Diabetes mellitus is associated with increased periodontal disease and tooth loss, resulting in the need for dental implants. But the disease then also has an impact on marginal bone loss, according to researchers from Pernambuco University and São Paulo State University.
Using a combination of free and medical subject headings terms, along with a manual search, the researchers found 130 systematic reviews from several databases. Based on their eligibility criteria, six reviews published between 2009 and 2007 with seven to 22 studies each were selected for analysis.
Next, the researchers examined whether diabetes influences dental implant survival rate and marginal bone loss. The Glenny and Assessing the Methodological Quality of Systematic Reviews 2 (AMSTAR 2) scales also were used to assess the quality of the reviews.
Four of the six reviews showed a negative change in marginal bone loss in diabetic patients. The researchers believe that diabetes may cause more marginal bone loss due to an inflammatory response that leads to an increase in the number of osteoclasts, or cells that resorb bone.
The study did not find different dental implant survival rates between diabetic and nondiabetic patients, but the researchers did note previous research showing that diabetes increases the risk of microvascular complications and peri-implantitis, which can contribute to implant failure.
Therefore, the researchers concluded, controlling glycemia levels in diabetic patients likely results in an increased number of osteoblasts, or cells that produce new bone. The increase in osteoblast numbers would improve implant outcomes through enhanced structural connections between the bone and implant.
The researchers also highlight the Glenny and AMSTAR scales, which report the quality of a systematic review. One limitation of this overview, they said, is the control of several risk factors accounting for bias. Also, they added, more conclusions about the studies could have been drawn if detailed information such as diabetes type and implant location had been included.
Reviews are valuable to doctors and policymakers because they summarize current research and provide information about its quality, the researchers said. This review has shown that patients with diabetes may experience a negative effect in marginal bone levels, they added, which can help clinicians guide patients in making appropriate treatment decisions.
The study, “Influence of Diabetes on the Survival Rate and Marginal Bone Loss of Dental Implants: An Overview of Systematic Reviews,” was published by the Journal of Oral Implantology.
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