{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T04:59:28Z","timestamp":1790312368466,"version":"4.1.0"},"reference-count":65,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T00:00:00Z","timestamp":1790208000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T00:00:00Z","timestamp":1790208000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100011970","name":"International Team for Implantology","doi-asserted-by":"publisher","award":["LG_2017_1250"],"award-info":[{"award-number":["LG_2017_1250"]}],"id":[{"id":"10.13039\/501100011970","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Oral Implants Res"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To compare \u23003.3\u2009mm and \u23004.1\u2009mm hydrophilic titanium\u2010zirconium implants supporting fixed dental prostheses (FDPs) in mandibular distal\u2010extension situations among participants with varying degrees of hyperglycaemia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>Participants were stratified according to HbA1c (5.8%\u2013&lt;\u20097.0% vs. \u2265\u20097.0%) and subsequently randomized within each stratum to receive either \u23003.3\u2009mm or \u23004.1\u2009mm titanium\u2010zirconium implants. Each participant received a two\u2010implant\u2010supported multi\u2010unit FDP. The primary outcome was marginal bone level (MBL) change at 12\u2009months after prosthesis delivery. Secondary outcomes included implant stability quotient (ISQ), peri\u2010implant indices, Healing Index and patient\u2010reported outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 88 enrolled participants, 83 (166 implants) were evaluated. Implant survival was 100%, with no peri\u2010implantitis. At 12\u2009months, MBL did not differ significantly between the \u23003.3\u2009mm [0.27\u2009mm (IQR, 0.07\u20130.68)] and \u23004.1\u2009mm groups [0.27\u2009mm (IQR, \u22120.04 to 0.54);\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.078]. Participants with HbA1c\u2009\u2265\u20097% had approximately sevenfold higher odds of MBL \u2265\u20090.5\u2009mm than those with HbA1c\u2009&lt;\u20097%. Secondary ISQ was significantly higher with \u23004.1\u2009mm implants (79.6 vs. 76.1;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), whereas early healing was better with \u23003.3\u2009mm implants (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.005). Chewing ability improved significantly from baseline to 12\u2009months irrespective of implant diameter or HbA1c category (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.0001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>At 1\u2009year, \u23003.3\u2009mm and \u23004.1\u2009mm hydrophilic Ti\u2010Zr implants demonstrated no statistically significant difference in MBL although \u23004.1\u2009mm implants demonstrated higher stability. Patient\u2010reported chewing ability improved substantially following rehabilitation for both implant diameters. Higher HbA1c was associated with greater odds of clinically relevant MBL.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial Registration<\/jats:title>\n                    <jats:p>The trial was registered prospectively with the Clinical Trials Registry\u2013India (CTRI\/2017\/08\/009315)<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/clr.70175","type":"journal-article","created":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T04:17:49Z","timestamp":1790309869000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Stratified Randomized Controlled Trial of \u22053.3\u2009mm Versus \u22054.1\u2009mm Hydrophilic Titanium\u2010Zirconium Implants Supporting Posterior Mandibular Fixed Prostheses in Hyperglycaemic Subjects"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8889-2570","authenticated-orcid":false,"given":"Supriya","family":"Ebenezer","sequence":"first","affiliation":[{"name":"Oral Rehabilitation Center  Bangalore India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-5776-3016","authenticated-orcid":false,"given":"Sreelakshmi","family":"Viswanath","sequence":"additional","affiliation":[{"name":"Oral Rehabilitation Center  Bangalore India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-6583-8517","authenticated-orcid":false,"given":"Chitradevi","family":"Ramanathan","sequence":"additional","affiliation":[{"name":"Sankara Nethralaya Medical Research Foundation  Chennai India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alampalli V.","family":"Ramesh","sequence":"additional","affiliation":[{"name":"Dental Health Clinic  Bangalore India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2279-4281","authenticated-orcid":false,"given":"Vinay V.","family":"Kumar","sequence":"additional","affiliation":[{"name":"Oral Rehabilitation Center  Bangalore India"},{"name":"Department of Odontology Maxillofacial Surgery, Division of Surgical Sciences Uppsala University  Uppsala Sweden"},{"name":"Coorg Institute of Dental Sciences  Karnataka India"},{"name":"Department of Maxillofacial Surgery and Dentistry Vydehi Superspeciality Hospital  Bangalore India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,24]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1563\/AAID\u2010JOI\u2010D\u201013\u201000149"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/cid.12778"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/cid.12712"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/cid.12584"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/cid.12392"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc13\u2010S011"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc21\u2010S006"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/jcpe.13970"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/ID.0000000000000557"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/cre2.521"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0284319"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/jcpe.12957"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.adaj.2017.02.039"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1177\/154405910408300704"},{"issue":"1","key":"e_1_2_11_16_1","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1034\/j.1600-0501.1990.010105.x","article-title":"Tissue Integration of Non\u2010Submerged Implants. 1\u2010Year Results of a Prospective Study With 100 ITI Hollow\u2010Cylinder and Hollow\u2010Screw Implants","volume":"1","author":"Buser D.","year":"1990","journal-title":"Clinical Oral Implants Research"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00784\u2010019\u201003110\u20109"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2022.934274"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00784\u2010024\u201005786\u20100"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1708\u20108208.2008.00124.x"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/cid.12465"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.3390\/healthcare11081123"},{"issue":"4","key":"e_1_2_11_23_1","first-page":"366","article-title":"A Retrospective Study of Dental Implants in Diabetic Patients","volume":"20","author":"Fiorellini J. 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