Abstract
Diabetes is an important modifying factor of periodontitis, but its association with peri-implant diseases has not been fully explored and the existing literature reports controversial results. The aim of this retrospective study was to evaluate the influence of diabetes on peri-implantitis and implant failure. Smoking status, history of periodontal disease, presence of diabetes, diabetes type, therapy and glycaemia levels were collected in a total of 204 subjects treated with 929 implants, with a mean follow-up time of 5.7 ± 3.82 years after loading. Odds ratio (OR) for diabetes as a direct cause of peri-implantitis and implant failure were calculated, adjusted for smoking status and history of periodontitis. Nineteen patients were diabetic and most of them presented a good control of the disease at the time of surgery. The overall patient-level prevalence of peri-implantitis was 11.3%. Among diabetic patients, one developed peri-implantitis, whereas one experienced multiple implant failures. The calculated ORs, adjusted for smoking status and periodontitis, were not statistically significant. The results revealed no association between diabetes and peri-implantitis or implant failure coherently with the existing scientific literature. The actual influence of hyperglycemia on implant failure is still uncertain and new studies with larger cohorts of patients are needed.
Highlights
In the last few decades, the scientific evidence on biofilm-related inflammatory peri-implant diseases has substantially increased
The results of our study revealed no association between diabetes and the occurrence of peri-implantitis, finding an insignificant
A meta-analysis published by Monje et al in 2017 [10] calculated that both the Odds ratio (OR) and RR for peri-implantitis were statistically higher in hyperglycemia than in normoglycemia; such meta-analysis could not evaluate the impact of smoking and glycemic level because of the lack of information from the included studies
Summary
In the last few decades, the scientific evidence on biofilm-related inflammatory peri-implant diseases has substantially increased. Peri-implantitis, which leads to progressive marginal bone loss around implants, represents the main cause of late implant failure. A new definition has been settled for peri-implantitis in the World Workshop on Periodontology (WWP) in 2017 [1], where the diagnosis of peri-implantitis required: (a) the presence of bleeding and/or suppuration on gentle probing; (b) an increased probing depth compared to previous examinations (in the absence of previous examination: PD ≥ 6 mm); (c) further bone loss as compared to the initial bone remodeling (in the absence of previous examination: bone levels ≥3 mm apical of the most coronal portion of the intraosseous part of the implant). History of periodontitis and low hygiene levels are proven risk factors for peri-implantitis, while the role of other factors, including smoking status and diabetes, is still unclear. Diabetes mellitus (DM) comprises a group of metabolic disorders characterized by
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