International Journal of Prosthodontics and Restorative Dentistry

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VOLUME 13 , ISSUE 2 ( April-June, 2023 ) > List of Articles


Correlation between Implant Stability and Alkaline Phosphatase in Controlled Diabetics: A Clinical Study

Sheezan Akhtar, Neha Jain, Anjana Goyal, Harsimran Kaur, Piyush Tandan

Keywords : Alkaline phosphatase, Biomarker, Dental implants, Diabetes, Implant stability

Citation Information : Akhtar S, Jain N, Goyal A, Kaur H, Tandan P. Correlation between Implant Stability and Alkaline Phosphatase in Controlled Diabetics: A Clinical Study. Int J Prosthodont Restor Dent 2023; 13 (2):81-87.

DOI: 10.5005/jp-journals-10019-1409

License: CC BY-NC 4.0

Published Online: 28-06-2023

Copyright Statement:  Copyright © 2023; The Author(s).


Purpose: The purpose of the present study was to find the correlation between gingival crevicular fluid (GCF)/peri-implant crevicular fluid (PICF) alkaline phosphatase (ALP) levels and implant stability in controlled diabetic patients. Materials and methods: In this study, 30 controlled diabetic patients needing implants in the mandibular posterior region were divided into two groups, that is, group I—patients with normal serum ALP and group II—patients with raised serum ALP. Each individual was rehabilitated with one implant following a nonfunctional immediate loading protocol. Implant stability in each individual was assessed by measuring implant stability quotient (ISQ) values. GCF/PICF samples were collected to evaluate the level of ALP. Both parameters were evaluated at baseline, 1, and 3 months postimplant placement, and the resulting values were compared using analysis of variance (ANOVA) and post hoc Bonferroni test within the group, and unpaired t-test was used for comparison between the two groups. The correlation between the two parameters was determined using Pearson's correlation coefficient (r) test. Results: In group I patients with normal serum ALP, the mean ALP in GCF/PICF and ISQ values at baseline was 685.19 IU/L and 72.53; at 1 month, were 608.08 IU/L and 68.73; at 3 months, were 766.26 IU/L and 79.33, respectively. In group II patients with raised serum ALP, the mean ALP in GCF/PICF and ISQ values at baseline were 1042.75 IU/L and 72.40; at 1 month, were 932.75 IU/L and 65.07; at 3 months, were 1111.73 IU/L and 76.80, respectively. A significant difference was seen in GCF/PICF ALP values between the two groups, whereas nonsignificant difference was observed in ISQ values between group I and group II. Conclusion: No direct correlation was found between implant stability and GCF/PICF ALP in patients with normal serum ALP, and a negative correlation (with an increase in GCF/PICF ALP values, there was a corresponding decrease in the ISQ values) was found in patients with raised serum ALP at different time intervals.

  1. Warreth A, McAleese E, McDonnell P, et al. Dental implants and single implant-supported restorations. J Ir Dent Assoc 2013;59(1):32–43. PMID: 23539970.
  2. Katyayan PA, Katyayan M, Shah RJ. Rehabilitative considerations for dental implants in the diabetic patient. J Indian Prosthodont Soc 2013;13(3):175–183. DOI: 10.1007/s13191-012-0207-9
  3. Al Ansari Y, Shahwan H, Chrcanovic BR. Diabetes mellitus and dental implants: a systematic review and meta-analysis. Materials (Basel) 2022;15(9): DOI: 10.3390/ma15093227
  4. Chen H, Li J, Wang Q. Associations between bone-alkaline phosphatase and bone mineral density in adults with and without diabetes. Medicine (Baltimore) 2018;97(17):e0432. DOI: 10.1097/MD.0000000000010432
  5. Dubey RK, Gupta DK, Singh AK. Dental implant survival in diabetic patients; review and recommendations. Natl J Maxillofac Surg 2013;4(2):142–150. DOI: 10.4103/0975-5950.127642
  6. Swami V, Vijayaraghavan V, Swami V. Current trends to measure implant stability. J Indian Prosthodont Soc 2016;16(2):124–130. DOI: 10.4103/0972-4052.176539
  7. Sachdeva A, Dhawan P, Madhukar P, et al. Implant stability measurements using resonance frequency analysis and radiographic evaluation of crestal bone loss in indigenously developed implants placed in fresh extraction sockets. J Interdiscip Dent 2016;6(3): 128–134. DOI: 10.4103/2229-5194.201648
  8. Sachdeva A, Dhawan P, Sindwani S. Assessment of implant stability: Methods and recent advances. Br J Med Med Res 2016;12(3):1–10. DOI: 10.9734/BJMMR/2016/21877
  9. Sundar G, Sridharan S, Sundaram RR, et al. Impact of well-controlled type 2 diabetes mellitus on implant stability and bone biomarkers. Int J Oral Maxillofac Implants 2019;34(6):1441–1449. DOI: 10.11607/jomi.7547
  10. Siller AF, Whyte MP. Alkaline phosphatase: discovery and naming of our favorite enzyme. J Bone Miner Res 2018;33(2):362–364. DOI: 10.1002/jbmr.3225
  11. Perticone F, Perticone M, Maio R, et al. Serum alkaline phosphatase negatively affects endothelium-dependent vasodilation in naive hypertensive patients. Hypertension 2015;66(4):874–880. DOI: 10.1161/HYPERTENSIONAHA.115.06117
  12. Nazar Majeed Z, Philip K, Alabsi AM, et al. Identification of gingival crevicular fluid sampling, analytical methods, and oral biomarkers for the diagnosis and monitoring of periodontal diseases: a systematic review. Disease markers 2016;16:1–23. DOI: 10.1155/2016/1804727
  13. Wang JH, Wang K, Bartling B, et al. The detection of alkaline phosphatase using an electrochemical biosensor in a single-step approach. Sensors 2009;9(11):8709–8721. DOI: 10.3390/s91108709
  14. Oates TW, Dowell S, Robinson M, et al. Glycemic control and implant stabilization in type 2 diabetes mellitus. J Dent Res 2009;88(4): 367–371. DOI: 10.1177/0022034509334203
  15. Parithimarkalaignan S, Padmanabhan TV. Osseointegration: an update. J Indian Prosthodont Soc 2013;13(1):2–6. DOI: 10.1007/s13191-013-0252-z
  16. Marsell R, Einhorn TA. The biology of fracture healing. Injury 2011;42(6):551–555. DOI: 10.1016/j.injury.2011.03.031
  17. Tanaka K, Sailer I, Iwama R, et al. Relationship between cortical bone thickness and implant stability at the time of surgery and secondary stability after osseointegration measured using resonance frequency analysis. J Periodontal Implant Sci 2018;48(6):360–372. DOI: 10.5051/jpis.2018.48.6.360
  18. Baishi SF, Wolfinger GJ, Baishi TJ. An examination of immediately loaded dental implant stability in the diabetic patient using resonance frequency analysis (RFA). Quintessence Int 2007;38(4);271–279.
  19. Durga B Y, Aditi R. Estimation of GCF alkaline phosphatase levels in health and periodontal disease – a clinico biochemical study. Int J Contemp Med Res 2018; 7(5):1–4. DOI: 10.21276/ijcmr.2018.5.7.7
  20. Monjo M, Ramis JM, Rønold HJ, et al. Correlation between molecular signals and bone bonding to titanium implants. Clincl Oral Imp Res 2013;24(9):1035–1043. DOI: 10.1111/j.1600-0501.2012.02496.x
  21. Piattelli A, Scarano A, Piattelli M. Detection of alkaline and acid phosphatases around titanium implants: a light microscopical and histochemical study in rabbits. Biomaterials 1995;16:1333–1338. DOI: 10.1016/0142-9612(95)91049-5
  22. Abdulhameed VS, Saliem SS, Hassan TA. Evaluation of crestal bone loss and alkaline phosphatase level in saliva according to different flap designs in single-tooth dental implant surgery (a clinical comparative study). Biomed Pharmacol J 2017;10(4):1863–1869. DOI: 10.13005/bpj/1305
  23. Tirachaimongkol C, Pothacharoen P, Reichart PA, et al. Relation between the stability of dental implants and two biological markers during the healing period: a prospective clinical study. Int J Implant Dent 2016;2(1):1–11. DOI: 10.1186/s40729-016-0058-y
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