Association between peri-implantitis and diabetes

Background + Aims

• Peri-implant diseases, such as peri-implant mucositis and peri-implantitis, are common complications affecting dental implants.
• Diabetes mellitus (DM) and hyperglycaemia have been associated with periodontal disease due to their impact on systemic inflammation, poor wound healing, and immune response. However, limited evidence exists on their influence on peri-implant diseases.
• This systematic review and meta-analysis aimed to investigate whether diabetes and hyperglycaemia increase the risk of peri-implant diseases, specifically peri-implant mucositis and peri-implantitis.

Materials + Methods

• The systematic review included observational studies (cohort, case-control, and cross-sectional) only.
• Inclusion criteria included:
  • Participants with osseointegrated dental implants.
  • Participants had hyperglycaemia or diagnosed diabetes (HbA1c ≥5.7% or fasting plasma glucose ≥100 mg/dL).
  • Studies assessing peri-implant mucositis (inflammation without bone loss) and peri-implantitis (inflammation with radiographic bone loss >2 mm).
• Data analyses involved:
  • Risk ratios (RR) and odds ratios (OR)
  • Heterogeneity was assessed using I² statistics.
  • Newcastle-Ottawa Scale (NOS) evaluated study quality.

Results

• 12 studies were included (1,955 participants; 2,892 implants).
  • 7 studies were included in the meta-analysis for peri-implantitis.
• Peri-implantitis:
  • Patients living with diabetes had a 46% higher risk of peri-implantitis compared to non-diabetics (RR = 1.46; 95% CI: 1.21–1.77).
  • Odds ratio indicated a nearly 2-fold increased risk (OR = 1.89; 95% CI: 1.31–2.46; p < 0.001).
• Non-Smokers:
  • Among non-smokers, hyperglycaemia increased the risk of peri-implantitis 3.39 times compared to normoglycaemic individuals (RR = 3.39; 95% CI: 1.06–10.81).
• Peri-implant mucositis:
  • No significant association between diabetes and peri-implant mucositis was found (RR = 0.92; p = 0.29).
• The mechanism is thought to involve hyperglycaemia promoting systemic inflammation and impairs tissue repair, increasing susceptibility to peri-implantitis.

Limitations