An umbrella review on the effects of diabetes on implant failure and peri-implant diseases

Abstract The aim of this review is to summarize the evidence on associations between diabetes mellitus (DM) and complications around dental implants. Electronic database searches of MEDLINE, EMBASE, JBI Database of Systematic Reviews and Implementation Reports, Cochrane Database of Systematic Reviews and the PROSPERO register were performed from 1990 up to and including May 2018, using MeSH terms and other keywords. Systematic reviews and meta-analyses investigating the associations of DM and implant complications (failure, survival, bone loss, peri-implant diseases, and post-surgery infection) were eligible. The quality of the included reviews was determined using the Assessment of Multiple Systematic Reviews Tool 2 (AMSTAR 2). Twelve systematic reviews were included. Implant survival rates ranged from 83.5% to 100%, while implant failure rates varied from 0% to 14.3% for subjects with DM. The three meta-analyses performed for event "implant failure" reported no statistically significant differences between diabetic and non-diabetic subjects. An apparently increased risk of peri-implantitis is reported in patients with DM. According to the AMSTAR 2 classification, 50% of the reviews were classified as being of "critically low", 25% as of "low" and 25% as of "moderate" quality. Evidence indicates high levels of survival and low levels of failure of implants inserted in patients with DM. However, DM was assessed as a whole in the majority of studies and, the actual influence of hyperglycemia on implant survival/failure is still uncertain. DM/hyperglycemia seems to be associated with a high risk of peri-implantitis. However, this conclusion is based on a limited number of systematic reviews.

Manifestaciones bucales en pacientes con insuficiencia renal crónica en hemodiálisis / Oral manifestations in patients with chronic renal failure in hemodialysis

Identificar las principales manifestaciones bucales en pacientes con insuficiencia renal crónica en hemodiálisis del Hospital Alberto Sabogal Sologuren (Bellavista, Callao, Perú) durante el periodo de julio-agosto 2013. Material y métodos: Se examinaron 119 pacientes de ambos sexos, realizándoseles una anamnesis y luego, con la ayuda de una linterna, espejos bucales y bajalenguas, se les examinó la cavidad bucal de manera minuciosa. Resultados: Los pacientes examinados presentaron: lengua saburral 88,2%, agrandamiento gingival 63%, sangrado gingival 55,5%, caries dental 85,7%, cálculo dental 80,7%, perdida de inserción dental 72,3%, xerostomía 84%, halitosis 66,4% y disgeusia 55,5%. Se estudió la relación de las manifestaciones bucales según el tiempo de hemodiálisis, encontrándose que existió una asociación estadísticamente significativa en la mayoría de las lesiones (prueba de Chi Cuadrado; p<0,05). Conclusión: Los pacientes con insuficiencia renal crónica en tratamiento de hemodiálisis, presentaron múltiples manifestaciones bucales propias de la enfermedad y también como consecuencia del tratamiento aplicado, donde se ven afectados los tejidos blandos, tejidos duros y glándulas salivales...

Objective: To identify the main oral manifestations in patients with chronic renal failure on hemodialysis of Alberto Sabogal Sologuren Hospital (Bellavista, Callao, Perú) during the period from July to August 2013. Methods: 119 patients of both sexes were examined performing an anamnesis and then with the help of a flashlight, mouth mirrors and tongue depressors, their buccal cavity were thoroughly examined. Results: The patients examined results were: furred tongue 88.2%, gingival enlargement 63%, gingival bleeding 55.5%, dental caries 80.7%, dental calculus 80.7%, dental insertion loss 72.3%, xerostomia 84%, halitosis 66.4% and dysgeusia 55.5%. The relationship of the oral manifestations by the time of hemodialysis was studied, finding that there was a statistically significant association in most lesions (chi square test, p <0.05). Conclusion: The patients with chronic renal failure undergoing hemodialysis showed multiple own oral manifestations of the disease and also as a result of the treatment applied, which affected soft tissues, hard tissues and salivary glands...