Is the Risk of BRONJ Greater in Diabetic Patients?

Background: Diabetes mellitus (DM) is a complex metabolic disease. It is characterized by defects in insulin production and secretion, as well as insulin resistance resulting in hyperglycemia. This contributes to inhibition of angiogenesis, impaired immune function, and reduced collagen production, which results in chronic inflammation and poor wound healing affecting both soft and hard tissue. This is manifested as an increased risk of nonunion or delayed healing of bone fractures, as well as osteomyelitis, in the diabetic patient, which is compounded by how well the disease is controlled. Objective: To assess if DM is a risk factor for developing bisphosphonate-associated osteonecrosis of the jaws (BRONJs). Design: Systematic review and meta-analysis. Methods: Central databases, such as PubMed, Scopus, Web of Science, COCHRANE, LILACS, and EBSCOhost, as well as Google Scholar, were searched. Cross-sectional, cohort, and case-control studies were selected that evaluate the associati more...