title: A critical review of diabetes, glycemic control, and dental implant therapy.
abstract: OBJECTIVE
  To systematically examine the evidence guiding the use of implant therapy relative to glycemic control for patients with diabetes and to consider the potential for both implant therapy to support diabetes management and hyperglycemia to compromise implant integration.
  
  
  METHODS
  A systematic approach was used to identify and review clinical investigations directly assessing implant survival or failure for patients with diabetes. A MEDLINE (PubMED) database search identified potential articles for inclusion using the search strategy: (dental implants OR oral implants) AND (diabetes OR diabetic). Inclusion in this review required longitudinal assessments including at least 10 patients, with included articles assessed relative to documentation of glycemic status for patients.
  
  
  RESULTS
  Although the initial search identified 129 publications, this was reduced to 16, for inclusion. Reported implant failure rates for diabetic patients ranged from 0% to 14.3%. The identification and reporting of glycemic control was insufficient or lacking in 13 of the 16 studies with 11 of these enrolling only patients deemed as having acceptable glycemic control, limiting interpretation of findings relative to glycemic control. Three of the 16 studies having interpretable information on glycemic control failed to demonstrate a significant relationship between glycemic control and implant failure, with failure rates ranging from 0% to 2.9%.
  
  
  CONCLUSIONS
  Clinical evidence is lacking for the association of glycemic control with implant failure while support is emerging for implant therapy in diabetes patients with appropriate accommodations for delays in implant integration based on glycemic control. The role for implants to improve oral function in diabetes management and the effects of hyperglycemia on implant integration remain to be determined.
authors: Department of Periodontics, University of Texas Health Science Center at San Antonio, San Antonio, TX 78229-3900, USA. oates@uthscsa.edu
authors: Thomas W
authors: TW
authors: Oates
authors: Guy
authors: G
authors: Huynh-Ba
authors: Adriana
authors: A
authors: Vargas
authors: Peggy
authors: P
authors: Alexander
authors: Jocelyne
authors: J
authors: Feine
mesh_terms: D001786:Blood Glucose / Q000032:analysis; D017742:Dental Care for Chronically Ill / Q000379:methods*; D003758:Dental Implantation, Endosseous; D015921:Dental Implants; D019232:Dental Restoration Failure; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000517:prevention & control; D006801:Humans; D006943:Hyperglycemia / Q000150:complications* / Q000517:prevention & control
chemical_list: D001786:Blood Glucose; D015921:Dental Implants