Page 21 - GP fall 2023

poor glycemic control compared to patients Treatment decisions should be made on a 10. Tan SJ, Baharin B, Nabil S, Mohd N, Zhu
with good glycemic control; however, the case-by-case basis considering all patient Y. Does Glycemic Control Have A Dose-Re-
clinical benefit is low because there are a factors. Ultimately the final treatment is the sponse Relationship With Implant Outcomes?
series of health consequences as a result of patient’s choice. Still, it is critical that the A Comprehensive Systematic Review And
uncontrolled diabetes. It is in the patient’s patient is informed about the importance of Meta-Analysis. J Evid Based Dent Pract.
2021 Jun;21(2):101543. doi: 10.1016/j.jeb-

best interest to control their glycemic level diabetes control and is encouraged to man- dp.2021.101543. Epub 2021 Mar 6. PMID:
before considering implant placement. age their Type 2 diabetes. 34391557.
11. Shi Q, Xu J, Huo N, Cai C, Liu H. Does a
Discussion References higher glycemic level lead to a higher rate of
The evidence is from three systematic re- 1. Pandey A, Chawla S, Guchhait P. Type-2 di- dental implant failure?: A meta-analysis. J Am
views, two with good methodological quali- abetes: Current understanding and future per- Dent Assoc. 2016 Nov;147(11):875-881. doi:
ty and one with moderate quality. The three spectives. IUBMB Life. 2015 Jul;67(7):506-13. 10.1016/j.adaj.2016.06.011. Epub 2016 Jul 18.
reviews included cross-sectional studies doi: 10.1002/iub.1396. Epub 2015 Jul 15. PMID: PMID: 27435008.
and retrospective and prospective studies - 26177573. 12. Oates TW, Huynh-Ba G, Vargas A, Alex-
2. Berbudi A, Rahmadika N, Tjahjadi AI, Ruslami
mostly cohort studies, the appropriate study R. Type 2 Diabetes and its Impact on the Immune ander P, Feine J. A critical review of diabetes,
design for clinical questions related to prog- System. Curr Diabetes Rev. 2020;16(5):442-449. glycemic control, and dental implant therapy.
Clin Oral Implants Res. 2013 Feb;24(2):117-
nosis. Most of the included studies have doi: 10.2174/1573399815666191024085838 PMID: 27. doi: 10.1111/j.1600-0501.2011.02374.x.
moderate to high bias risk and were exclud- 31657690; PMCID: PMC7475801. Epub 2011 Nov 24. PMID: 22111901; PMCID:
ed through the appraisal process. For exam- 3. Viigimaa M, Sachinidis A, Toumpourleka PMC3329564.
ple, Oates et al. 2013 focused on only three M, Koutsampasopoulos K, Alliksoo S, Titma T.
out of the 16 studies because they were the Macrovascular Complications of Type 2 Diabetes Liana Umbrio is a den-
only studies that had acceptable documen- Mellitus. Curr Vasc Pharmacol. 2020;18(2):110- tal student in the class of
tation of glycemic control. However, the 116. doi: 10.2174/157016111766619040516515 2025 at NYU College of
studies that did use HbA1C values had other 1. PMID: 30961498. Dentistry.
4. Bin Rakhis SA Sr, AlDuwayhis NM, Aleid N,
limitations. Shi et al. 2016 reviewed studies AlBarrak AN, Aloraini AA. Glycemic Control
where the glycemic levels of the patients for Type 2 Diabetes Mellitus Patients: A System-
overlapped: levels were less than 8% in pa- atic Review. Cureus. 2022 Jun 21;14(6):e26180.
tients with well-controlled diabetes, and the doi: 10.7759/cureus.26180. PMID: 35891859;
levels ranged from 7% to 13.8% in patients PMCID: PMC9304683. Gary Berkowitz, DDS,
with diabetes that were not well-controlled. 5. Sherwani SI, Khan HA, Ekhzaimy A, Masood is a Clinical Associate
Also, the methods of evaluating glycemic A, Sakharkar MK. Significance of HbA1c Test Professor in the Depart-
levels were inconsistent: the investigators in Diagnosis and Prognosis of Diabetic Patients. ment of Cariology and
of six studies used HbA1c, and the investi- Biomark Insights. 2016 Jul 3;11:95-104. doi: Comprehensive Care, a
gators of one study used FPG. Lastly, Tan et 10.4137/BMI.S38440. PMID: 27398023; PM- senior mentor at NYU
CID: PMC4933534.
al. 2021 only used baseline HbA1c values. 6. Preshaw PM, Bissett SM. Periodontitis and di- College of Dentistry, and
Still, since glycemic control is a dynam- abetes. Br Dent J. 2019 Oct;227(7):577-584. doi: Group Practice Director.
ic value, it was assumed that each patient 10.1038/s41415-019-0794-5. PMID: 31605062.
remained in the same category of control 7. Weijdijk LPM, Ziukaite L, Van der Weijden Analia Veitz-Keenan, DDS,
throughout the study period. No statistically GAF, Bakker EWP, Slot DE. The risk of tooth is a Clinical Professor in
significant results were found, and only one loss in patients with diabetes: A systematic re- the Department of Oral
systematic review actually measured statis- view and meta-analysis. Int J Dent Hyg. 2022 Maxillofacial Pathology,
tical significance between the studies. Feb;20(1):145-166. doi: 10.1111/idh.12512. Radiology and Medicine,
Epub 2021 Aug 24. PMID: 33973353; PMCID: and Epidemiology and
Despite the fact that implants may fail at PMC9291053. Health Promotion at NYU
similar rates in people with diabetes with 8. Naujokat H, Kunzendorf B, Wiltfang J. Dental College of Dentistry. She is the current
implants and diabetes mellitus-a systematic re-
good glycemic control and poor glycemic view. Int J Implant Dent. 2016 Dec;2(1):5. doi: NYSAGD President-elect.
control, there are still many other health 10.1186/s40729-016-0038-2. Epub 2016 Feb 11.
consequences that follow being an un- PMID: 27747697; PMCID: PMC5005734.
controlled diabetic. These consequences 9. Misch CE, Perel ML, Wang HL, Sammarti-
include hyperglycemia and metabolic aci- no G, Galindo-Moreno P, Trisi P, Steigmann M,
dosis, increased risk of infections, delayed Rebaudi A, Palti A, Pikos MA, Schwartz-Arad
wound healing, and micro- and macrovas- D, Choukroun J, Gutierrez-Perez JL, Maren-
cular complications. Patients should always zi G, Valavanis DK. Implant success, survival,
be encouraged to control their diabetes, and and failure: the International Congress of Oral
despite research showing implants can suc- Implantologists (ICOI) Pisa Consensus Con-
ference. Implant Dent. 2008 Mar;17(1):5-15.
ceed in patients with poor glycemic control, doi: 10.1097/ID.0b013e3181676059. PMID:
it may not be the case for every patient, even 18332753.
patients with reasonable glycemic control.

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