Does diabetes affect implant failure rates?

This summary is based on the article published in the Journal of Dental Research: Diabetes and oral implant failure: a systematic review (September 2014)

B.R. Chrcanovic, T. Albrektsson, and A. Wennerberg

Context

• Dental implant survival is initially dependent on successful osseointegration following placement.
• As an implant is restored and placed into function, bone remodeling becomes a critical aspect of implant survival in responding to the functional demands placed on the implant restoration and supporting bone. The critical dependence on bone metabolism for implant survival may be heightened in patients with diabetes (1).
• Diabetic patients have increased frequency of periodontitis and tooth loss (2), and diabetes has been considered a risky condition for dental implants with the fact that it is associated with delayed wound healing (3), prevalence of microvascular disease, and impaired response to infection (4).
• However, well-controlled diabetic patients may be considered appropriate for implant therapy, while diabetic patients lacking good glycemic control may be denied the benefits of implant therapy (1).

Purpose or the Review

To investigate whether there are any effects of diabetes mellitus on implant failure rates, postoperative infections, and marginal bone loss.

Key Findings

• The results of the study were inconclusive due to uncontrolled confounding factors in the studies reviewed.
• Although there was a statistically significant difference between diabetic and non-diabetic patients concerning marginal bone loss, favoring non-diabetic patients, the difference between patients did not significantly affect implant failure rates.

References

1. Oates TW, Huynh-Ba G, Vargas A, Alexander P, Feine J (2013). A critical review of diabetes, glycemic control, and dental implant therapy. Clin Oral Impl Res 24:117-127.
2. Khader YS, Dauod AS, El-Qaderi SS, Alkafajei A, Batayha WQ (2006). Periodontal status of diabetics compared with non-diabetics: a meta-analysis. J Diabetes Complications 20:59-68.
3. Rothwell BR, Richard EL (1984). Diabetes mellitus: medical and dental considerations. Spec Care Dent 4:58-65.
4. McMahon MM, Bistrian BR (1995). Host defenses and susceptibility in patients with diabetes mellitus. Infect Dis Clin North Am 9:1-9.

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