Are Dyslipidemias a risk factor for Peri-Implant complications? A Systematic review and meta-analysis.

Abstract

<h4>Background</h4>Dyslipidemia, characterized by high levels of lipids in the blood, can influence bone metabolism, interfere with the osseointegration of dental implants, and favor peri-implant complications. This systematic review aimed to analyze whether elevated serum levels of total cholesterol and its fractions, as well as triglycerides, constitute a risk factor for peri-implant complications.<h4>Material and methods</h4>This systematic review was conducted by PRISMA and was registered in PROPSPERO under CRD number 42023456517. The search strategy was performed in the Medline (Pubmed), Embase, Scopus, Web of Science, Cochrane Library, and LLACS/BVS databases. Additional searches were conducted in the gray literature, as well as manual searches. Experimental and observational studies of patients undergoing dental implants, in which their lipid levels were analyzed and in which the outcomes of peri-implantitis, implant loss, or bone resorption were evaluated. The assessment of methodological quality was performed using the JBI Instrument, and the assessment of the certainty of the evidence was performed using GRADE.<h4>Results</h4>The database search strategy resulted in 2,714. After removing duplicates and reading titles and abstracts, 48 were read in full. Of these, eight were included in the systematic review, in addition to three articles included from additional searches, totaling 11 studies, and a total of 1704 patients constituted the sample. Nine studies identified a significant association between elevated lipid levels and peri-implant complications. The meta-analysis demonstrated a strong association between peri-implantitis and dyslipidemia (OR 12.36; 95% CI: 7.85-19.46; <i>P</i>< 0.00001).<h4>Conclusions</h4>Dyslipidemia was identified as a risk factor for peri-implant complications. This can be explained by the interference that high levels of cholesterol and its fractions can cause in bone metabolism, making it deficient due to an exacerbated inflammatory response. Cholesterol and triglyceride levels must be assessed and controlled preoperatively to reduce peri-implant complications. <b>Key words:</b>Dyslipidemias, Hyperlipidemias, Dental implants, Peri-Implantitis, Systematic Review.