I have never looked for such research, but my gut feeling is that increased glycaemia leads to increased chance of infection, so this is a concern. Also, problems with microcirculation leads to slow wound healing, in diabetic patients, so this is also a concern. Whether or not there is a recommended cutoff, I cannot say, but it would be a good idea for diabetics to have their BG stable and as close to normal as possible if considering surgery of any kind.

The best resource I was able to find is : Impact of diabetes mellitus and glycemic control on the osseointegration of dental implants: a systematic literature review, J Periodontol. 2009 Nov;80(11):1719-30

Thank you Dr.Elizabeth and Dr.Sorin .

I have found interesting finding in an article:

"Based on available literature to date, there are no clear clinical data supporting increased implant failures for patients lacking good glycemic control and, in

fact, more recent studies support the use of dental implant therapy for patients in the absence of good glycemic control with appropriate accommodations for delays in implant integration. Therefore, with the potential benefit implant therapy has to offer, it may be in the diabetic patient’s best interest to consider implant therapy, even in the absence of proper glycemic control. While this represents a shift in attitude toward diabetic patient care, it is one that requires careful consideration of both the risks and benefits of care, as well as our current limitations in our understanding of these relationships."

Clin Oral Implants Res. 2013 Feb;24(2):117-27. doi: 10.1111/j.1600-0501.2011.02374.x. Epub 2011 Nov 24. A critical review of diabetes, glycemic control, and dental implant therapy. Oates TW1, Huynh-Ba G, Vargas A, Alexander P, Feine J.

I don't Know is it the HbA1c or the control of sugar level before and following the procedure that counts. I hope to find a well designed article that address this issue!!

More interesting finding with this meta analysis:

" Five studies were included to analyze on dental implant failure with regard to diabetes (6,774 implants). The results of the pooled analysis are shown in Figure 4. The pooled RR for patients with diabetes versus patients without diabetes was 0.90 (95% CI, 0.62– 1.32), indicating no association between diabetes and the risk of dental implant failure. We found high heterogeneity across the studies (P= 0.07, I 2= 58%)."

PLoS One. 2013 Aug 5;8(8):e71955. doi: 10.1371/journal.pone.0071955. Print 2013. Smoking, radiotherapy, diabetes and osteoporosis as risk factors for dental implant failure: a meta-analysis. Chen H1, Liu N, Xu X, Qu X, Lu E.

Not aware of any study correlating implant success and failure whith high HbA1c readings. Most surgeons treat poorly controlled diabetics with great caution, urging control before any elective surgical procedure, WB

Thank you William . I had a patient coming from outside my country to get three implants in the upper Jaw. His HbA1c was 8.3. but his readings for random blood sugar for three days were around 130.

I was confused to go for the surgery immediately since his readings were good at the time of proposed surgery. or to ask the patient to come back again after his HbA1c below 7 which is something he was working on. I took the second option since it is safer and better for the patient.