Systematic review on diabetes mellitus and dental implants: an update

Abstract

Purpose Dental implant surgery was developed to be the most suitable and comfortable instrument for dental and oral rehabilitation in the past decades, but with increasing numbers of inserted implants, complications are becoming more common. Diabetes mellitus as well as prediabetic conditions represent a common and increasing health problem (International Diabetes Federation in IDF Diabetes Atlas, International Diabetes Federation, Brussels, 2019) with extensive harmful effects on the entire organism [(Abiko and Selimovic in Bosnian J Basic Med Sci 10:186–191, 2010), (Khader et al., in J Diabetes Complicat 20:59–68, 2006, 10.1016/j.jdiacomp.2005.05.006)]. Hence, this study aimed to give an update on current literature on effects of prediabetes and diabetes mellitus on dental implant success. Methods A systematic literature research based on the PRISMA statement was conducted to answer the PICO question “Do diabetic patients with dental implants have a higher complication rate in comparison to healthy controls?”. We included 40 clinical studies and 16 publications of aggregated literature in this systematic review. Results We conclude that patients with poorly controlled diabetes mellitus suffer more often from peri-implantitis, especially in the post-implantation time. Moreover, these patients show higher implant loss rates than healthy individuals in long term. Whereas, under controlled conditions success rates are similar. Perioperative anti-infective therapy, such as the supportive administration of antibiotics and chlorhexidine, is the standard nowadays as it seems to improve implant success. Only few studies regarding dental implants in patients with prediabetic conditions are available, indicating a possible negative effect on developing peri-implant diseases but no influence on implant survival. Conclusion Dental implant procedures represent a safe way of oral rehabilitation in patients with prediabetes or diabetes mellitus, as long as appropriate precautions can be adhered to. Accordingly, under controlled conditions there is still no contraindication for dental implant surgery in patients with diabetes mellitus or prediabetic conditions.

Periodontitis and implant complications in diabetes

“…231,232 A very recent systematic review pointed that poorly controlled diabetes mellitus patients have a higher rate of peri-implantitis over time after implant placement and a lower survival rate in the long term than healthy patients do. 233 Furthermore, authors observed that there was no difference in terms of survival rate when considering diabetes mellitus-controlled subjects and that implant success was improved when an adequate perioperative anti-infective therapy, including administration of antibiotics and chlorhexidine, was used. 233 However, some controversial reports also exist.…”

“…Other systematic reviews reported that type 2 diabetes patients are more prone to develop peri‐implant disease and bone loss; additionally, authors found that implant complications increased as glycated hemoglobin levels increased (hyperglycemia; eg, values of 8%), highlighting the importance of maintaining an adequate glycemic control 231,232 . A very recent systematic review pointed that poorly controlled diabetes mellitus patients have a higher rate of peri‐implantitis over time after implant placement and a lower survival rate in the long term than healthy patients do 233 . Furthermore, authors observed that there was no difference in terms of survival rate when considering diabetes mellitus–controlled subjects and that implant success was improved when an adequate perioperative anti‐infective therapy, including administration of antibiotics and chlorhexidine, was used 233 …”

Use of the Probiotic Bifidobacterium animalis subsp. lactis HN019 in Oral Diseases

“…Currently, the use of dental implants in oral rehabilitation is increasing in popularity, because of their ability to address aesthetic and functional needs and due to their durability and high success rates [ 85 ]. However, there are frequent complications with dental implants, such as peri-implant mucositis and peri-implantitis [ 86 , 87 ].…”

Full Arch Implant-Prosthetic Rehabilitation in Patients with Type I Diabetes Mellitus: Retrospective Clinical Study with 10 Year Follow-Up

“…In cases of implant rehabilitation, the incorrect management of the diabetic patient may increase the risk of both intra-operative complications, such as hypoglycemic crisis [ 14 ], and post-operative complications, such as failure of osseointegration, impaired soft tissue healing, mucositis, and peri-implantitis [ 15 , 16 , 17 ].…”