Implant Rehabilitation Following Loss of Tooth Restorability Associated With Poorly Controlled Type 2 Diabetes...

Type 2 diabetes mellitus is associated with an increased risk of periodontal disease, impaired bone metabolism, delayed wound healing, and progressive alveolar bone loss, all of which may adversely affect the prognosis of compromised teeth. This case report describes the management of a 42-year-old man with type 2 diabetes mellitus who presented with a severely compromised maxillary canine. The patient had previously been advised to undergo definitive restorative treatment with a full-coverage crown because of extensive structural deterioration. However, financial limitations, inconsistent medical follow-up, and repeated replacement of large restorations delayed definitive care. Over time, progressive structural deterioration, increasing tooth mobility, and loss of periodontal support rendered the tooth non-restorable. Initial medical evaluation revealed a glycated hemoglobin (HbA1c) level of 7.0%, indicating suboptimal glycemic control. The patient was referred to his primary care physician and counseled on improving glycemic control through adherence to prescribed metformin therapy, dietary modifications, and regular medical follow-up. After approximately one month of improved diabetes management, extraction of the tooth and ridge preservation using particulate bone graft and a resorbable collagen membrane were performed. Following six months of healing, a dental implant was placed, and after successful osseointegration, the definitive implant-supported crown was delivered. This case highlights the importance of timely definitive restorative treatment, optimization of glycemic control before implant therapy, and interdisciplinary collaboration in achieving predictable implant rehabilitation in patients with type 2 diabetes mellitus.