I Have Diabetes: Is this a Contraindication for Implants and Grafts?

Question:

Joseph asks:

I am 58 years old and diabetic with controlled high blood pressure. Five months ago, I had a bone graft to augment bone at the sinus activity for preparation of an implant at #3 molar. Today the Doc told me that there was NOT enough height at the grafted area, so he wants to do a sinus lift with additional bone powder (another graft) while also placing the implant. Is it likely that my diabetes and/or controlled high blood pressure will again cause the graft to fail? If it fails again, should I expect another attempt at no additional cost or is my diabetes a contraindication for these procedures?

Answer:
Answered by: Dr. Thomas R. Gibbs

Glen Ellyn, IL

Hi Joseph,

If your diabetes is well controlled, it should not interfere with your bone grafting or implant procedure. .

If there is concern that the diabetes is NOT controlled, additional blood work can be ordered to check the HbA1c glycated hemoglobin in your blood.

Nevertheless, diabetic patients still have a greater incidence of post-operative infection after these procedures, so home care and your periodontal condition should also be immaculate. Typically, the blood pressure and blood sugar will be taken at time of surgery.

But again, to sum up, in general, controlled diabetes is not a contra-indication for bone grafting and dental implants, but infection is higher, and failure rate is slightly higher.

Please also note, that when a sinus augmentation is performed, there will be some reduction in the volume of bone found months later as the regenerated bone forms. Typically the surgeon will add sufficient bone to compensate for this shrinkage, but a variety of factors may have prevented this. Your individual biology is a factor, as the rate in which your bone matures or resorbs will vary. Importantly, insufficient bone volume at time of planned placement in not necessarily the fault of the surgeon, but a result of many factors and can never be promised.

As for cost of a second procedure, this will vary by doctor. Most will do the second procedure at a lower cost, especially if there is now sufficient bone to place the implant (with additional augmentation).

(Editor's Note: Please see Dental Implant Patient with Diabetes? for another discussion of this topic)



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