The burden of diabetes on the soft tissue seal surrounding the dental implants

Abstract

Soft tissue seal around implant prostheses is considered the primary barrier against adverse external stimuli and is a critical factor in maintaining dental implants’ stability. Soft tissue seal is formed mainly by the adhesion of epithelial tissue and fibrous connective tissue to the transmembrane portion of the implant. Type 2 diabetes mellitus (T2DM) is one of the risk factors for peri-implant inflammation, and peri-implant disease may be triggered by dysfunction of the soft tissue barrier around dental implants. This is increasingly considered a promising target for disease treatment and management. However, many studies have demonstrated that pathogenic bacterial infestation, gingival immune inflammation, overactive matrix metalloproteinases (MMPs), impaired wound healing processes and excessive oxidative stress may trigger poor peri-implant soft tissue sealing, which may be more severe in the T2DM state. This article reviews the structure of peri-implant soft tissue seal, peri-implant disease and treatment, and moderating mechanisms of impaired soft tissue seal around implants due to T2DM to inform the development of treatment strategies for dental implants in patients with dental defects.

The Critical Role of Pyroptosis in Peri-Implantitis

“…Zhang et al have suggested that excessive oxidative stress may trigger poor peri-implant soft tissue sealing, thereby exacerbating peri-implantitis, which may be more severe in Type 2 diabetes mellitus patients. 62 Moreover, Buranasin et al have identified oxidative stress as a link between diabetes mellitus and periodontitis, highlighting increased reactive oxygen species in periodontal tissues of diabetic patients. This elevation in reactive oxygen species contributes to impaired wound healing and tissue repair in periodontal tissues.…”

Endowing Polyetheretherketone with Anti‐Infection and Immunomodulatory Properties through Guanidination Carbon Dots Modification to Promote Osseointegration in Diabetes with MRSA Infection

“…Moreover, the foundation of diabetes will also lead to an inflammatory stress state that limits the integrating performance of implants. [ 40 ] In the face of the special microenvironment of susceptibility and inflammation in diabetes patients, the feasible strategy is supposed to improve the osseointegration ability of implant surgery in diabetes mellitus by loading both antibacterial and immunomodulatory drugs on the implant surface to achieve the functions of antibacterial activity and inflammatory regulation.…”

Diabetes‐related Screw Loosening: The Distinction of Surgical Sites and the Relationship among Diabetes, Implant Stabilization and Clinical Outcomes

“…A growing number of studies have illustrated that DM posed adverse effect on the quality of bone in normal or even increased bone mineral density (BMD) situations 11,12 . Many studies confirmed that DM prominently affected dental implant stabilization 13 and elevated overall risk of revision for aseptic loosening in total joint arthroplasty 14 . The failure of serum glucose control in DM patients who took pedicle‐based dynamic stabilization system treatment showed a higher visual analogue scale (VAS) score, presumably due to postoperative instability of pedicle screws 15 .…”