If you are a diabetic patient and you want to replace a lost tooth with a dental implant, you may be out of luck. This is unwelcome news given that diabetics are twice as likely as non-diabetics to suffer from tooth loss during their lifetime. The popular belief among oral scientists has long been that diabetes, controlled or not, rules out the possibility of treating tooth loss with a dental implant. Indeed, one only needs to take a quick glance to see that most clinical trials involving dental implants exclude patients with diabetes as candidates for the study.
And their reasoning is not unfounded. Diabetes mellitus results in hyperglycemia, which has profound effects on oral health. In particular, it inhibits normal bone regrowth in response to response to surgery, and is one of the leading causes of periodontitis—inflammation of the gums. Unfortunately, poor bone growth and inflammation surrounding teeth are red flags for possible implant failure.
But how much does the scientific oral health community know about how this translates into statistics – what is the implant survival rate actually like in patients with diabetes? As it turns out, the results are fairly positive. For example, some studies that have examined dental implantation in patients with controlled diabetes have found that the early implant failure rate was slightly higher than in patients without diabetes. Moreover, other studies have even shown high implantation success rates in diabetics with uncontrolled glycemic levels.
Although these results are contradictory to the common clinical perception, what seems to facilitate the overall success of the implant in the diabetic patient is providing adequate time for osseointegration to occur, which may mean performing surgeries in stages, in addition to using longer implants with bioactive surface coatings, all of which can aid with establishing the primary stability of the implant.
More robust clinical studies need to be conducted before definitive conclusions can be made about the risk of dental implant surgery in diabetic patients. However, given that about 9% of the global population is afflicted with diabetes, among which many will also experience tooth loss, clinicians and medtech companies should look to work together to develop a line of treatment methods and dental implant technologies that could be specifically tailored to diabetic patients, filling their unmet oral health needs, and undoubtedly improving the quality of their lives.