Title |
Do Endosseous Implants Have Success in Patients With Type II Diabetes Mellitus? |
Clinical Question |
In a patient with type II diabetes mellitus, do endosseous implants have a lower success rate compared to a healthy individual? |
Clinical Bottom Line |
Dental implants placed in patients with type II diabetes mellitus had results ranging from slightly higher failure rates to no significant difference compared to healthy patients. (See Comments on the CAT below) |
Best Evidence |
|
PubMed ID |
Author / Year |
Patient Group |
Study type
(level of evidence) |
16958701 | Kotsovilis/2006 | Diabetic patients as well as animals | Systematic Review | Key results | Within the limits of the existing investigations, experimental studies seem to reveal an impaired bone healing response to implant placement in diabetic animals compared with non-diabetic controls, both quantitatively and qualitatively. The majority of clinical studies tend to indicate that diabetes is no contraindication for implant placement, on condition that it remains under metabolic control. However, definitive guidelines with objective criteria, such as type and duration of diabetes and glucosylated hemoglobin levels, need to be established in the future. | 11885176 | Morris/2000 | 2,632 (91%) implants were placed in non-diabetic patients and 255 (8.8%) in Type 2 patients | Retrospective Analysis | Key results | Type 2 diabetic patients tend to have more failures than non-diabetic patients; however, the influence was marginally significant. | 11151579 | Olson/2000 | 89 male type 2 diabetic subjects | Clinical Trial | Key results | There was no statistically significant difference in failure rates between the 3 different implant systems used in this study. | |
Evidence Search |
Search "Dental Implants"[Mesh] AND "Diabetes Mellitus"[Mesh] Limits: Meta-Analysis Search "Diabetes Mellitus"[Mesh] AND "Dental Implantation, Endosseous"[Mesh] Limits: ReviewSearch "Diabetes Mellitus"[Mesh] AND "Dental Implantation, Endosseous"[Mesh] Limits: Meta-Analysis Search "Diabetes Mellitus"[Mesh] AND "Dental Implantation, Endosseous"[Mesh]Search "Diabetes Mellitus"[Mesh] AND "Dental Implantation, Endosseous"[Mesh] Limits: Randomized Controlled Trial, Search "Diabetes Mellitus"[Mesh] AND "Dental Implantation, Endosseous"[Mesh] Limits: Review, Search "Diabetes Mellitus"[Mesh] AND "Dental Implantation, Endosseous"[Mesh] Limits: Meta-Analysis, Search "Diabetes Mellitus"[Mesh] AND "Dental Implantation, Endosseous"[Mesh]Search ((Garrett[Author]) AND diabetes[MeSH Terms]) AND endosseous implants[MeSH Terms], Search ((Garrett[Author]) AND diabetes[MeSH Terms]) AND implants[MeSH Terms] |
Comments on
The Evidence |
There were comprehensive detailed searches done on the relevant trials. The Kotsovilis et al., (2006) study is a systemic review of RCTs. The Morris article appears to be a retrospective analysis of an existing database that included diabetic and non-diabetic subjects. The Olson article did not have a non-diabetic controls. |
Applicability |
The information generated by this CAT is applicable for Type II Diabetes Mellitus individuals considering dental implants. |
Specialty |
(General Dentistry) (Oral Surgery) (Periodontics) (Prosthodontics) |
Keywords |
|
ID# |
634 |
Date of submission |
05/05/2010 |
E-mail |
koelker@uthscsa.edu |
Author |
Kris Koelker |
Co-author(s) |
|
Co-author(s) e-mail |
|
Faculty mentor |
Thomas Oates, DMD, PhD |
Faculty mentor e-mail |
OATES@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?) |
None available | |
|
Comments and Evidence-Based Updates on the CAT
(FOR PRACTICING DENTISTS', FACULTY, RESIDENTS and/or STUDENTS COMMENTS ON PUBLISHED CATs) |
by Kelly Lemke (San Antonio, TX) on 07/06/2018 See the more recently published CAT #3320 for an update on implant survival rates in diabetic patients. | by Thomas Oates (San Antonio, TX) on 01/13/2014 This comment highlights the limited understanding of this relationship in 2010. There have been multiple publications that have greatly extended our understanding since this time. These findings question the role of hyperglycemia in the survival of dental implants. Please see:
-for a thorough review PMID: 22111901
-recent primary study PMID: 22145978 | by Ray Caesar; Kasia Szozda (San Antonio, TX) on 01/06/2014 The articles referenced in this CAT include: a animal study, a statistically inconclusive study, and a study that indicated patients with type 2 diabetes were more likely to experience dental implant failure. However, since the date of this publication, a review article by Courtney, 2010; 20521447 elucidates the effect of “glycosylated hemoglobin levels (HbA1C)” on rising success of dental implants on patients with Type 2 diabetes. In conjunction with other articles written since the publication of this CAT, evidence has been provided supporting the claim that appropriate therapy significantly improves the likelihood of a successful dental implant. | |