Hurst Dominic
Department of Adult Oral Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK and Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
Evid Based Dent. 2014 Dec;15(4):102-3. doi: 10.1038/sj.ebd.6401057.
PubMed, Web of Science and the Cochrane Oral Health Group Trials Register, www.clinicaltrials.gov, www.centerwatch.com and www.clinicalconnection.com databases. Manual searches of a number of dental journals and the reference lists of identified studies were undertaken.
Human clinical studies comparing implant failure rates in diabetic and non-diabetic patients were considered. Three reviewers independently selected studies.
The definition of implant failure used was complete loss of the implant. Study quality was assessed using the Cochrane risk of bias approach. A narrative summary of the studies and meta-analysis are presented.
Fourteen studies were included (one randomised controlled trial, six controlled clinical trials and seven retrospective analysis); all 14 were considered to be at high risk of bias. Meta-analysis (14 studies) found no significant difference between diabetic and non-diabetic patients; risk ratio of 1.07 (95% CI = 0.80, 1.44)(p = 65). A meta-analysis of two studies found a statistically significant difference (mean difference =0.20, 95% CI = 0.08, 0.31 p = 001;) between diabetic and non-diabetic patients concerning marginal bone loss, favouring non-diabetic patients. Meta-analysis was not possible for postoperative infections.
The results of the present systematic review should be interpreted with caution because of the presence of uncontrolled confounding factors in the included studies. Within the limits of the existing investigations, the difference between the insertion of dental implants in non-diabetic and diabetic patients did not statistically affect the implant failure rates.
PubMed、科学网、Cochrane口腔健康组试验注册库、www.clinicaltrials.gov、www.centerwatch.com以及www.clinicalconnection.com数据库。对一些牙科期刊进行了手工检索，并查阅了已识别研究的参考文献列表。
纳入比较糖尿病患者和非糖尿病患者种植体失败率的人体临床研究。三名评审员独立选择研究。
种植体失败的定义为种植体完全丧失。采用Cochrane偏倚风险评估方法评估研究质量。对研究进行了叙述性总结并进行了荟萃分析。
纳入14项研究（1项随机对照试验、6项对照临床试验和7项回顾性分析）；所有14项研究均被认为存在高偏倚风险。荟萃分析（14项研究）发现糖尿病患者和非糖尿病患者之间无显著差异；风险比为1.07（95%置信区间=0.80, 1.44）（p = 0.65）。两项研究的荟萃分析发现，糖尿病患者和非糖尿病患者在边缘骨丢失方面存在统计学显著差异（平均差异=0.20, 95%置信区间=0.08, 0.31；p = 0.001），非糖尿病患者更具优势。术后感染无法进行荟萃分析。
由于纳入研究中存在未控制的混杂因素，本系统评价的结果应谨慎解读。在现有研究的范围内，非糖尿病患者和糖尿病患者植入牙种植体的差异在统计学上并未影响种植体失败率。
