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Diabetes Patients at Increased Risk for Dental Implant Complications
Journal of Oral Implantology – Diabetes mellitus is associated with increased periodontal disease and tooth loss. This often results in the need for the placement of dental implants. The high incidence of diabetes (422 million people world-wide) illustrates the need to understand how the disease impacts dental implant success. An article published in the latest issue of the Journal of Oral Implantology analyzed systematic reviews to determine whether diabetes status affects implant survival rate and marginal bone loss.
By using a combination of free and Medical Subject Headings terms, along with a manual search, researchers from Pernambuco University and São Paulo State University found 130 systematic reviews from several databases. Six reviews for analysis, based on their eligibility criteria, were selected. The reviews were published between 2009 and 2017 and contained seven to 22 studies each. Next, the authors examined whether diabetes influences dental implant survival rate and marginal bone loss. The Glenny and Assessing the Methodological Quality of Systematic Reviews 2 (AMSTAR 2) scales were also used to assess the quality of the reviews. Four of the six reviews showed a negative change in marginal bone loss in diabetic patients. The authors’ reasoning for why diabetes may cause more marginal bone loss was due to an inflammatory response that leads to an increase in the number of osteoclasts (cells that resorb bone).
Although this study did not find that implant survival rate was different between diabetic and non-diabetic patients, the authors point to previous research that shows diabetes increases the risk of micro-vascular complications and peri-implantitis. These two complications can contribute to implant failure. Therefore, controlling glycemia levels in the diabetic patients likely results in an increased number of osteoblasts (cells that produce new bone). The increase in osteoblast numbers would improve implant outcomes through enhanced structural connections between the bone and implant. The authors also highlight Glenny and AMSTAR scales, which report the quality of a systematic review. One limitation of this overview is the control of several risk factors accounting for bias. Additionally, more conclusions about the studies could have been drawn if detailed information, such as diabetes type and implant location, had been included.
Reviews are valuable to doctors and policy makers because they summarize current research and provide information about the quality of the research. This review has shown that patients with diabetes may experience a negative effect in marginal bone levels which can help clinicians in guiding patients to make appropriate treatment decisions.
Full text of the article “Influence of Diabetes on the Survival Rate and Marginal Bone Loss of Dental Implants: An Overview of Systematic Reviews,” Journal of Oral Implantology, is available here.
About Journal of Oral Implantology
The Journal of Oral Implantology (JOI) is the official publication of the American Academy of Implant Dentistry. It is dedicated to providing valuable information to general dentists, oral surgeons, prosthodontists, periodontists, scientists, clinicians, laboratory owners and technicians, manufacturers, and educators. The JOI distinguishes itself as the first and oldest journal in the world devoted exclusively to implant dentistry.
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