Can I get dental implants for diabetes?

With the increasing standard of living and improved medical and health care conditions, various factors have led to the rapid growth of China’s population, while the average age has exceeded seventy years old, until 2012, the population over 65 years old exceeded 12,000,000, the problem of aging of society has come to the fore. With the increase of population aging and the improvement of nutrition level, the incidence of diabetes in China is on the rise. According to statistics, the current prevalence of diabetes in China is about 6.09%, and the prevalence of over 65 years old is over 18%. The prevalence is so high that its existence is as common as a cold. Can such a common disease really be taken for granted and treated as lightly as a cold? Diabetes is a group of metabolic diseases characterized by hyperglycemia, which is caused by a defect in insulin secretion or impairment of its biological action, or both. The long-term presence of hyperglycemia in diabetic patients will lead to chronic damage and dysfunction of various tissues, especially the eyes, kidneys, heart, blood vessels and nerves. In addition, in the field of dentistry, is diabetes also damaging to artificial dental implants? As the development of oral implant technology gradually matured and people’s pursuit of quality of life gradually improved, artificial dental implants were favored by the majority of patients as the preferred restoration solution for missing teeth, which made the application of implants in dentistry more and more extensive and promoted the rapid development of the oral implant restoration industry. The enthusiasm for dental implants today is reminiscent of the popularity of porcelain teeth in the early 1990s, and it can be inferred that the expensive dental implants will gradually change from a luxury item to an ordinary necessity. The aging of the population and the increasing standard of living have led to a gradual increase in the consumption of dental implants, while the middle-aged and elderly people are the ones who have a high incidence of diabetes and are the ones who consume the most dental implants. Diabetes promotes and exacerbates periodontitis, and similarly, individuals with diabetes are more likely to develop peri-implantitis. The use of implants in diabetic patients is also risky due to the counterproductive effect of hyperglycemia on osseointegration. In clinical studies, it has been found that bone loss at the apex of the alveolar ridge is more accelerated in diabetic patients compared to healthy individuals. And this can be explained by the fact that increased inflammatory factors (IL-1b, IL-6, TNF-a) in the serum and in the gingival sulcus fluid promote the interaction of the glycosylation end products and their receptors (AGE-RAGE) system in diabetic patients. AGEs lead to abnormal synthesis of extracellular matrix components such as collagen on the one hand, and also affect cell adhesion, growth and AGEs on the one hand lead to abnormal synthesis of extracellular matrix components such as collagen, but also affect cell adhesion, growth and matrix secretion and deposition, which in turn can affect the tissue healing process of bone trauma and thus have an accelerating effect on bone resorption. Diabetes has an effect on bone metabolism. Hyperglycemia inhibits osteoblast differentiation and proliferation and converts the thyrotropin response to regulate calcium and phosphorus metabolism. In addition, it can have deleterious effects on the bone matrix and its constituents, and affect cell adhesion, growth and bone matrix deposition. It has been demonstrated in different experimental models of diabetes that the dynamic balance of mineralization, formation of bone-like tissue, and bone formation are reduced. Diabetes causes secondary bone loss in patients and diseases such as osteoporosis and disorders of bone metabolism, which have an impact on implant osseointegration. According to the relevant clinical data and studies, diabetic patients with good glycemic control and reasonable anti-infection modalities may reduce the inflammatory destructive effects after surgery when the glycemia is well controlled, allowing the interference of high glycemia on bone trauma healing and the inhibition of bone transformation to be alleviated and lifted. The success rate of implants over 1 year can still reach 90%. Another report showed that the success rate of full implant-supported overdenture restorations in diabetic patients with well-controlled disease was 97.3% and 94.4% at 1 and 5 years, respectively, which indicate that diabetic patients can receive dental implants with well-controlled disease. The following are some suggestions for dental implants for diabetic patients: 1. If the blood glucose (FPG) is 5. 6mmol/L but OGTT2hPG<7.8mmol/L, lifestyle interventions should also be actively advocated for lifestyle interventions, controlling diet, increasing exercise, and regular follow-up observations; 2. intake, eat less greasy food, fried food, control the total daily calorie intake. Foods that lower blood sugar include buckwheat, pumpkin, celery, winter melon, bamboo shoots, fungus, etc.; 3. Diabetic patients need to control their blood sugar at fasting blood sugar <8.8 mmol/L (or 2 hours after meal blood sugar <10.0 mmol/L) before and after implantation, patients should develop appropriate dietary recommendations to develop good eating habits and improve bone union. Due to the poor anti-infection ability of diabetic patients, antibiotics need to be given appropriately to reduce the risk of local infection; 4. After implant restoration, it is still necessary to continue to control blood sugar, in addition to daily oral hygiene self-maintenance, and regular follow-up maintenance, which can achieve a more satisfactory short-term effect.