ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM
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Title Reduced Implant Efficacy In Diabetic Patients with Poor Glycemic Control Compared with Patients with Good Metabolic Control
Clinical Question In a patient with type II diabetes mellitus, does poor glycemic control have a significant impact on the implant survival rate at 5 years as compared with that of a glycemic well-controlled patient?
Clinical Bottom Line Poor glycemic control has a negative effect on dental implant osseointegration. (See Comments on the CAT below)
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) 19905942Javed/2009Humans and diabetes- induced animal modelsSystematic Review
Key resultsThe included studies reported that poorly controlled diabetes negatively affects implant osseointegration. In diabetic patients with normal serum glycemic blood values osseointegration can successfully occur. Also, the use of antiseptic mouthrinses and oral-hygiene and maintenance protocols can help in obtaining successful dental implant osseointegration.
#2) 11915551Abdulwassie/200225 controlled diabetic patients, 10 men and 15 womenClinical Study
Key resultsDiabetes mellitus is no longer considered to be a contraindication for implant-supported prostheses, provided that the patient’s blood sugar is under control, and that there is motivation for oral hygiene procedures. This study shows a high success rate that can be achieved if treatment is properly planned, executed, and followed-up.
#3) 19407159Oates/200910 non-diabetic subjects and 20 subjects with type II diabetesClinical Study
Key resultsThis study demonstrates alterations in implant stability consistent with impaired implant integration for persons with type II diabetes mellitus in direct relation to hyperglycemic conditions. The findings of the current study are consistent with reports from previous studies that have demonstrated that hyperglycemic conditions lead to alterations in bone physiology. The results justify the continued investigation of the effects of diabetes and glycemic control on bone metabolism, as well as the longer-term effects of glycemic control on implant integration, success, and complications for persons with type II diabetes. Findings from this study and future studies must be consider potential increased risk for long-term complications, such as peri-implant inflammation and bone loss.
Evidence Search Randomized Controlled Trial Limits: Systematic Reviews Limits: Meta-Analysis Search "Diabetes Mellitus, Type 2"[Mesh] Search "Blood Glucose"[Mesh]Search "Hyperglycemia"[Mesh] Search "Glycemic Index"[Mesh]Search "Dental Implantation"[Mesh]Search "Dental Implants"[Mesh]
Comments on
The Evidence
There was a general consensus that patients with well-controlled diabetes have similar success rates for dental implants as individuals without diabetes.
Applicability Successful dental implant osseointegration and high implant survival rates can be accomplished in subjects with diabetes with good metabolic control.
Specialty/Discipline (General Dentistry) (Periodontics)
Keywords Dental implants, diabetes mellitus, hyperglycemia
ID# 800
Date of submission: 03/18/2011spacer Revised: 02/02/2012
E-mail twining@livemail.uthscsa.edu
Author Vanessa Twining
Co-author(s)
Co-author(s) e-mail
Faculty mentor/Co-author Richard Finlayson, DDS
Faculty mentor/Co-author e-mail finlaysonr@uthscsa.edu
Basic Science Rationale
(Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?)
post a rationale
None available
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Comments on the CAT
(FOR PRACTICING DENTISTS' and/or FACULTY COMMENTS ON PUBLISHED CATs)
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by Talal T. Al-Rasheed & Abdulmohsen Alqasir (Riyadh) on 06/25/2014
A PubMed and TRIP data base search has been done in June 2014 and we did not find any new articles related to the clinical question.
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