Diabetic Patients: Are You a Candidate for Dental Implants?

By Spec. Dr. Ana Gugushovska , Oral Surgeon

Diabetes is the name for a group of metabolic diseases that affect how the body processes glucose, a simple sugar that supplies energy for living cells. Glucose levels in the blood are regulated by the hormone insulin, which is produced in the pancreas. When the hormonal system for regulating glucose is not self-controlled, the amount of glucose in the blood can vary dangerously

Rising population of diabetic individuals across the world has become a big concern to the society. The persistent hyperglycemia may affect each and every tissue and consequently results in morbidity and eventually mortality in diabetic patients.

Even the fairly or moderately controlled diabetes persisting for very longer duration (more than 10 years) may produce complications and diminish the health of tissues. The compromised condition along with some unfavorable restorative factors may bargain the success of dental implants. The persistent hyperglycemia is responsible for development of micro-vascular complication and consequently the early or late implant failure. Patients with diabetes often require longer healing times than other patients.

Type -1 diabetes causes decreased bone mineral density, as well as reduced bone formation and higher bone resorption.
Type -2 diabetes produces normal or greater bone mineral density in some patients. It has been observed that insulin not only reduces the deleterious effect of hyperglycemia by controlling it but also stimulates osteoblastic activity.

Diabetes mellitus was once considered a contraindication to the use of dental implant therapy as it has been associated with comorbidities, including increased susceptibility to infection, impaired wound healing, and periodontitis. Since dental implants and techniques for controlling diabetes have evolved, dental implant therapy has become increasingly common among patients with diabetes. The rising success of dental implants, along with the realized benefits of implant therapy has shifted current trends to accommodate patients with controlled diabetes as good candidates for treatment. The literature currently suggests that successful treatment results can be attained when placing implants on carefully selected patients with glycosylated hemoglobin levels (HbA1C) less than 8 percent and with possible prophylactic antibiotic administration.

The published retrospective and prospective studies data, retrieved through various sources from 1994 to 2011, indicated that the success rate of dental implants in diabetic patients were in range of 85.5-100% and were comparable to the non-diabetic patients.

The survival of dental implant in well/fairly controlled diabetic patients appears as good as in general population. Use of prophylactic antibiotic, longer duration of post-surgical antibiotic course, chlorhexidine mouth rinse, bioactive material coated implants and implant with higher width and length seems to further improve the survival of implant in diabetic individuals.

However, it is advisable to delay the placement of implant in poorly controlled diabetics till the control of diabetes. Longer duration prospective clinical studies with greater number of diabetic individuals and non-diabetic controls are still required to develop better understanding of impact of diabetes over dental implant success.

If you are interested in dental implants, but aren’t sure if you’re a candidate because of diabetes or other health condition, your dentist is your best source of information. He or she will be able to evaluate your unique health situation to determine the type of dental implants that might work best for you while minimizing your risk of infection or other problems. Taking this information into account with your diabetic history, including the type of diabetes you have and the length of time you’ve had it are big factors.

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