Periodontitis, type 2 diabetes, and other risk factors for implant failure: A nested case-control study.

BACKGROUND

Type 2 diabetes (T2DM) and periodontitis have been suggested as risk factors for dental implant failure, but data supporting such a link are limited. This study investigates the association between T2DM and periodontitis and the risk of dental implant failure.

METHODS

A nested case-control study with a risk-set sampling scheme was performed. Implant failure cases (550 failed implants in 328 subjects) and controls (1156 implants in 502 subjects) with a mean of 59.07 months follow-up were identified and information on patient-related factors was collected from patient records. Univariate analysis was used to estimate odds ratios (ORs) and 95% confidence intervals (CI) between cases and controls. The impact of covariates and risk factors for implant failure was evaluated by multiple logistic regression.

RESULTS

The likelihood of implant failure was significantly elevated in smokers (OR = 2.70, 95% CI: 1.60-4.57), patients with T2DM (OR = 1.70, 95% CI: 1.11-2.61), and those with periodontitis (OR = 12.82, 95% CI: 7.12-23.08). The use of immunosuppressive medication also correlated with higher failure rates (OR = 2.75, 95% CI: 1.31-5.76). Stage III and IV periodontitis were associated with higher likelihood of implant failure, independent of T2DM and smoking (OR = 1.64, 95% CI: 1.24-2.18). Multivariate analysis identified independent risk factors, including periodontitis history, smoking, osteoporosis, and statin use, while adherence to periodontal maintenance significantly reduced failure risks. Implant placement in the maxilla short implant length (≤10 mm), and smoking were associated with early implant failure.

CONCLUSION

Our study findings substantiate the association between T2DM and periodontitis with an increased risk of dental implant failure. Our analysis underscores the influence of various patient-related factors, including the use of immunosuppressive medications, smoking, and patient compliance, on the likelihood of implant failure.

PLAIN LANGUAGE SUMMARY

People with type 2 diabetes or gum disease (also known as periodontitis) may face a higher chance of dental implants failing, but until now, evidence has been limited. This study looked at hundreds of people who had dental implants to see which factors might be linked to implant problems. It found that individuals who smoke, have diabetes, or have gum disease-especially advanced gum disease-are more likely to experience implant failure. Other health factors like taking immune-suppressing medications, having osteoporosis, or using certain medications like statins also played a role. However, patients who kept up with regular dental cleanings and checkups were less likely to lose their implants. This research highlights the importance of managing health conditions and staying on top of dental care to improve the chances of successful dental implants.