Does diabetes mellitus affect guided bone regeneration outcomes in individuals undergoing dental implants? A systematic review and meta-analysis

L. M. Oliveira, F. Zanatta, R. Antoniazzi, Patrícia Almeida Miguez
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Abstract

This systematic review aimed to verify if diabetes affects vertical and horizontal ridge augmentation in individuals undergoing dental implant treatment with guided bone regeneration (GBR).Five databases were systematically screened up to September 2023, according to predefined eligibility criteria. The methodological risk of bias of included studies was assessed using the ROBINS-I tool, and GRADE was used to evaluate the certainty of evidence. Random-effects pairwise meta-analyses were used to compare changes in vertical (height) and horizontal (width) alveolar bone dimensions between individuals exposed and unexposed to diabetes, through standardized mean differences (SMDs).Three non-randomized controlled trials met the inclusion criteria, all of which showed a serious risk of bias. The results showed, with overall very low certainty on evidence, that individuals with diabetes did not exhibit a significant difference in horizontal (SMD = −0.41, 95% CI: −0.92–0.10) and vertical (SMD = 0.06, 95% CI: −0.43–0.56) ridge augmentation compared to the those without diabetes.The available evidence, albeit of very low certainty, suggests that diabetic individuals with moderate or good glycemic control undergoing dental implants and GBR show comparable horizontal and vertical bone gains to their unexposed counterparts. https://osf.io/bpx3t.
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糖尿病是否会影响牙科植入物引导下的骨再生效果?系统回顾和荟萃分析
本系统性综述旨在验证糖尿病是否会影响接受引导骨再生(GBR)种植牙治疗的患者的垂直和水平牙脊增量。根据预先定义的资格标准,系统性筛选了截至 2023 年 9 月的五个数据库。使用 ROBINS-I 工具评估了纳入研究的方法学偏倚风险,并使用 GRADE 评估了证据的确定性。采用随机效应配对荟萃分析法,通过标准化平均差(SMDs)比较暴露于糖尿病和未暴露于糖尿病的个体之间牙槽骨垂直(高度)和水平(宽度)尺寸的变化。结果显示,与无糖尿病者相比,糖尿病患者在水平(SMD = -0.41,95% CI:-0.92-0.10)和垂直(SMD = 0.06,95% CI:-0.43-0.56)牙槽骨增量方面没有显著差异。现有证据(尽管确定性很低)表明,血糖控制适中或良好的糖尿病患者在接受牙科种植体和 GBR 治疗后,其水平和垂直骨增量与未暴露的糖尿病患者相当。https://osf.io/bpx3t。
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