Shi Quan, Xu Juan, Huo Na, Cai Chuan, Liu Hongchen
J Am Dent Assoc. 2016 Nov;147(11):875-881. doi: 10.1016/j.adaj.2016.06.011. Epub 2016 Jul 18.
Owing to limited evidence, it is unclear whether diabetes that is not well controlled would lead to a higher rate of dental implant failure. The authors of this meta-analysis evaluated whether the failure rate for patients with diabetes that was not well controlled was higher than the failure rate for patients with well-controlled diabetes.
The authors searched PubMed, the Cochrane Library, and ClinicalTrials.gov without limitations for studies whose investigators compared the dental implant failure rates between patients with well-controlled diabetes and diabetes that was not well controlled. The authors pooled the relative risk (RR) and 95% confidence interval (CI) values to estimate the relative effect of the glycemic level on dental implant failures. The authors used a subgroup analysis to identify the association between the implant failure rate and the stage at which the failure occurred.
The authors included 7 studies in this meta-analysis, including a total of 252 patients and 587 dental implants. The results of the pooled analysis did not indicate a direct association between the glycemic level in patients with diabetes and the dental implant failure rate (RR, 0.620; 95% CI, 0.225-1.705). The pooled RR in the subgroup of patients who experienced early implant failure was 0.817 (95% CI, 0.096-6.927), whereas in the subgroup of patients who experienced late implant failure, the pooled RR was 0.572 (95% CI, 0.206-1.586).
On the basis of the evidence, the results of this meta-analysis failed to show a difference in the failure rates for dental implants between patients with well-controlled diabetes and patients with diabetes that was not well controlled. However, considering the limitations associated with this meta-analysis, the authors determined that future studies that are well designed and provide adequate controls for confounding factors are required.
由于证据有限，血糖控制不佳的糖尿病是否会导致更高的牙种植失败率尚不清楚。本荟萃分析的作者评估了血糖控制不佳的糖尿病患者的失败率是否高于血糖控制良好的糖尿病患者。
作者对PubMed、Cochrane图书馆和ClinicalTrials.gov进行了无限制检索，以查找研究者比较血糖控制良好的糖尿病患者和血糖控制不佳的糖尿病患者之间牙种植失败率的研究。作者汇总相对风险（RR）和95%置信区间（CI）值，以估计血糖水平对牙种植失败的相对影响。作者采用亚组分析来确定种植失败率与失败发生阶段之间的关联。
作者在本荟萃分析中纳入了7项研究，共涉及252例患者和587颗牙种植体。汇总分析结果未表明糖尿病患者的血糖水平与牙种植失败率之间存在直接关联（RR，0.620；95%CI，0.225 - 1.705）。早期种植失败患者亚组的汇总RR为0.817（95%CI，0.096 - 6.927），而晚期种植失败患者亚组的汇总RR为0.572（95%CI，0.206 - 1.586）。
基于现有证据，本荟萃分析结果未能显示血糖控制良好的糖尿病患者和血糖控制不佳的糖尿病患者在牙种植失败率上存在差异。然而，考虑到本荟萃分析的局限性，作者认为需要未来设计良好并对混杂因素提供充分对照的研究。
