James Yashab, Butt Wajeeh Mohsin M, Shahid Habiba, Ahmad Shayzmin, Imran Muhammad Talha Bin, Anthony Nouman
Dentistry, Abbottabad Medical College, Peshawar, PAK.
Dentistry, Pakistan Institute of Medical Sciences, Islamabad, PAK.
Cureus. 2024 Dec 25;16(12):e76361. doi: 10.7759/cureus.76361. eCollection 2024 Dec.
This systematic review evaluates the success rates of dental implants in patients with type 2 diabetes mellitus, focusing on outcomes such as implant survival, marginal bone loss, and peri-implant biomarkers. A comprehensive literature search was conducted across multiple databases, including PubMed, Cochrane, Embase, Scopus, and Web of Science, to identify relevant systematic reviews and meta-analyses. Four studies were included, encompassing diverse populations and interventions. Findings indicate that diabetes, when well-managed (HbA1c < 8%), does not significantly compromise implant survival rates, with survival percentages ranging from 96.1% to 97.3% at one year and 87.3% to 96.1% at five years, comparable to non-diabetic populations. However, peri-implant health metrics, such as marginal bone loss (mean difference: -0.08 mm; 95% CI: -0.25 to 0.08) and probing depth, were adversely affected in poorly controlled diabetes (HbA1c > 8%), highlighting the critical role of glycemic control. Advanced statistical approaches, including dose-response relationships, revealed a progressive worsening of peri-implant outcomes as HbA1c levels increased. The review underscores the importance of interdisciplinary care and strict adherence to clinical protocols to optimize outcomes for diabetic patients receiving dental implants. Despite robust findings, limitations include heterogeneity among included studies and the need for long-term data to validate the observed trends. Future research should focus on standardized reporting and exploring the impact of advanced glycemic thresholds on implant success.
本系统评价评估了2型糖尿病患者牙种植体的成功率，重点关注种植体存活率、边缘骨丢失和种植体周围生物标志物等结果。在多个数据库中进行了全面的文献检索，包括PubMed、Cochrane、Embase、Scopus和Web of Science，以识别相关的系统评价和荟萃分析。纳入了四项研究，涵盖了不同的人群和干预措施。研究结果表明，当糖尿病得到良好控制（糖化血红蛋白<8%）时，不会显著影响种植体存活率，一年时的存活率为96.1%至97.3%，五年时为87.3%至96.1%，与非糖尿病人群相当。然而，在控制不佳的糖尿病（糖化血红蛋白>8%）中，种植体周围健康指标，如边缘骨丢失（平均差异：-0.08mm；95%置信区间：-0.25至0.08）和探诊深度，受到不利影响，突出了血糖控制的关键作用。包括剂量反应关系在内的先进统计方法表明，随着糖化血红蛋白水平的升高，种植体周围结果逐渐恶化。该评价强调了跨学科护理和严格遵守临床方案对于优化接受牙种植体的糖尿病患者结局的重要性。尽管有确凿的研究结果，但局限性包括纳入研究之间的异质性以及需要长期数据来验证观察到的趋势。未来的研究应侧重于标准化报告，并探索先进血糖阈值对种植体成功的影响。
