Дентальная имплантация у пациентов с метаболическим синдромом: факторы риска, особенности остеоинтеграции и периимплантатные осложнения. Обзор литературы
Научно-практический журнал Институт Стоматологии №2 (111), июнь 2026
стр. 96-99
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250 руб.
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Аннотация
Цель исследования. Проанализировать и обобщить современные научные данные о влиянии метаболического синдрома на остеоинтеграцию дентальных имплантатов, риск развития периимплантатных осложнений и результаты имплантологического лечения. Материалы и методы. Проведен обзор опубликованных отечественных и зарубежных исследований, посвященных метаболическому синдрому, системным факторам риска нарушения остеоинтеграции, периимплантатному заживлению, костному ремоделированию и периимплантатным заболеваниям. Результаты. Систематизированы современные представления о влиянии метаболического синдрома на процессы периимплантатного заживления и костного ремоделирования. Показано, что инсулинорезистентность, хроническое низкоинтенсивное воспаление, нарушения микроциркуляции, оксидативный стресс, дислипидемия и нарушения костного обмена формируют неблагоприятный системный фон для дентальной имплантации. Указанные факторы могут способствовать замедлению заживления, снижению эффективности репаративного остеогенеза, нарушению остеоинтеграции, маргинальной потере костной ткани и более выраженному воспалению периимплантатных тканей. Выводы. Метаболический синдром следует рассматривать как клинически значимый системный фактор риска при планировании дентальной имплантации. Пациенты с метаболической отягощенностью нуждаются в расширенной предимплантационной клинико-лабораторной оценке, контроле гликемического и воспалительного статуса, оценке факторов риска нарушения костного ремоделирования и междисциплинарном сопровождении.
Аннотация (англ)
Objective. To analyze and summarize current scientific data on the influence of metabolic syndrome on the osseointegration of dental implants, the risk of peri-implant complications, and the outcomes of implant treatment. Materials and methods. A literature review was conducted based on the search and analysis of published Russian and international studies addressing metabolic syndrome, systemic risk factors for impaired osseointegration, peri-implant healing, bone remodeling, and peri-implant diseases. Results. Current concepts regarding the influence of metabolic syndrome on peri-implant healing and bone remodeling were systematized. Insulin resistance, chronic low-grade inflammation, microcirculatory disorders, oxidative stress, dyslipidemia, and impaired bone metabolism create an unfavorable systemic background for dental implantation. These factors may contribute to delayed wound healing, reduced reparative osteogenesis, impaired osseointegration, marginal bone loss, and more pronounced inflammation in peri-implant tissues. Conclusions. Metabolic syndrome should be considered a clinically significant systemic risk factor in dental implantation. Patients with metabolic disorders require extended pre-implant clinical and laboratory assessment, evaluation of glycemic and inflammatory status, identification of risk factors for impaired bone remodeling, and interdisciplinary management.
Ключевые Слова
метаболический синдром, дентальная имплантация, остеоинтеграция, периимплантит, сахарный диабет, воспаление, костное ремоделирование.
Ключевые Слова (англ)
metabolic syndrome, dental implantation, osseointegration, peri-implantitis, diabetes mellitus, inflammation, bone remodeling.
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18. Bazal-Bonelli S., Sánchez-Labrador L., Cortés-Bretón Brinkmann J., Cobo-Vázquez C., Martínez-Rodríguez N., Beca-Campoy T., Santos-Marino J., Rodríguez-Fernández E., Alvarado-Lorenzo M. Influence of Serum Vitamin D Levels on Survival Rate and Marginal Bone Loss in Dental Implants: A Systematic Review // Int J. Environ Res Public Health. 2022;19(16):10120.
19. Bressan E., Ferroni L., Gardin C., Bellin G., Sbricoli L., Sivolella S., Brunello G., Schwartz-Arad D., Mijiritsky E., Penarrocha M. Metal nanoparticles released from dental implant surfaces: Potential contribution to chronic inflammation and peri-implant bone loss. Materials. 2019;12:2036.
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21. Corrêa M.G., Pimentel S.P., Ribeiro F.V., Cirano F.R., Casati M.Z. Host response and peri-implantitis // Braz Oral Res. 2019;33.
22. D’Aiuto F., Gkranias N., Bhowruth D., Khan T., Orlandi M., Suvan J., Masi S., Tsakos G., Hurel S., Hingorani A.D. et al. Systemic effects of periodontitis treatment in patients with type 2 diabetes: a 12 month, single-centre, investigator-masked, randomised trial. Lancet Diabetes Endocrinol. 2018;6:954-965.
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16. Aroor A.R., McKarns S., DeMarco V.G., Jia G., Sowers J.R. Maladaptive immune and inflammatory pathways lead to cardiovascular insulin resistance. Metabolism. - 2013;62(11): 1543-1552.
17. Bălăşoiu M., Avramescu C.S., Bălăşoiu A.T., Stepan A.E., Mogoantă S.S., Matei M., Manolea H.O., Militaru C.F., Streba C.T., Petrescu I.O., Muşetescu A.E., Mogoantă L. Proatherogenic adipocytokines levels in metabolic syndrome // Rom J. Morphol Embryol. - 2014;55(1):29-33.
18. Bazal-Bonelli S., Sánchez-Labrador L., Cortés-Bretón Brinkmann J., Cobo-Vázquez C., Martínez-Rodríguez N., Beca-Campoy T., Santos-Marino J., Rodríguez-Fernández E., Alvarado-Lorenzo M. Influence of Serum Vitamin D Levels on Survival Rate and Marginal Bone Loss in Dental Implants: A Systematic Review // Int J. Environ Res Public Health. - 2022;19(16):10120.
19. Bressan E., Ferroni L., Gardin C., Bellin G., Sbricoli L., Sivolella S., Brunello G., Schwartz-Arad D., Mijiritsky E., Penarrocha M. Metal nanoparticles released from dental implant surfaces: Potential contribution to chronic inflammation and peri-implant bone loss. Materials. - 2019;12:2036.
20. Coelho P.G., Pippenger B., Tovar N., Koopmans S.J., Plana N.M., Graves D.T., Engebretson S., van Beusekom H.M.M., Oliveira P.G.F.P., Dard M. Effect of Obesity or Metabolic Syndrome and Diabetes on Osseointegration of Dental Implants in a Miniature Swine Model: A Pilot Study // J. Oral Maxillofac Surg. - 2018;76(8):1677-1687.
21. Corrêa M.G., Pimentel S.P., Ribeiro F.V., Cirano F.R., Casati M.Z. Host response and peri-implantitis. Braz Oral Res. - 2019;33.
22. D’Aiuto F., Gkranias N., Bhowruth D., Khan T., Orlandi M., Suvan J., Masi S., Tsakos G., Hurel S., Hingorani A.D. et al. Systemic effects of periodontitis treatment in patients with type 2 diabetes: a 12 month, single-centre, investigator-masked, randomised trial. Lancet Diabetes Endocrinol. - 2018;6:954-965.
23. de Molon R.S., Morais-Camilo J.A., Verzola M.H., Faeda R.S., Pepato M.T., Marcantonio E.Jr. Impact of diabetes mellitus and metabolic control on bone healing around osseointegrated implants: Removal torque and histomorphometric analysis in rats. Clin Oral Implants Res. - 2013;24:831-837.
24. de Oliveira P.G.F.P., Bonfante E.A., Bergamo E.T.P., de Souza S.L.S., Riella L., Torroni A., Benalcazar Jalkh E.B., Witek L., Lopez C.D., Zambuzzi W.F., Coelho P.G. Obesity/Metabolic Syndrome and Diabetes Mellitus on Peri-implantitis. Trends Endocrinol Metab. - 2020;31(8):596-610.
25. Dhir S. Biofilm and dental implant: The microbial link // J. Indian Soc Periodontol. - 2013;17:5.
26. Durrani F., Singh R. Myeloperoxidase level around dental implants as an indicator of an inflammatory process // Indian J. Dent. - 2015;6:2.
27. Esmeili T., Ellison J., Walsh M.M. Dentists’ attitudes and practices related to diabetes in the dental setting. J Public Health Dent. - 2010;70(2):108-114.
28. Fernández-Sánchez A., Madrigal-Santillán E., Bautista M., Esquivel-Soto J., Morales-González Á., Esquivel-Chirino C., Durante-Montiel I., Sánchez-Rivera G., Valadez-Vega C., Morales-González J.A. Inflammation, oxidative stress, and obesity // Int J. Mol Sci. - 2011;12(5):3117-3132.
29. Gasmi Benahmed A., Gasmi A., Tippairote T., Mujawdiya P.K., Avdeev O., Shanaida Y., Bjørklund G. Metabolic Conditions and Peri-Implantitis. Antibiotics (Basel). - 2022;12(1):65.
30. Ghiraldini B., Conte A., Casarin R.C., Casati M.Z., Pimentel S.P., Cirano F.R., Ribeiro F.V. Influence of Glycemic Control on Peri-Implant Bone Healing: 12-Month Outcomes of Local Release of Bone-Related Factors and Implant Stabilization in Type 2 Diabetics. Clin Implant Dent Relat Res. - 2016;18(4):801-809.
31. Giannobile W.V. C-telopeptide pyridinoline cross-links: Sensitive indicators of periodontal tissue destruction. Ann NY Acad Sci. - 1999;878:404.
32. Guillaume B. Dental implants: A review. Morphologie. - 2016;100(331):189-198.
33. Hotamisligil G.S. Inflammation and metabolic disorders. Nature. - 2006;444(7121):860-867.
34. Hosseinpour S., Nanda A., Walsh L.J., Xu C. Microbial Decontamination and Antibacterial Activity of Nanostructured Titanium Dental Implants: A Narrative Review. Nanomaterials. - 2021;11:2336.
35. International Diabetes Federation. The IDF consensus worldwide definition of the metabolic syndrome. Brussels: International Diabetes Federation, 2006.
36. Javed F., Romanos G.E. Chronic hyperglycemia as a risk factor in implant therapy // Periodontol 2000. - 2019;81(1):57-63.
37. Javed F., Romanos G.E. Impact of diabetes mellitus and glycemic control on the osseointegration of dental implants: a systematic literature review // J. Periodontol. - 2009.
38. Karoussis I., Salvi G., Heitz-Mayfield L., Brägger U., Hammerle C., Lang N. Long-term implant prognosis in patients with and without a history of chronic periodontitis: a 10-year prospective cohort study // Clin Oral Implants Res. - 2003;14:329-339.
39. Keuroghlian A., Barroso A.D.V., Kirikian G., Bezouglaia O., Tintut Y., Tetradis S., Moy P., Pirih F., Aghaloo T. The effects of hyperlipidemia on implant osseointegration in the mouse femur // J. Oral Implantol. - 2015;41:e7-e11.
40. Khalil D., Hultin M. Peri-implantitis Microbiota // An Update of Dental Implantology and Biomaterial. - 2018.
41. Kim J., Yoon D.W., Lee S.K., Lee S., Choi K.M., Robert T.J., Shin C. Concurrent presence of inflammation and obstructive sleep apnea exacerbates the risk of metabolic syndrome: A KoGES 6-year follow-up study. Medicine (Baltimore). - 2017;96(7):e4488.
42. Lafaurie G.I., Sabogal M.A., Castillo D.M., Rincón M.V., Gómez L.A., Lesmes Y.A., Chambrone L. Microbiome and microbial biofilm profiles of peri-implantitis: A systematic review // J. Periodontol. - 2017;88:1066-1089.
43. Lau P., Tran A., Chen M., Boyce E., Martin R., Calache H. Interprofessional diabetes and oral health management: what do primary healthcare professionals think? F1000Res. - 2021;10:339.
44. Martin A., Zhou P., Singh B.B., Kotsakis G.A. Transcriptome-wide Gene Expression Analysis in Peri-implantitis Reveals Candidate Cellular Pathways. JDR Clin Trans Res. - 2022;7:415-424.
45. Mombelli A., Feloutzis A., Bragger U., Lang N.P. Treatment of peri-implantitis by local delivery of tetracycline // Clin Oral Implants Res. - 2001;12:287-294.
46. Musialik K., Drygas W., Szcześniewska D., Kozakiewicz K., Głuszek J., Wierzbowska-Drabik K., Tykarski A. The Influence of Chosen Adipocytokines on Blood Pressure Values in Patients with Metabolic Syndrome. Kardiol Pol. - 2012;70(12):1237-1242.
47. Nazir M.A., Izhar F., Akhtar K., Almas K. Dentists’ awareness about the link between oral and systemic health // J. Family Community Med. -2019;26(3):206-212.
48. Naujokat H., Kunzendorf B., Wiltfang J. Dental implants and diabetes mellitus-A systematic review // Int J. Implant Dent. - 2016;2:5.
49. Ouchi N., Parker J.L., Lugus J.J., Walsh K. Adipokines in inflammation and metabolic disease. Nat Rev Immunol. - 2011;11(2):85-97.
50. Paquette D.W., Bell K.P., Phillips C., Offenbacher S., Wilder R.S. Dentists’ knowledge and opinions of oral-systemic disease relationships: relevance to patient care and education // J. Dent Educ. - 2015;79(6):626-635.
51. Passarelli P.C., Netti A., Lopez M.A., Giaquinto E.F., De Rosa G., Aureli G., Bodnarenko A., Papi P., Starzynska A., Pompa G. et al. Local/Topical Antibiotics for Peri-Implantitis Treatment: A Systematic Review. Antibiotics. - 2021;10:1298.
52. Pietropaoli D., Ortu E., Severino M., Ciarrocchi I., Gatto R., Monaco A. Glycation and oxidative stress in the failure of dental implants: A case series. BMC Res Notes. - 2013;6:296.
53. Polymeri A., Horst J., Anssari Moin D., Wismeijer D., Loos B., Laine M. Non-surgical peri-implantitis treatment with or without systemic antibiotics; a randomized controlled clinical trial // Clin Oral Implants Res. - 2022;33.
54. Prathapachandran J., Suresh N. Management of peri-implantitis // Dent Res J. - 2012;9:516.
55. Ranasinghe P., Mathangasinghe Y., Jayawardena R., Hills A.P., Misra A. Prevalence and trends of metabolic syndrome among adults in the Asia-Pacific region: a systematic review. BMC Public Health. - 2017;17:101.
56. Reaven G.M. Banting lecture 1988. Role of insulin resistance in human disease. Diabetes. - 1988;37(12):1595-1607.
57. Reaven G.M. Syndrome X: molecular basis and clinical implications. J Clin Endocrinol Metab. 1998;83(6):1897-1899.
58. Romeo E., Ghisolfi M., Carmagnola D. Peri-implant diseases. A systematic review of the literature. Minerva Stomatol. - 2004;53:215-230.
59. Roos-Jansåker A.M., Renvert S., Egelberg J. Treatment of peri-implant infections: A literature review // J. Clin Periodontol. - 2003;30:467-485.
60. Sánchez-Siles M., Lucas-Azorin J., Salazar-Sánchez N., Carbonell-Meseguer L., Camacho-Alonso F. Salivary concentration of oxidative stress biomarkers in a group of patients with peri-implantitis: A transversal study. Clin Implant Dent Relat Res. - 2016;18:1015-1022.
61. Schminke B., Vom Orde F., Gruber R., Schliephake H., Bürgers R., Miosge N. The pathology of bone tissue during peri-implantitis // J. Dent Res. - 2015;94:354-361.
62. Silva R.C., Zanin L., Ambrosano G.M.B., Flório F.M. Need and use of dental prostheses and oral health-related quality of life among adults and older adults: a systematic review // Gerodontology. - 2022.
63. Song Z., Weigl P., Wang B. Correlations of inflammatory cytokines, oxidative stress markers, and matrix metalloproteinases in gingival crevicular fluid with peri-implantitis // Eur J. Inflamm. - 2019;17:2058739219845542.
64. Souza J.G.S., Bertolini M.M., Costa R.C., Nagay B.E., Dongari-Bagtzoglou A., Barao V.A.R. Targeting implant-associated infections: Titanium surface loaded with antimicrobial. iScience. - 2021;24:102008.
65. Suh J.S., Kim S., Boström K.I., Wang C.-Y., Kim R.H., Park N.-H. Periodontitis-induced systemic inflammation exacerbates atherosclerosis partly via endothelial-mesenchymal transition in mice // Int J. Oral Sci. - 2019;11:21.
66. Tan S.J., Baharin B., Nabil S., Mohd N., Zhu Y. Does glycemic control have a dose-response relationship with implant outcomes? A comprehensive systematic review and meta-analysis // J. Evid Based Dent Pract. - 2021;21(2):101543.
67. Tekin M.B., Toker H. The effect of hyperlipidemia on bone graft regeneration of peri-implantal created defects in rabbits // Int J. Implant Dent. - 2019;5:18.
68. Tziomalos K., Athyros V.G., Karagiannis A., Mikhailidis D.P. Endothelial dysfunction in metabolic syndrome: prevalence, pathogenesis and management. Nutr Metab Cardiovasc Dis. - 2010;20(2):140-146.
69. Udagawa N., Takahashi N., Yasuda H., Mizuno A., Itoh K., Ueno Y., Shinki T., Gillespie M.T., Martin T.J., Higashio K. Osteoprotegerin produced by osteoblasts is an important regulator in osteoclast development and function // Endocrinology. - 2000;141:3478-3484.
70. van Winkelhoff A.J. Antibiotics in the treatment of peri-implantitis // Eur J. Oral Implantol. - 2012;5(Suppl):S43-S50.
71. Vohra F., Alkhudhairy F., Al-Kheraif A.A., Akram Z., Javed F. Peri-implant parameters and C-reactive protein levels among patients with different obesity levels // Clin Implant Dent Relat Res. - 2018;20:130-136.
72. Wang H., Liu Y., Li W., Li W., Xu H., Niu G., Wang Z. Microbiota in Gingival Crevicular Fluid Before and After Mechanical Debridement With Antimicrobial Photodynamic Therapy in Peri-Implantitis. Front Cell Infect Microbiol. - 2022;11:777627.
73. Werny J.G., Sagheb K., Diaz L., Kämmerer P.W., Al-Nawas B., Schiegnitz E. Does vitamin D have an effect on osseointegration of dental implants? A systematic review // Int J. Implant Dent. - 2022;8(1):16.
74. Zhang S., Wang M., Jiang T., Zhou Y., Wang Y. Roles of a new drug-delivery healing abutment in the prevention and treatment of peri-implant infections: A preliminary study. RSC Adv. - 2018;8:38836-38843.
75. Zhao Y., Pu R., Qian Y., Shi J., Si M. Antimicrobial photodynamic therapy versus antibiotics as an adjunct in the treatment of periodontitis and peri-implantitis: A systematic review and meta-analysis. Photodiagnosis Photodyn Ther. - 2021;34:102231.
76. Ziebolz D., Reiss L., Schmalz G., Krause F., Haak R., Mausberg R.F. Different views of dentists and general medical practitioners on dental care for patients with diabetes mellitus and coronary heart diseases: results of a questionnaire-based survey in a district of Germany // Int Dent J. - 2018;68(3):197-203.
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66. Tan S.J., Baharin B., Nabil S., Mohd N., Zhu Y. Does glycemic control have a dose-response relationship with implant outcomes? A comprehensive systematic review and meta-analysis // J. Evid Based Dent Pract. - 2021;21(2):101543.
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68. Tziomalos K., Athyros V.G., Karagiannis A., Mikhailidis D.P. Endothelial dysfunction in metabolic syndrome: prevalence, pathogenesis and management. Nutr Metab Cardiovasc Dis. - 2010;20(2):140-146.
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71. Vohra F., Alkhudhairy F., Al-Kheraif A.A., Akram Z., Javed F. Peri-implant parameters and C-reactive protein levels among patients with different obesity levels // Clin Implant Dent Relat Res. - 2018;20:130-136.
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73. Werny J.G., Sagheb K., Diaz L., Kämmerer P.W., Al-Nawas B., Schiegnitz E. Does vitamin D have an effect on osseointegration of dental implants? A systematic review // Int J. Implant Dent. - 2022;8(1):16.
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75. Zhao Y., Pu R., Qian Y., Shi J., Si M. Antimicrobial photodynamic therapy versus antibiotics as an adjunct in the treatment of periodontitis and peri-implantitis: A systematic review and meta-analysis. Photodiagnosis Photodyn Ther. - 2021;34:102231.
76. Ziebolz D., Reiss L., Schmalz G., Krause F., Haak R., Mausberg R.F. Different views of dentists and general medical practitioners on dental care for patients with diabetes mellitus and coronary heart diseases: results of a questionnaire-based survey in a district of Germany // Int Dent J. - 2018;68(3):197-203.
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