A new doctoral thesis has provided population-level evidence on the association between diabetes and implant-related complications. (Image: Jayk/AdobeStock)
GOTHENBURG, Sweden: While diabetes is an established risk factor for periodontitis, evidence on the long-term impact of diabetes on peri-implantitis and implant loss has remained inconclusive. A recent doctoral thesis from the University of Gothenburg has now provided population-level evidence on the association between Type 1 and Type 2 diabetes and implant outcomes.
Dr Anna Trullenque Eriksson is a researcher in periodontics at the University of Gothenburg. (Image: Majk Zanqrelle)
The thesis was written by Dr Anna Trullenque Eriksson, a researcher in the Institute of Odontology at Sahlgrenska Academy. As part of her doctoral research, she analysed data from seven Swedish national registers and compared people with Type 1 or Type 2 diabetes with matched cohorts without diabetes. The large dataset, which included a particularly high number of individuals with Type 1 diabetes, enabled her to investigate associations between diabetes and oral health outcomes that had previously been difficult to assess.
“Our findings suggest that diabetes may influence not only periodontal health but also the long-term prognosis of implants,” Dr Trullenque Eriksson told Dental Tribune International. “Previous evidence on this matter was inconclusive and was based mostly on cross-sectional studies that included small numbers of patients, primarily with Type 2 diabetes. Our study adds population-level evidence that diabetes is associated with an increased risk of peri-implantitis and implant loss.”
The study found that both people with Type 1 diabetes and those with Type 2 diabetes had a higher risk of developing peri-implantitis. However, implant loss due to peri-implantitis was more strongly associated with Type 1 diabetes.
Glycaemic control appeared to be an important factor in the observed associations. Compared with people without diabetes, people with Type 1 diabetes and poor glycaemic control had an increased risk of peri-implantitis and implant loss. For people with Type 2 diabetes, glycaemic control was not associated with peri-implantitis prevalence, but implant loss was more frequent among those with poor glycaemic control than in people without diabetes.
The findings also demonstrated that, compared with people without diabetes, people with Type 1 diabetes and poor glycaemic control had an increased risk of periodontitis and tooth loss, whereas no increased risk was evident among those with good glycaemic control. For people with Type 2 diabetes, the risk was elevated regardless of glycaemic control, but appeared to be strongest among those with poor control.
“We did see indications of a stronger association in the presence of poor glycaemic control, but these results need to be interpreted with caution,” Dr Trullenque Eriksson explained. “When we looked at subgroups according to glycaemic control, the sample sizes were smaller, which made the estimates less precise and limited our ability to draw robust conclusions.”
Implications for dental implant therapy
“I believe that diabetes, particularly when poorly controlled, should be considered a risk factor when planning implant therapy,” said Dr Trullenque Eriksson. “It is important that dental professionals discuss diabetes diagnosis and glycaemic control with patients and support them in achieving the best possible glycaemic control before implant placement.” She added: “It is also important to inform the patient about the risks and plan maintenance care accordingly to ensure early diagnosis and treatment should peri-implantitis occur.”
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