Dental Implants for Diabetics?

Dr. Fuchs asks us:
I recently had a diabetic patient come in for a dental implant consultation.

I´m wondering if some of you can update me on the latest research concerning dental implant placement in diabetics. Some studies suggest that most diabetics who lack good glycemic control are unable to receive dental implants due to the implant’s inability to heal properly to the jaw bone. Others have stated categorically that diabetes is not a contraindication for dental implants. What has been your actual experience with dental implants in diabetics? What kind of precautions, if any, should I be taking?  What about the healing time for these types of patients? Thanks very much for any insights you can provide.

12 thoughts on “Dental Implants for Diabetics?

  1. Diabetes, if uncontrolled, has repeatedly been shown to be a negative factor, both in early osseointegration and later in progressive bone loss. I have placed a great number of implants over a 22 year span and estimate about 125 of them have been in diabetics. I have attempted to instruct these candidates on the importance of good glycemic control. From my observations, I feel I can only say with some certainty that 2 implant losses were likely due to the diabetic condition. Both of these losses occurred after at least five years of service. I do not feel that diabetes, if reasonably controlled, should by itself be a contra-indication. If other factors such as smoking or marginal bone volume exist in combination with diabetes, I believe the risk factor may then become too great.

  2. I have had a similar experience with my diabetic patients. Good control makes them excellent candidates. As a matter of fact, the restoration of the dentition with stable, functional implants allows better nutrition as a side benefit. Do a service to your patients… help their quality of life, not just giving them teeth.

  3. Dear Dr. fuchs diabetic patient is a very complicated case in implantology because
    it is very dificult to control his diabetics therefor i advise
    you to study good your patient and let him know all
    the dificult befor you do the implant.

  4. Your question refers to the literature – you answered your own question in that regard.

    Use of the blood test HbA1c which gives a % may give you an indication of the level of diabetic control. This may aid you in your decision.

    Having said that I have seen a patient with HbA1c of 9 who had implants placed by another practitioner and there is no bone loss whatsoever.

    I think taking all the parameters like diabetes, smoking, compliance with medication, occlusion etc will help you decide for each individual whether to place implants or not.

  5. The old axiom “never say never” or “always say always” is to be avoided here. One should perform patient assessment prior to any treatment to determine the chances for treatment success and/or risks for complications. Such is the case especially with diabetes. The degree of blood sugar control is key. This can be determined thru a number of means, including lab determination (HgBA1c) or simply by history. Patient physical evaluation, # of mediations, and simple history may also provide the astute clincian with ample data to determine patient suitability. This, I might add, is the strength of a bona fide surgical residency.

    In my practice, rarely is IDDM or NIDDM an absolute contradindication to implant surgery. It is more a relative issue dependent upon those patient evaluation criteria previously noted.

    Best,

    David Lambert

  6. i AM A TYPE 2 DIABETIC WITH BLOOD SUGAR LEVELS RARELY OVER 130. I WOULD LIKE TO HAVE DENTAL IMPLANTS REPLACE MY 6 FRONT TEETH. IN YOUR OPINION CAN YOU FORESEE ANY PROBLEMS. THANK YOU

  7. Jane- Patient healing response with diabetes was always a concern and caused the loss of implants placed in patients with type 2 diabetes, until the development of subantimicrobial dose doxycycline, aka Periostat 20mg. It was developed by Dr. Loren Golub to treat the periodontal patient, previously very difficult to manage, with your condition. Since using this very safe drug for over 10 years, in thousands of patients, I have not lost an implant. It decreases HbAlc and has many other positive systemic benefits. Please email me at dr.neilg@verizon.net if you need any further information.

  8. I have been a diabetic ever since 1992, fairly controlled with medications and insulin shot. My recent HbA1C= 5.9, little higher, my blood test in the range of 125 – 150.

    I am thinking of teeth implentation, would you please to give me you opinion, with my condition, if I an the a good condidate for such procedure? Thanks.

    Margaret

  9. I have had Type 1 Diabetes since the age of 5(57 years). this disease has cause significant bone loss and gingival problems which have all been addressed at Columbia U. School of Dentistry here in NYC.
    I monitor my blood glucose 10x/day and use Insulin as a titration for meals and elevated blood sugars. My current A1c is 6.0
    The problem is that I have an abscess (deep) growing on my left upper occlusive and it is recommended based on the MRI to pull all the remaining teeth on the Upper(4 teeth) and implant 4 Titanium implants to those areas that show more heightened gingival bone.
    My question is, that since T1DM is auto-immune in etiology, will my body REJECT the Titanium implants or are they the most bio-compatible material to use?
    How do I keep gingival bone that will be used for the implants from receding…….which occurs in Diabetes, so as to have a “strong placement” with success?
    Thank you in advance for your answers.

  10. how long is the healing period for diabetes patient after implant placement n wen the restoration process can b done?

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