Dr. Prachi Rajput 1, Dr. Anju Aggarwal2, Dr. Aditya Chaudhary3 ,

Dr. Kartika N Kumar4,  Dr. Aryen Kaushik5

1Post graduate student,

2,3 Professor,


 5Senior Lecturer

Department of Prosthodontics and Oral Implantology

ITS Dental college and Hospital, Greater Noida.


Diabetes has long been known to be a risky factor for implant failure due to susceptibility to infection, impaired healing and other complications. Diabetes is always considered a relative contraindication to treatment with dental implants. Implant treatment is highly preferred by the majority of patients due to its advantages of minimizing harm to the adjacent teeth and reduced impact on alveolar bone in contrast to fixed bridge treatment and removable restoration.

There are few studies reporting the success or failure rate of implants in Type-1 diabetes. So this study was planned to check the success and failure rate of implants in Type-1and Type-2 diabetic patient.

Key Words: Dental Implants, Type I Diabetes, Type II Diabetes

Citation: Rajput P, Aggarwal A, Chaudhary A, Kumar K, Kaushik A. Rate of Failure of Dental Implants in Diabetic Patients: A Systematic Review. J Prosthodont Dent Mater 2023;4(1):3-10.


Diabetes Mellitus is a chronic metabolic disease, which is caused by impaired insulin secretion, function or both.1 This can lead to severe complications including kidney failure, neuropathy, cardiac infraction and non-traumatic limb amputation. and is closely related to overall oral health. Therefore, successful implant treatment has been a subject for many diabetic patients.2


Materials and method

Information sources

(PRISMA) was followed. Manual and electronic article search were performed in several databases studies, including Pubmed and MEDLINE, Cochrane, Google Scholar for articles from January 2000 to June 2021 with limitation to English language.

Selection And Data Collection Process

Search Strategy

MeSH keywords-

“Dental Implants, "Diabetes Mellitus “, "Type I Diabetes” and “, "Type II Diabetes “, “failure rate” "Systematic Review’’. In addition, other terms not indexed as Me SH were searched using the following key terms and Boolean operators (AND, OR, NOT).

The search string was:

((dental implant Abstract]) OR Diabetes [Title/Abstract]


((diabetes) OR (implants) OR (Endoseeous implant) OR (implant restoration) OR (dental implantation) OR (Osseointegrated implants) AND (failure rate) AND (bone loss) OR (clinical outcomes) AND (peri-implantitis) OR (peri-implant mucositis).

In addition to this, screening was conducted with reference to researched articles and website.

PICO Criteria was followed:


This systematic review analyses the failure rate between diabetic and non-diabetic patients and comparing between Type I and Type II diabetic patients.Cabrera Dominguez et al concluded that reduced-diameter Ti Zr alloy implants having hydrophilic surface represents a safe treatment option in patients with type 2 diabetes with well-controlled glycemia (HbA1c).3

Nouf -al Shibani stated that NDIs show reliable clinical stability and radiographic bone levels as RDIs placed in T2DM and non-diabetic individuals, who maintained their oral hygiene and glycemic status.4 Gerardo Gomez- Moreno et all showed that Marginal bone loss was found to increase in relation to increases in HbA1c levels.9

T.W Oates6, Marchand F7, Mohammad N Alasqah14 and Tariq Abduljabbar11 proved that Implant therapies for diabetic patients can be predictable, providing these patients fall within controlled ranges of glycemia over time, assessed by monitoring HbA1c levels.

Mohammad D., Al.Amri in his study on Comparison of clinical and radiographic status around dental implants placed in patients with and without prediabetes with 1 year follow up , concluded that dental implants inserted in prediabetic and healthy patients have similar success rates and remain clinically and radiographically stable after 1-year follow-up. 10

Payam Farzad’s showed that 5 of the 136 implants in 25 patients failed after first-stage surgery, yielding a success rate of 96.3% during the healing period.16 Namita Khandelwal’s study showed clinically successful implant placement even in poorly controlled diabetic patients. She evaluated the potential for a chemically modified Sand blasted, Large grit, Acid etched (SLA) surface, compared with a conventional SLA surface, to enhance implant healing and integration in poorly controlled diabetic patients. 8



Dental-implant surgery is feasible in selected diabetic patients with the provision of patient preparation and follow-up. In some studies, slightly higher rate of failure in type I Diabetic patients could have been due to higher blood glucose levels or presence of insulin in the tissues in type II diabetes.

In conclusion diabetic patients can be successfully treated if the patient maintains controlled blood glucose levels.



  1. Xue Jiang, Yanlin Zhu, Zhaoying Liu, Zilu Tian & Song Zhu (2020): Association between diabetes and dental implant complications: a systematic review and meta-analysis, Acta Odontologica Scandinavica
  2. Erdogan Ö, Uçar Y, Tatlı U, Sert M, Benlidayı ME, Evlice B. A clinical prospective study on alveolar bone augmentation and dental implant success in patients with type 2 diabetes. Clin Oral Implants Res. 2015 Nov;26(11):1267-75.
  3. Marchand F, Raskin A, Dionnes-Hornes A, Barry T, Dubois N, Valéro R, Vialettes Dental implants and diabetes: conditions for success. Diabetes Metab. 2012 Feb;38(1):14-9.
  4. Domínguez JJ, Castellanos-Cosano L, Torres-Lagares D, Pérez-Fierro M, Machuca-Portillo G. Clinical performance of titanium-zirconium implants with a hydrophilic surface in patients with controlled type 2 diabetes mellitus: 2-year results from a prospective case-control clinical study. Clin Oral Investig. 2020 Jul;24(7):2477-2486.
  5. Al-Shibani N, Al-Aali KA, Al-Hamdan RS, Alrabiah M, Basunbul G, Abduljabbar T. Comparison of clinical peri-implant indices and crestal bone levels around narrow and regular diameter implants placed in diabetic and non-diabetic patients: A 3-year follow-up study. Clin Implant Dent Relat Res. 2019 Apr;21(2):247-252.
  6. Alrabiah M, Alrahlah A, Al-Hamdan RS, Al-Aali KA, Labban N, Abduljabbar T. Survival of adjacent- dental-implants in prediabetic and systemically healthy subjects at 5-years follow-up. Clin Implant Dent Relat Res. 2019 Apr;21(2):232-237.
  7. Gómez-Moreno G, Aguilar-Salvatierra A, Rubio Roldán J, Guardia J, Gargallo J, Calvo-Guirado Peri- implant evaluation in type 2 diabetes mellitus patients: a 3-year study. Clin Oral Implants Res. 2015 Sep;26(9):1031-5.
  8. Oates TW, Dowell S, Robinson M, McMahan CA. Glycemic control and implant stabilization in type 2 diabetes mellitus. J Dent Res. 2009 Apr;88(4):367-71.
  9. Abduljabbar T, Al-Sahaly F, Al-Kathami M, Afzal S, Vohra F. Comparison of periodontal and peri- implant inflammatory parameters among patients with prediabetes, type 2 diabetes mellitus and non- diabetic controls. Acta Odontol Scand. 2017 Jul;75(5):319-324.
  10. Abdulwassie H, Dhanrajani PJ. Diabetes mellitus and dental implants: a clinical study. Implant Dent. 2002;11(1):83-6.
  11. Alsahhaf A, Alshiddi IF, Alshagroud RS, Al-Aali KA, Vohra F, Abduljabbar Clinical and radiographic indices around narrow diameter implants placed in different glycemic-level patients. Clin Implant Dent Relat Res. 2019 Aug;21(4):621-626.
  12. Al Zahrani S, Al Mutairi Stability and bone loss around submerged and non-submerged implants in diabetic and non-diabetic patients: a 7-year follow-up. Braz Oral Res. 2018 Jul 10;32:e57.
  13. Al Amri MD, Abduljabbar TS, Al-Kheraif AA, Romanos GE, Javed F. Comparison of clinical and radiographic status around dental implants placed in patients with and without prediabetes: 1-year follow- up outcomes. Clin Oral Implants Res. 2017 Feb;28(2):231-235.
  14. Alasqah MN, Alrabiah M, Al-Aali KA, Mokeem SA, Binmahfooz AM, ArRejaie AS, Abduljabbar T. Peri-implant soft tissue status and crestal bone levels around adjacent implants placed in patients with and without type-2 diabetes mellitus: 6 years follow-up results. Clin Implant Dent Relat Res. 2018 Aug;20(4):562-568.
  15. Erdogan Ö, Uçar Y, Tatlı U, Sert M, Benlidayı ME, Evlice B. A clinical prospective study on alveolar bone augmentation and dental implant success in patients with type 2 diabetes. Clin Oral Implants Res. 2015 Nov;26(11):1267-75.
  16. Farzad P, Andersson L, Nyberg J. Dental implant treatment in diabetic patients. Implant Dent. 2002;11(3):262-7.
  17. Khandelwal N, Oates TW, Vargas A, Alexander PP, Schoolfield JD, Alex McMahan C. Conventional SLA and chemically modified SLA implants in patients with poorly controlled type 2 diabetes mellitus-- a randomized controlled trial. Clin Oral Implants Res. 2013 Jan;24(1):13-9.