J Am Dent Assoc. 2021 Mar;152(3):189-201.e1. doi: 10.1016/j.adaj.2020.11.015.
The impact of hyperglycemia on dental implant therapy remains unclear. In this systematic review and meta-analysis, the authors compared the rates of implant failure and peri-implant bleeding on probing (BOP), probing depth (PD), and peri-implant bone loss (PIBL) among patients with type 2 diabetes mellitus and nondiabetic patients. The authors performed subgroup analyses based on glycemic level to evaluate whether patients with higher glycemic levels were more prone to peri-implant inflammation.
The authors searched 4 databases for original clinical studies. Studies in which the researchers provided information on the rate of implant failure or peri-implant parameters were included.
Nine clinical studies were identified on the basis of the inclusion criteria. No significant differences were found in rates of implant failure (P = .46) and PD (P = .1) between diabetic and nondiabetic patients. Significant differences in BOP (P < .00001) and PIBL (P = .02), favoring nondiabetic patients, were observed. Results of subgroup analyses indicated that the increase in glycemic level did not significantly influence BOP, PD, and PIBL values among diabetic patients.
Patients with type 2 diabetes mellitus seem to be able to achieve a rate of implant survival similar to that of healthy patients. Regarding peri-implant parameters, BOP and PIBL were higher in patients with type 2 diabetes mellitus, indicating that hyperglycemia is an important risk factor for peri-implant inflammation. No association was found between peri-implant parameters and glycemic level among patients with type 2 diabetes mellitus, providing oral hygiene was strictly maintained.
高血糖对牙种植体治疗的影响尚不清楚。在这项系统评价和荟萃分析中,作者比较了 2 型糖尿病患者和非糖尿病患者的种植体失败率以及探诊时的牙周袋探诊深度(BOP)、探诊深度(PD)和种植体周围骨丧失(PIBL)。作者根据血糖水平进行了亚组分析,以评估血糖水平较高的患者是否更容易发生种植体周围炎症。
作者检索了 4 个数据库中的原始临床研究。纳入了提供种植体失败率或种植体周围参数信息的研究。
根据纳入标准,确定了 9 项临床研究。糖尿病患者和非糖尿病患者的种植体失败率(P=0.46)和 PD(P=0.1)无显著差异。非糖尿病患者的 BOP(P<0.00001)和 PIBL(P=0.02)显著较高。亚组分析结果表明,血糖水平的升高并没有显著影响糖尿病患者的 BOP、PD 和 PIBL 值。
2 型糖尿病患者似乎能够达到与健康患者相似的种植体存活率。就种植体周围参数而言,BOP 和 PIBL 在 2 型糖尿病患者中更高,表明高血糖是种植体周围炎症的一个重要危险因素。在保持良好口腔卫生的前提下,2 型糖尿病患者的种植体周围参数与血糖水平之间没有关联。