Chronic hyperglycemia as a risk factor in implant therapy
Fawad Javed1,2, Georgios E Romanos1,2
1Department of Periodontology, School of Dental Medicine, Stony Brook University, Stony Brook, New York.
Periodontology 2000
|August 14, 2019
Summary
Diabetes impairs wound healing and implant osseointegration due to chronic hyperglycemia. However, with optimal glycemic control and oral hygiene, patients with diabetes can achieve high dental implant success rates.
Area of Science:
- Endocrinology
- Biomaterials Science
- Periodontology
Background:
- Diabetes mellitus is a growing global health concern, with a projected increase in older adults. Chronic hyperglycemia negatively impacts wound healing and osseointegration.
- Hyperglycemia in diabetes mellitus is linked to reduced growth factor expression, impaired re-epithelialization, and inhibited stromal cell-derived factor-1alpha production.
- Persistent hyperglycemia affects bone metabolism by interfering with fibronectin and integrin expression, leading to abnormal osteoclast differentiation and increased bone resorption.
Purpose of the Study:
- To review the impact of chronic hyperglycemia on wound healing and osseointegration in patients with diabetes.
- To evaluate the success and survival rates of dental implants in diabetic patients.
- To emphasize the importance of glycemic control and oral hygiene in managing diabetic patients undergoing dental implant therapy.
Main Methods:
- Literature review of experimental and clinical studies.
- Analysis of the effects of hyperglycemia on growth factors, cellular signaling, and bone metabolism.
- Examination of clinical outcomes of dental implants in diabetic populations.
Main Results:
- Chronic hyperglycemia delays wound healing and compromises osseointegration by affecting key molecular pathways and bone remodeling.
- Experimental studies show reduced bone-to-implant contact in diabetic animal models compared to healthy controls.
- Clinical data indicate that dental implants can achieve high success rates (up to 100%) in diabetic patients under optimal glycemic control and with diligent oral hygiene.
Conclusions:
- Diabetes-related hyperglycemia poses significant challenges to wound healing and dental implant success.
- Effective glycemic management and consistent oral hygiene are critical for favorable outcomes in diabetic patients receiving dental implants.
- Despite potential complications, diabetic patients can successfully undergo dental implant procedures with appropriate medical and dental care.
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