title: Association between diabetes mellitus/hyperglycaemia and peri-implant diseases: Systematic review and meta-analysis.
abstract: OBJECTIVE
  This systematic review investigates whether hyperglycaemia/diabetes mellitus is associated with peri-implant diseases (peri-implant mucositis and peri-implantitis).
  
  
  METHODS
  Electronic and manual literature searching was conducted. An a priori case definition for peri-implantitis was used as an inclusion criterion to minimize risk of bias. The Newcastle-Ottawa Scale was used for quality assessment; random effect models were applied; and results were reported according to the PRISMA Statement.
  
  
  RESULTS
  Twelve studies were eligible for qualitative and seven of them for quantitative analyses. Meta-analyses detected the risk of peri-implantitis was about 50% higher in diabetes than in non-diabetes (RR = 1.46; 95% CI: 1.21-1.77 and OR = 1.89; 95% CI: 1.31-2.46; z = 5.98; p < .001). Importantly, among non-smokers, those with hyperglycaemia had 3.39-fold higher risk for peri-implantitis compared with normoglycaemia (95% CI: 1.06-10.81). Conversely, the association between diabetes and peri-implant mucositis was not statistically significant (RR = 0.92; 95% CI: 0.72-1.16 and OR = 1.06; 95% CI: 0.84-1.27; z = 1.06, p = .29).
  
  
  CONCLUSIONS
  Within its limits that demand great caution when interpreting its findings, this systematic review suggests that diabetes mellitus/hyperglycaemia is associated with greater risk of peri-implantitis, independently of smoking, but not with peri-implant mucositis.
authors.affiliation: Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI, USA.|Department of Oral Surgery and Stomatology, ZMK School of Dental Medicine, University of Bern, Bern, Switzerland.
authors.forename: Alberto
authors.identifier: http://orcid.org/0000-0001-8292-1927
authors.initials: A
authors.lastname: Monje
authors.affiliation: Department of Experimental Psychology, University of Granada, Granada, Spain.
authors.forename: Andres
authors.initials: A
authors.lastname: Catena
authors.affiliation: Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI, USA.
authors.forename: Wenche S
authors.identifier: http://orcid.org/0000-0003-3593-093X
authors.initials: WS
authors.lastname: Borgnakke
mesh_terms: D006801:Humans; D016208:Databases, Factual; D015921:Dental Implants; D019232:Dental Restoration Failure; D048909:Diabetes Complications; D003920:Diabetes Mellitus; D006943:Hyperglycemia / Q000150:complications; D052016:Mucositis / Q000209:etiology; D057873:Peri-Implantitis / Q000453:epidemiology / Q000209:etiology; D012307:Risk Factors; D012907:Smoking
chemical_list: D015921:Dental Implants
keywords: dental implants; diabetes complications; epidemiology; gestational diabetes; glycosylated; haemoglobin A; humans; review; systematic