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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) 19905942 | Javed/2009 | Humans and diabetes- induced animal models | Systematic Review | Key results | The 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) 11915551 | Abdulwassie/2002 | 25 controlled diabetic patients, 10 men and 15 women | Clinical Study | Key results | Diabetes 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) 19407159 | Oates/2009 | 10 non-diabetic subjects and 20 subjects with type II diabetes | Clinical Study | Key results | This 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 ReviewsLimits: Meta-AnalysisSearch "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: |
03/18/2011 Revised: 02/02/2012 |
E-mail |
twining@livemail.uthscsa.edu |
Author |
Vanessa Twining |
Co-author(s) |
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Co-author(s) e-mail |
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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 and Evidence-Based Updates on the CAT
(FOR PRACTICING DENTISTS', FACULTY, RESIDENTS and/or STUDENTS COMMENTS ON PUBLISHED CATs) |
post a comment |
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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