Does a higher glycemic level lead to a higher rate of dental implant failure?: A meta-analysis

Abstract

Background: 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.

Types of studies reviewed: 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.

Results: 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).

Conclusions and practical implications: 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.

Keywords: Uncontrolled diabetes; dental implant failure; glycemic control; meta-analysis.