Bone healing around implants placed in subjects with metabolically compromised systemic conditions

Area of Science:

• Oral Surgery
• Biomaterials Science
• Endocrinology

Background:

• Metabolic syndrome (MS) and type-2 Diabetes Mellitus (T2DM) are prevalent systemic conditions impacting bone metabolism.
• Impaired bone healing in these conditions can compromise the success of dental implant osseointegration.
• Understanding the specific effects of MS and T2DM on implant bone healing in different jaw locations is crucial for clinical practice.

Purpose of the Study:

• To evaluate and compare the bone healing response around dental implants in subjects with MS and T2DM versus healthy controls.
• To investigate potential differences in bone healing between the maxilla and mandible in these systemic conditions.

Main Methods:

• Eighteen Göttingen minipigs were allocated into control, MS, and T2DM groups.
• Tight-fit implants with progressive small buttress threads were placed in extracted premolar and molar sites after 8 weeks of healing.
• Histomorphometric analysis, including bone-to-implant contact (%BIC) and bone area fraction occupancy (%BAFO), was performed after 6 weeks of integration.

Main Results:

• Bone healing occurred primarily through interfacial remodeling and apposition.
• Significantly higher %BIC and %BAFO were observed in healthy and MS groups compared to the T2DM group.
• While no significant differences were found between maxilla and mandible overall, T2DM showed higher %BIC and %BAFO in the maxilla, whereas healthy and MS groups trended higher in the mandible.

Conclusions:

• Type-2 Diabetes Mellitus significantly impairs bone formation and osseointegration around dental implants compared to metabolic syndrome and healthy states.
• Metabolic syndrome alone does not significantly compromise implant bone healing compared to healthy controls.
• Jaw location may influence implant healing outcomes in T2DM, with potentially better results in the maxilla.