Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI, USA.
Department of Oral Surgery and Stomatology, ZMK School of Dental Medicine, University of Bern, Bern, Switzerland.
J Clin Periodontol. 2017 Jun;44(6):636-648. doi: 10.1111/jcpe.12724. Epub 2017 May 5.
This systematic review investigates whether hyperglycaemia/diabetes mellitus is associated with peri-implant diseases (peri-implant mucositis and peri-implantitis).
Electronic and manual literature searching was conducted. An a priori case definition for peri-implantitis was used as an inclusion criterion to minimize risk of bias. The Newcastle-Ottawa Scale was used for quality assessment; random effect models were applied; and results were reported according to the PRISMA Statement.
Twelve studies were eligible for qualitative and seven of them for quantitative analyses. Meta-analyses detected the risk of peri-implantitis was about 50% higher in diabetes than in non-diabetes (RR = 1.46; 95% CI: 1.21-1.77 and OR = 1.89; 95% CI: 1.31-2.46; z = 5.98; p < .001). Importantly, among non-smokers, those with hyperglycaemia had 3.39-fold higher risk for peri-implantitis compared with normoglycaemia (95% CI: 1.06-10.81). Conversely, the association between diabetes and peri-implant mucositis was not statistically significant (RR = 0.92; 95% CI: 0.72-1.16 and OR = 1.06; 95% CI: 0.84-1.27; z = 1.06, p = .29).
Within its limits that demand great caution when interpreting its findings, this systematic review suggests that diabetes mellitus/hyperglycaemia is associated with greater risk of peri-implantitis, independently of smoking, but not with peri-implant mucositis.
本系统综述旨在调查高血糖/糖尿病是否与种植体周围疾病(种植体周围黏膜炎和种植体周围炎)相关。
进行了电子和手动文献检索。采用种植体周围炎的预先设定病例定义作为纳入标准,以最大程度降低偏倚风险。使用纽卡斯尔-渥太华量表进行质量评估;应用随机效应模型;并根据 PRISMA 声明报告结果。
有 12 项研究符合定性分析的纳入标准,有 7 项研究符合定量分析的纳入标准。荟萃分析发现,糖尿病患者发生种植体周围炎的风险比非糖尿病患者高约 50%(RR=1.46;95%CI:1.21-1.77 和 OR=1.89;95%CI:1.31-2.46;z=5.98;p<.001)。重要的是,在不吸烟者中,与血糖正常者相比,血糖升高者发生种植体周围炎的风险高 3.39 倍(95%CI:1.06-10.81)。相反,糖尿病与种植体周围黏膜炎之间的关联无统计学意义(RR=0.92;95%CI:0.72-1.16 和 OR=1.06;95%CI:0.84-1.27;z=1.06,p=0.29)。
在需要高度谨慎解读其研究结果的限制范围内,本系统综述表明,糖尿病/高血糖与种植体周围炎的风险增加相关,这与吸烟无关,但与种植体周围黏膜炎无关。