Bone regeneration in diabetic patients. A systematic review

BACKGROUND: Oral bone regeneration techniques (OBRT) attempt to provide the appropriate bone volume and density to correctly accomplish dental implant treatments. The objective was to determine whether differences exist in the clinical outcomes of these techniques between diabetic and non-diabetic patients, considering the level of scientific evidence. MATERIAL AND METHODS: A systematic review following PRISMA statements was conducted in the PubMed, Scopus and Cochrane databases with the search terms: 'Diabetes Mellitus', 'guided bone regeneration', 'bone regeneration', 'alveolar ridge augmentation', 'ridge augmentation', bone graft*, 'sinus floor augmentation', 'sinus floor elevation', 'sinus lift', implant*. Articles were limited to those published less than 10 years ago and in English. Inclusion criteria were: human studies of all bone regeneration techniques, including at least 10 patients and the using OBRT in diabetic and non-diabetic patients. Non-human studies were excluded. They were stratified according to their level of scientific evidence related to SORT criteria (Strength of Recommendation Taxonomy). RESULTS: The initial search provided 131 articles, after reading the abstracts a total of 33 relevant articles were selected to read the full text and analyzed to decide eligibility. Finally, seven of them accomplished the inclusion criteria: two controlled clinical trials, one cohort study and four case series. CONCLUSIONS: A low grade of evidence regarding the use of OBRT in diabetic patients was found. The recommendation for this intervention in diabetic patients is considered type C due to the high heterogeneity of the type of diabetic patients included and the variability of the techniques applied