treated patients with stage 0 disease in the absence of bone exposure.
Long-term survival and success of oral implants in the treatment of full and partial arches: a 7-year
prospective study with the ITI dental implant system. After removing 1190 duplicate articles and
checking the titles, abstracts and full texts for relevance, 70 articles were selected for the present
analysis. DVDs may not be returned for refund or exchange unless broken upon opening or defective
upon viewing. Paper should be a substantial original Article that involves several techniques or
approaches, provides an outlook for. The high incidence of tooth intrusion and ad ditional visits for
maintenance led to the authors suggesting that other treatment methods that do not connect teeth to
implants may be needed. You have no obligation to purchase the product once you know the price.
Randomized multicenter comparison of two coatings of intramobile cylinder implants in 313 partially
edentulous mandibles followed up for 5 years. Articles on this topic revealed a marked heterogeneity
as concerns the type of study conducted and the results obtained, but the evidence to support such
an association was limited or inconsistent for most of the systemic conditions considered. 5.1.
Diabetes The role of diabetes in the onset of complications affecting osseo-integrated dental implants
has been investigated much more than that of the other systemic diseases considered here, but
contrasting findings have emerged. Articles grouped by findings concerning obesity as a risk factor
for biological complications of dental implants. If the item is still sealed in the original packaging,
gIDE will exchange it or offer a refund based on the original method of payment. Implant therapy in
these patients can be a successful outcome as long as the tissues are kept healthy from a
microbiologic viewpoint. The cases (12 maxillary and six mandibular prostheses) were monitored 1 to
14 years. Yet, by the tenth year, a TISP has a reduced survival rate when compared with an ISP or a
tooth-supported prosthesis ( Table 5 ). Characteristics of implant failures in patients with a history of
oral bisphosphonate therapy. Unlocking the Power of ChatGPT and AI in Testing - A Real-World
Look, present.
Recommendations are made to facilitate attaining high success rates with TISPs. The high incidence
of tooth intrusion and ad ditional visits for maintenance led to the authors suggesting that other
treatment methods that do not connect teeth to implants may be needed. Flowchart of the decision-
making process for the selection of the articles eligible for review. The link between systemic
diseases and periodontitis has been amply discussed in the literature. For instance, Lang et al 1
performed a meta-analysis to specifically determine the survivability of TISPs. Jacobsen found 14
patients: 5 osteoporosis, 5 breast cancer, 2 multiple myeloma, 1 prostate and 1 lung cancer patient.
Further longitudinal studies are needed to better understand the effects of systemic diseases on
rehabilitation with dental implants. Intrusion phenomenon in combination tooth-implant restorations:
a review of the literature. Funding This research received no external funding. Systemic Diseases and
Biological Dental Implant Complications: A Narrative Review. Dent. J. 2023, 11, 10. Enhance
resistance form with boxes and retention grooves if the clinical crown is not long ( Figure 5 ).
Subscribe to receive issue release notifications and newsletters from MDPI journals. International
Journal of Translational Medicine (IJTM). Implant versus tooth-implant supported prostheses in the
posterior maxilla: a 2-year report. Oral bisphosphonate-associated osteonecrosis of the jaw after
implant surgery: a case report and literature review. For example, Naert et al 5,6 monitored 140 ISPs
and 140 TISPs (1 to 15 years) and concluded an ISP is preferable because of an increased number of
technical problems associated with a TISP. Journal of Pharmaceutical and BioTech Industry (JPBI).
Their existence reflects the changes in the bone remodeling due to the anti-resorptive therapy and
might be associated with a higher osteonecrosis risk, but there is no evidence supporting this theory.
While desertcart makes reasonable efforts to only show products available in your country, some
items may be cancelled if they are prohibited for import in United Arab Emirates. The risk of
osteonecrosis development needs to be explained to the patient. Chronic inflammation also induces
oxidative stress, which could contribute to the onset of insulin resistance. American Association of
Oral and Maxillofacial Surgeons position paper on bisphosphonate-related osteonecrosis of the jaws.
Clarification of risk factors or indicators leading to peri-implant disease is necessary to provide
clinicians more effective strategies for prevention and treatment. Hanover Park, IL: Quintessence
Publishing Co. Inc.; 1990;48-57. At present, there are no large long-term studies that assessed
textured surface im plants as an integral part of a TISP. They found the survival rate was similar after
5 years for an ISP and a TISP, but a TISP had a reduced survival rate between the fifth and tenth
years ( Table 5 ). In addition, patients with nonrigid connections needed more maintenance visits.
Preferably, place one pontic between two abutments. There are no studies about implant therapy in
patients with malignant diseases. Osteonecrosis of the jaws secondary to bisphosphonate therapy: a
case series.
The ability of currently available stress-breaking elements for osseointegrated im plants to imitate
natural tooth mobility. Surgical procedures such as implant insertion and potential complications
such as periimplantitis are associated with an inflammatory condition and can potentially trigger a
BP-ONJ. Grotz Authors Christian Walter View author publications You can also search for this
author in. This was a small study and lacked adequate power to find small differences between the
test and control groups. 1 Data related to this one cohort of patients were published at three different
times: 3 years, 63 5 years, 46 and 10 years. 49. European Journal of Investigation in Health,
Psychology and Education (EJIHPE). Please let us know what you think of our products and
services. A recently performed systematic review on masticatory performance, bite force, nutritional
state and patient’s satisfaction showed that implant-supported dentures were associated with high
patient satisfaction regarding denture comfort and bite force. Osteonecrosis associated with dental
implants in patients undergoing bisphosphonate treatment. If the transmission is interrupted in any
way, you can use your gIDE account and password to begin the process again. Articles grouped by
findings concerning obesity as a risk factor for biological complications of dental implants. Dental
and periodontal history of oncologic patients on parenteral bisphosphonates with or without
osteonecrosis of the jaws: a pilot study. The risk of osteonecrosis development has already been
described in the chapter referring to the osteonecrosis risk. If possible, bone augmentations should
be avoided, and a perioperative antimicrobiological prophylaxis is strongly recommended in these
patients. Nowadays, it is well known that preventing and controlling such systemic diseases is also
fundamentally important to the health of the oral cavity. After reading the full texts, clinical studies
diverging from the purposes of the present review were also rejected. In contrast, some factors
suggest it may be prudent to avoid a TISP. Outcomes of placing dental implants in patients taking
oral bisphosphonates: a review of 115 cases. In very few of these studies, the primary disease was
not given, but the prescribed bisphosphonates strongly suggest osteoporosis as the primary disease
(see Table 2 ). Unfortunately the literature dealing with this topic is very sparse and consists mainly
of case reports, case series, and a few retrospective studies. If gIDE cannot obtain authorization to
charge the credit card submitted, gIDE will send instructions, via email, for completing the purchase.
Finite element stress analysis of tooth-to-implant fixed partial denture designs. Osteonecrosis of the
jaws secondary to bisphosphonate therapy: a case series. Patients with a history of periodontitis
represent a unique group of individuals who previously succumbed to a bacterial challenge.
Download citation Received: 26 September 2015 Accepted: 23 March 2016 Published: 04 April
2016 DOI: Share this article Anyone you share the following link with will be able to read this
content: Get shareable link Sorry, a shareable link is not currently available for this article. The
observational studies selected for review thus include cross-sectional, retrospective and prospective
studies on series of clinical cases, case-control studies and cohort studies. Quality assessment of
selected studies Due to the available data, an explicit quality assessment was not performed. Taken
together, cardiovascular and chronic respiratory diseases, cancer and diabetes are responsible for
almost 75% of deaths in Europe as a whole, and the principal cause of death in the 53 member states
of the WHO European Region. However, they noted if the teeth were well supported, immobile, and
positioned close to the implant, a TISP was not destructive. To browse Academia.edu and the wider
internet faster and more securely, please take a few seconds to upgrade your browser. When
comparing diabetics with nondiabetics, it would be important to assess patients’ oral hygiene levels
as well.