Implant survival and peri-implant health in prediabetic and healthy patients with adjacent implants over 5 years: A systematic review.

STATEMENT OF PROBLEM: Prediabetes, a metabolic condition occurring before diabetes, involves chronic low-grade inflammation that may impair peri-implant tissue health. Its impact on survival and outcomes of adjacent dental implants remains unexamined.

PURPOSE: The purpose of this systematic review was to compare implant survival and peri-implant health outcomes between prediabetic and systemically healthy patients with adjacent dental implants over a minimum 5-year follow-up period.

MATERIAL AND

METHODS

A systematic search was conducted in PubMed, Web of Science, Scopus, LILACS, and Google Scholar from January 2000 to April 2025, with an update in August 2025. Studies including prediabetic and healthy patients with at least two adjacent implants and more than 5 years of follow-up were eligible. Outcomes included implant survival, marginal bone loss, probing depth, bleeding on probing, and inflammatory markers. Risk of bias was assessed using the Newcastle-Ottawa Scale (NOS) for the cohort study and the Appraisal Tool for Cross-Sectional Studies (AXIS) for the cross-sectional study, and data were synthesized narratively due to heterogeneity.

RESULTS

Two studies met inclusion criteria, comprising 139 patients and 336 implants. Implant survival was 100% in both prediabetic and healthy groups (P>.05). Peri-implant parameters were worse in prediabetic patients, with higher mean probing depth (3.9 to 4.6 mm versus 2.2 to 3.3 mm; P<.05), greater bleeding on probing (24% to 48% versus 18 to 23%; P<.05), higher plaque index, increased marginal bone loss (1.6 to 5.3 mm versus 0.8 to 2.3 mm; P<.05), and elevated interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α) levels (P<.05).

CONCLUSIONS

While implant survival remains comparable, patients with prediabetes exhibit poorer peri-implant tissue health. Early glycemic assessment may aid in optimizing implant prognosis.