Edentulism among diabetic patients compared to non-diabetic controls: A systematic review and meta-analysis.

OBJECTIVE: The purpose of this paper is to systematically and critically appraise the available scientific evidence concerning the prevalence of edentulism among diabetic patients compared to non-diabetic people. METHODS: MEDLINE-PubMed and Cochrane-CENTRAL databases were comprehensively searched up to April 2023 to identify appropriate studies. The inclusion criteria were observational studies conducted in human subjects ≥18 years of age with the primary aim of investigating the prevalence of edentulism among diabetic patients. Based on the extracted data, a meta-analysis was performed. Recommendations based on the body of evidence were formulated using the GRADE approach. RESULTS: Independent screening of 2085 unique titles and abstracts revealed seven publications that met the eligibility criteria. Study size ranged from 293 to 15,943 participants. Data from all seven studies were suitable for meta-analysis. Overall, 8.3% of the studied population was edentulous. The weighted mean prevalence of edentulism among diabetic and non-diabetics was 14.0% and 7.1%, respectively. The overall odds ratio for diabetic patients to be edentulous as compared to non-diabetics was 2.39 (95% CI [1.73, 3.28], p < 0.00001). CONCLUSION: There appears to be moderate certainty that the risk of being edentulous for diabetic patients compared to non-diabetic people is significant, but the odds ratio is estimated to be small.

The risk of tooth loss in patients with diabetes: A systematic review and meta-analysis.

AIM: The aim of this systematic review was to comprehensively and critically summarize and synthesize the risk of losing teeth among with diabetes mellitus (DM) compared to those without DM, as established in observational studies. MATERIALS AND METHODS: MEDLINE-PubMed and Cochrane databases were searched through a period from their inception through October 2020 to identify eligible studies. Papers that primarily evaluate the number of teeth in DM patients compared to non-DM individuals were included. A descriptive analysis of the selected studies was conducted, and when feasible, a meta-analysis was performed. The quality of the studies was assessed. RESULTS: A total of 1087 references were generated, and screening of the papers resulted in 10 eligible publications. A descriptive analysis demonstrated that six of these studies indicate a significantly higher risk of tooth loss in DM patients. This was confirmed by the meta-analysis risk ratio of 1.63 95% CI (1.33; 2.00, p < 0.00001). Subgroup analysis illustrates that this is irrespective of the risk-of-bias assessment. The higher risk of tooth loss in DM patients was also higher when only DM type II patients or studies with a cross-sectional design were considered. Patients with a poor DM control status presented a significantly increased risk of tooth loss. When the data were separated by the world continent where the study was performed, Asia and South America had numerically higher risks and a 95% CI that did not overlap with Europe and North America. CONCLUSION: There is moderate certainty for a small but significantly higher risk of tooth loss in DM patients as compared to those without DM.