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Title Controlled Diabetic Patients Undergoing Implant Therapy Have Similar Survival Rates Compared to Healthy Individuals
Clinical Question Do diabetic patients desiring implant therapy, compared to non-diabetic patients, have lower implant survival rates?
Clinical Bottom Line Implant therapy can be carried out in healthy and diabetic patients with an expectation of similar survival and success rates. This finding is supported by a systematic review that demonstrated that, in diabetic patients with good glycemic control, implant procedures are safe and predictable with a complication rate similar to that of healthy patients. Frequent recall visits should be done to detect early signs of peri-implantitis in diabetic patients.
Best Evidence (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 27747697Naujokat/20169,614 diabetic and non-diabetic patients who had received dental implant treatment in 22 studiesSystematic review
Key resultsImplant survival rate for diabetic patients ranged from 100% to 96.4% at 1 year and 97.2% to 92% at 5 years in studies with a healthy control; these rates were similar to survival rates in non-diabetic patients. Poorly controlled diabetic patients have shown delayed osseointegration, although after 1 year the success of osseointegration is the same among healthy and diabetic patients. Risk of peri-implantitis is higher in diabetic patients. No difference in the success of bone augmentation procedures was found. HbA1c levels within a normal range indicates good glycemic control, and there was evidence that good glycemic control improves osseointegration and implant survival.
Evidence Search “Diabetes Mellitus and dental implants” [MeSH]
Comments on
The Evidence
The systematic review by Naujoka et al. had strict inclusion and exclusion criteria. A total of 327 articles were identified and screened, out of which 305 articles were excluded based on the title, abstract evaluation, and full-text article. The 22 articles selected were prospective, retrospective and cross-sectional studies. Despite the strict inclusion criteria, all 22 articles studied had a low level of evidence in terms of individual study design; however, all studies were rated as having only low or medium risk of bias. Also, there was a high level of heterogeneity among all articles considered in terms of methods and results. Note that the CAT #634, published in 2011, also addressed the topic of implant failure rates in diabetics and was updated in 2014 with more recent evidence.
Applicability Dentists can deliver dental implant therapy in well-controlled diabetic patients with predictable survival rates. Good glycemic control should be established to to improve the success of osseointegration. Diabetic patients should keep their HbA1c levels within the normal range to decrease the likelihood for complications with implants.
Specialty/Discipline (Oral Surgery) (Periodontics) (Prosthodontics) (Restorative Dentistry)
Keywords Dental implants, diabetes, osseointegration, survival rates
ID# 3320
Date of submission: 07/06/2018spacer
E-mail supneet.wadhwa@ucdenver.edu
Author Supneet Singh Wadhwa
Co-author(s) Bobby Keyvan-Jafari, Domonique Coleman
Co-author(s) e-mail
Faculty mentor/Co-author Ethelyn Thomason
Faculty mentor/Co-author e-mail ethelyn.thomasonlarsen@ucdenver.edu
Basic Science Rationale
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