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Table 1 List of the included studies and its main characteristics

From: Dental implants and diabetes mellitus—a systematic review

Author Year Study type Diabetes type Control Diabetes therapy Glycemic control [HbA1c %] Duration of diabetes (years) Number of patients Number of implants Duration of study (years) Implant survival [%] Conclusion
Alsaadi 2007 Retrospective Type II Non-diabetes n.d. n.d. n.d. 2004 (overall) 6946 (overall) 6 months 96.4 (global) Diabetes does not cause higher failure rate in the first 6 months.
Aguilar-Salvatierra 2015 Prospective Type II 3 groups (HbA1c) n.d. 6–8 (well), 8–10 (moderately), >10 (poorly) n.d. 85 85 2 100 vs. 96.6 vs. 86.3 Patients with diabetes can receive implant-based treatments, providing they present moderate HbA1c values. Peri-implantitis increases with elevated HbA1c.
Anner 2010 Retrospective n.d. Non-diabetes n.d. n.d. n.d. 49 diabetes, 475 overall 1626 3 ± 2 97.2 vs. 95 Diabetes was not related to implant survival in this patient cohort.
Busenlechner 2014 Retrospective n.d. Non-diabetes n.d. n.d. n.d. 4316 >10,000 8 years 95.1 vs. 97 Diabetes does not have any influence on implant survival after 8 years, if blood sugar is effectively controlled.
Daubert 2015 Cross-sectional n.d. Non-diabetes n.d. n.d. n.d. 8 diabetes, 96 overall 225 10 n.d. Significant associations between implant failure and diabetes (relative risk 4.8 and 3.3) and peri-implant diseases and diabetes (relative risk 4.1).
Dowell 2007 Prospective Type II Non-diabetes Diet, oral, insulin and combination 6–8 (well), 8–10 (moderately), >10 (poorly) n.d. 25 diabetes, 10 non-diabetes 38 diabetes, 12 non-diabetes 4 months 100 Diabetes has no negative influence; the quality of glycemic control has no effect on implant success.
Erdogan 2014 Prospective Type II Non-diabetes n.d. Mean 6.8 7.5 12 diabetes, 12 control 43 1 100 No significant difference for wound healing, radiographic findings, implant success and volume of augmentation (guided bone regeneration with bone scrapes and bone substitute material).
Ferreira 2006 Cross-sectional n.d. Non-diabetes n.d. Blood sugar >126 mg/dl or diabetic medication subscribed n.d. 212 (overall) 578 (overall) 6 months–5 years n.d. Risk for peri-implantitis in “uncontrolled” diabetes is 1.9 times higher compared to the non-diabetes group.
Fiorellini 2000 Retrospective Types I and II None n.d. “Proper levels of glycemic control” 8.9 ± 14.3 40 215 6.5 85.6 Survival rate is lower than for general population, but there is still a reasonable success rate. Most implant failures are in the first year after loading.
Ghiraldini 2015 Prospective Type II Non-diabetes n.d. <8 (better) >8 (poorly) 10.7 ± 5 16 better, 16 poorly, 19 control 51 1 100 Poor glycemic control negatively modulated the bone factors during healing, although diabetes (regardless of glycemic control) had no effect on implant stabilization.
Gomez-Moreno 2014 Prospective Type II 4 groups (HbA1c) n.d. <6 (healthy), 6–8 (well), 8–10 (moderately) >10 (poorly) n.d. 67 67 3 n.d. Elevated HbA1c causes more bone loss (not significant) and significantly higher BOP. Probing depth is not influenced by glycemic control.
Khandelwal 2011 Prospective Type II 2 different types of implants n.d. 7.5–11.4 (poorly controlled) n.d. 24 48 4 months 98 Successful implant therapy in patients suffering poorly controlled diabetes. No difference between the two implant systems.
Morris 2005 Prospective Type II Non-diabetes n.d. n.d. n.d. 663 255 diabetes, 2632 non-diabetes 3 92.2 and 93.2, respectively Diabetic patients tend to have more failures than non-diabetic patients. The use of CHX resulted in a slight improvement in survival in non-diabetic patients and in a greater improvement in type II patients, the same effect for antibiotic use.
Moy 2005 Retrospective n.d. Non-diabetes n.d. n.d. n.d. 48 diabetes, 1140 overall 4684 (overall) up to 20 n.d. Significantly increased relative risk for implant failure (relative risk = 2.75).
Oates 2009 Prospective Type II Non-diabetes Diet, oral, insulin and combination 6–8 (well), 8–10 (moderately), >10 (poorly) n.d. 32 42 4 months   Patients with poorly controlled HbA1c have lower stability in the first 2–6 weeks, but it reaches the baseline in the following weeks. But reaching the baseline takes two times the duration it needs in the non-diabetic group.
Oates 2014 Prospective Type II Non-diabetes n.d. 6–8 (well), >8 (poorly) n.d. 44 well, 19 poorly, 49 control 220 1 99 The initial implant stability is lower in diabetic patient, but 1 year after insertion there in so difference even in the poorly controlled group. Diabetes has no influence on implant survival.
Olson 2000 Prospective, multicenter Type II None Diet, oral, insulin and combination n.d. n.d. 89 178 5 91 vs. 88 Implants in mandibular symphysis in diabetic patient are a predictable procedure. Duration of diabetes may be associated with implant failure, CHX improves implant survival.
Peled 2003 Retrospective Type II None n.d. “Well-controlled,” no data for HbA1c n.d. 41 141 1 and 5 97.3 vs. 94.4 No correlation was found between failed implants and glucose level. The clinical outcome of dental implants in a selected group of patients with well-controlled type II diabetes mellitus is satisfying and encouraging.
Tawil 2008 Prospective Type II Non-diabetes n.d. <7 (well), 7–9 (moderately), >9 (poorly) mean 7.2 n.d. 54 diabetes, 54 control 255 diabetes, 244 control 1 to 12 97.2 vs. 98.8 No significant difference for implant survival between the groups and no difference between good and medium glycemic control for bone resorption. Augmentations caused no complications. Duration of diabetes was no confounder.
Tatarakis 2013 Prospective Type II None n.d. Mean 7.1 n.d. 32 >32 1 n.d. The clinical, microbiological, salivary biomarkers and psychosocial profiles of patient with diabetes under good control are very similar to those of non-diabetes.
Turkyilmaz 2010 Retrospective Type II None Diet, oral, insulin and combination 5–10 5–21 10 23 1 100 No evidence of diminished clinical success, BOP negative, no pathological probing depth, marginal bone loss 0.3 ± 0.2 mm.
Zupnik 2011 Retrospective n.d. Non-diabetes n.d. n.d. n.d. n.d. 25 diabetes, 316 non-diabetes 4 96.4 (global) Implant failure (explantation) is 2.57 times higher for patient with diabetes than patients without diabetes after 4 years.
  1. n.d. no data provided