Outcome of dental implants in diabetic patients with and without cardiovascular disease: A 5-year post-loading retrospective study

Purpose: To investigate the outcome of immediate function of dental implant rehabilitations in diabetic patients with and without coexisting cardiovascular diseases (CVD). Materials and methods: This retrospective study included 70 diabetic patients (33 females and 37 males, average age: 59 years old), rehabilitated with 352 implants and divided into two groups (CVD: 38 patients; non-CVD: 32 patients). Diabetes mellitus was defined as fasting plasma glucose ≥ 7.0 mmol/l (126 mg/dl) or 2 h plasma glucose ≥ 11.1mmol/l (200 mg/dl). The data was retrieved from patient records. Primary outcome measures were prosthesis and implant survival; secondary outcome measures were marginal bone loss and complications (biological or mechanical). The follow-up was 5 years after loading for all patients. Results: Seven patients (10%) were lost to follow-up (one patient in the CVD group; and six patients in the non-CVD group). One prosthesis failed in the non-CVD group, rendering a 97.4% survival rate, compared to 100% in the CVD group (non-significant difference between groups; P = 0.359). Ten implants failed in 7 patients: CVD group with eight implant failures in 5 patients (86.7% cumulative survival rate) versus two implants in 2 patients in the non-CVD group (93.8% cumulative survival rate) with a non-significant difference between both groups (P = 0.365). The average (95% confidence interval) marginal bone loss at 1- and 5-years was 0.95 mm (0.66 mm; 1.23 mm) and 1.52 mm (1.20 mm; 1.88 mm), respectively in the CVD group; and 0.78 mm (0.40 mm; 1.16 mm) and 1.54 mm (0.86 mm; 2.31 mm), respectively for the non-CVD group; with no significant differences between groups at 1 year (P = 0.979) and 5 years (P = 0.300). Complications occurred in 38 patients (CVD group: 21 patients; non-CVD group: 16 patients); with a non-significant difference between both groups (P = 0.660). Conclusions: Implant rehabilitations represent a valid treatment for diabetic patients with or without coexisting CVD, with a good risk/benefit ratio. Keywords: cardiovascular disease, dental implant, diabetes; risk patient, fixed implant prosthesis, marginal bone loss