Efectos a corto plazo de la diabetes tipo 1 en la formación de hueso nuevo después de la expansión maxilar rápida

Given the overlap between the age of onset of type 1 diabetes mellitus (DM) and the typical timing of rapid maxillary expansion, this study aimed to evaluate the short-term effects of hyperglycemia and insulin treatment on maxillary new bone formation using radiologic and histologic analyses in an experimental rat model.

Wistar rats with type 1 DM induced with streptozotocin underwent a 5-day maxillary expansion and 12-day retention procedure (groups: control, DM, expansion, DM + expansion, and DM + expansion + insulin). Bone microstructure was assessed in the maxillae of the sacrificed rats using micro-computed tomography imaging. Then, histopathologic examination was performed to assess new bone and vascular formation and osteoblast density.

In all expansion groups, new bone formation, osteoblast number, and vascularity were histologically increased compared with the nonexpansion groups (P <0.01). The diabetic expansion (DM + expansion and DM + expansion + insulin) groups have increased bone mineral density, bone volume/trabecular volume, and trabecular thickness. The diabetic expansion (DM + expansion and DM + expansion + insulin) groups have decreased bone surface/volume ratio; trabecular separation was detected compared with the control, DM, and expansion groups, but no difference was detected in tissue volume and trabecular number.

Although metabolic status does not appear to significantly affect early bone remodeling activity associated with maxillary expansion in type 1 DM, timely intervention remains critical because of reduced bone remodeling capacity.