Diabetes mellitus—Dental implants and periodontal disease

Periodontitis is a chronic multifactorial inflammatory disease associated with dysbiotic plaque biofilms initiating host immuno-inflammatory response and further destroying soft and hard tissues that support teeth. Scientific studies confirmed that diabetes is a risk factor for developing periodontitis, and the level of glycemic control appears to be an important determinant in this relationship. Diabetes mellitus is associated with periodontitis mainly from impairing the host immuno-inflammatory response and wound healing, resulting in more tissue breakdown. Therefore, patients with diabetes should be educated that they are at increased risk for periodontitis and be advised to comply with strict oral home and professional care. Dental implant treatment is a standardized treatment modality performed on a daily basis to replace edentulous areas with fixed partial dentures or to support removable prostheses. Despite high dental implant survival rates (> 90%), peri-implant diseases including peri-implant mucositis and peri-implantitis may occur. In general, well-controlled diabetes mellitus patients do not pose a higher risk of implant failure or developing peri-implantitis. However, poorly controlled diabetes patients might have a potential to develop implant-related complications and should be monitored closely during and after implant therapy. Hence, when patients with diabetes mellitus are seeking dental implant therapy, it is crucial to have good glycemic control and oral hygiene with regular professional care to succeed and maintain the health of peri-implant tissues.