CLINICAL JUSTIFICATION OF THE USE OF CHONDROITIN SULFATE IN DENTAL IMPLANTATION IN PATIENTS WITH LOW OSTEOGENIC POTENTIAL

Relevance. Modern dental implantology has achieved significant success, but patients with metabolic disorders, especially type 2 diabetes mellitus (T2DM), are still a complex category characterized by a high risk of developing osseointegration disorders and postoperative complications. In such patients, there is a decrease in osteogenic potential, deterioration of regenerative processes and increased bone resorption. In this regard, an urgent task is to find and implement additional methods that help improve osseointegration. One of the promising directions is considered to be the use of chondroitin sulfate, a natural biopolymer with proven osteotropic, anti-inflammatory and regenerative properties capable of stimulating bone metabolism and improving the microenvironment in the implantation area. Aim. To conduct a clinical evaluation of the effectiveness of the combined use of chondroitin sulfate (systemic and local) in dental implantation in patients with DM2 and signs of reduced osteogenic potential. Materials and methods. The study included 72 patients with a verified diagnosis of DM2 and signs of osteopenia (type D3–D4 according to the Misch classification). The participants were divided into three groups: O1 — combined use of chondroitin sulfate (oral and topical), O2 — systemic therapy only, K — control group without chondroitin sulfate. Over the course of 12 months, hygienic and periodontal status, ISQ indices, bone density (in HU), and marginal resorption were assessed using RFA, CBCT, and visiography techniques. Results. The O1 group showed the best clinical results: an increase in ISQ was +16.91%, bone density increased by 18.3%, and marginal bone resorption was minimal — 0.10 mm. The implant survival rate was 100% in the experimental groups and 95.8% in the control group. The developed protocol confirmed its high clinical efficacy and osteoprotective effect.