title: Diabetes and oral implant failure: a systematic review.
abstract: The aim of this systematic review and meta-analysis was to investigate whether there are any effects of diabetes mellitus on implant failure rates, postoperative infections, and marginal bone loss. An electronic search without time or language restrictions was undertaken in March 2014. The present review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Eligibility criteria included clinical human studies. The search strategy resulted in 14 publications. The I (2) statistic was used to express the percentage of total variation across studies due to heterogeneity. The inverse variance method was used for the random effects model when heterogeneity was detected or for the fixed effects model when heterogeneity was not detected. The estimates of an intervention for dichotomous outcomes were expressed in risk ratio and in mean difference in millimeters for continuous outcomes, both with a 95% confidence interval. There was a statistically significant difference (p = .001; mean difference = 0.20, 95% confidence interval = 0.08, 0.31) between diabetic and non-diabetic patients concerning marginal bone loss, favoring non-diabetic patients. A meta-analysis was not possible for postoperative infections. The difference between the patients (diabetic vs. non-diabetic) did not significantly affect implant failure rates (p = .65), with a risk ratio of 1.07 (95% confidence interval = 0.80, 1.44). Studies are lacking that include both patient types, with larger sample sizes, and that report the outcome data separately for each group. The results of the present meta-analysis should be interpreted with caution because of the presence of uncontrolled confounding factors in the included studies.
authors.affiliation: Department of Prosthodontics, Faculty of Odontology, Malmö University, Malmö, Sweden bruno.chrcanovic@mah.se brunochrcanovic@hotmail.com.
authors.forename: B R
authors.initials: BR
authors.lastname: Chrcanovic
authors.affiliation: Department of Prosthodontics, Faculty of Odontology, Malmö University, Malmö, Sweden Department of Biomaterials, Göteborg University, Göteborg, Sweden.
authors.forename: T
authors.initials: T
authors.lastname: Albrektsson
authors.affiliation: Department of Prosthodontics, Faculty of Odontology, Malmö University, Malmö, Sweden.
authors.forename: A
authors.initials: A
authors.lastname: Wennerberg
mesh_terms: D016301:Alveolar Bone Loss / Q000209:etiology; D015921:Dental Implants; D019232:Dental Restoration Failure; D048909:Diabetes Complications; D006801:Humans; D013530:Surgical Wound Infection / Q000209:etiology
chemical_list: D015921:Dental Implants
keywords: blood glucose; dental implants; diabetes mellitus; infection; meta-analysis; periodontal bone loss