DOI:
10.37988/1811-153X_2024_2_122Meta-analysis of clinical studies on the occurrence of biological complications in patients with diabetes with dental implants
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Abstract
Dental implantation and following prosthetic rehabilitation are a widely employed approach for treating patients with teeth loss. Some authors report that the incidence of biological complications in somatically healthy patients can reach 43% in Europe, 22% in North and South America, and between 11.2% and 19% in China. The likelihood of biological complications in dental implantation, both in the short and long-term periods, significantly increases in polymorbid patients, particularly those with type 2 diabetes. Treatment of biological complications, including peri-implantitis, currently lacks a robust evidence base, and existing methods show limited predictability, especially in the presence of proinflammatory systemic conditions. Considering these challenges, the risks of peri-implantitis and implant loss must be assessed by clinicians and patients in advance during the planning stage. The aim of this study is to conduct a meta-analysis of published research to determine the association between diabetes and biological complications in implant therapy.Materials and methods.
For the meta-analysis, we employed the PRISMA international protocol for systematic review and meta-analysis. The search criterion was the studies published not earlier than 2000, devoted to the analysis of the dental implants functioning before and after the prosthetic device placement, as well as the emerged complications in the form of peri-implant mucositis, peri-implantitis and implant failure in patients with diabetes mellitus. A mandatory inclusion criterion was the presence of information in the literature regarding the risk ratio of implant rejection in the presence of diabetes or data allowing for the calculation of the corresponding risk ratios. PubMed, eLibrary, and international scholarly networks such as ResearchGate and Mendeley were used as databases for article retrieval. The meta-analysis was conducted using the metafor library in the R statistical modeling environment.
Results.
Out of a total of 2411 publications, 11 studies published between 2017 and 2021 were selected following the screening process. Evaluation of potential publication bias among the included studies revealed that 2 studies deviated from homogeneity. After excluding these studies, the Cochrane test confirmed the absence of heterogeneity among the selected 9 studies (Q=6.67, p=0.5732). The meta-analysis result for the occurrence of biological complications in the presence of diabetes, based on the synthesis of 9 studies, is statistically significant with p<0.01 (RR=1.48, 95% CI 1.16—1.88).
Conclusion.
Our conducted meta-analysis confirms the association between diabetes and the development of biological complications in dental implantation. The results obtained can be applied by clinicians in planning the rehabilitation of patients with tooth loss, guiding treatment strategies, and assessing the necessity and justification of implant protocols in specific clinical cases.
Key words:
meta-analysis, dental implantation, implant rejection, biological complications of dental implantation, peri-implantitis, peri implant mucositis, implant failure, diabetesFor Citation
[1]
Lakman I.A., Dolgalev A.A., Usmanova I.N., Senina V.O., Zolotaev K.E., Stomatov D.V., Gezuev G.K., Akramov M.L., Omarov R.M. Meta-analysis of clinical studies on the occurrence of biological complications in patients with diabetes with dental implants. Clinical Dentistry (Russia). 2024; 27 (2): 122—129. DOI: 10.37988/1811-153X_2024_2_122
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Received
January 29, 2024
Accepted
June 8, 2024
Published on
June 28, 2024