Bone response around immediately placed titanium implant in the extraction socket of diabetic and insulin-treated rat maxilla

Dae-Won Kim; Hyun-A Heo; Sang-Gyu Lim; Won Lee; Young-Sil Kim; Sung-Woon Pyo

doi:10.5125/jkaoms.2011.37.1.30

Journal List > J Korean Assoc Oral Maxillofac Surg > v.37(1) > 1032481

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Kim, Heo, Lim, Lee, Kim, and Pyo: Bone response around immediately placed titanium implant in the extraction socket of diabetic and insulin-treated rat maxilla

Original Article

J Korean Assoc Oral Maxillofac Surg 2011;37(1):30-35.

Published online: 10 January 2011

DOI: https://doi.org/10.5125/jkaoms.2011.37.1.30

Bone response around immediately placed titanium implant in the extraction socket of diabetic and insulin-treated rat maxilla

Dae-Won Kim¹, Hyun-A Heo², Sang-Gyu Lim², Won Lee^1,², Young-Sil Kim³, Sung-Woon Pyo^1,²

¹Department of Oral and Maxillofacial Surgery, Graduate School of Clinical Dental Science, The Catholic University of Korea

²Division of Oral and Maxillofacial Surgery, Department of Dentistry, School of Medicine, The Catholic University of Korea, Bucheon

³Department of Pathology, College of Medicine, Jeju National University, Jeju, Korea

Sung-Woon Pyo Department of Oral and Maxillofacial Surgery, Bucheon St. Mary's Hospital, 2 Sosa-dong, Wonmi-gu, Bucheon, 420-717, Korea TEL: +82-32-340-2134 FAX: +82-32-340-2255 E-mail: spyo@catholic.ac.kr

Received 28 September 2010 Revised 17 December 2010 Accepted 20 January 2011

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Introduction

Dental implants are used routinely with high success rates in generally healthy individuals. By contrast, their use in patients with diabetes mellitus is controversial because altered bone healing around implants has been reported. This study examined the bone healing response around titanium implants placed immediately in rats with controlled and uncontrolled diabetes.

Materials and Methods

Twenty rats were divided into the control, insulin-treated and diabetic groups. The rats received streptozotocin (60 mg/kg) to induce diabetes; animals in the insulin-treated group also received three units of subcutaneous slow-release insulin. A titanium implant (1.2×3 mm) was placed in the extraction socket of the maxillary first molar and bone block was harvested at 1, 2 and 4 weeks.

Results

Bone formation around the implants was consistently (from 1 to 4 week post-implantation) slower for the diabetic group than the control and insulin-treated group. Bone morphogenesis in the diabetic rats was characterized by fragmented bone tissues and extensive soft tissue intervention.

Conclusion

The immediate placement of titanium implants in the maxilla of diabetic rats led to an unwanted bone healing response. These results suggest that immediate implant insertion in patients with poorly controlled diabetes might be contraindicated.

Keywords: Diabetes mellitus, Dental implants, Insulin, Bone remodeling, Osseointegration

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Fig. 1.

Schematic design of the experiment A and titanium implants placed in the extraction socket of both maxillary first molars B.

Fig. 2.

Hematoxylin and eosin-stained histological sections of bone implant interface 2 weeks after implantation.(original magnification ×40) No apparent differences between the groups could be observed. A. Control group. B. Diabetic group. C. Insulin-treated group.

Fig. 3.

Hematoxylin and eosin-stained sections of bone implant interface 2 weeks after implantation.(original magnification ×200) Less organized and more cellular woven bone in sections from diabetic group is observed. A. Control group. B. Diabetic group. C. Insulin-treated group.

Fig. 4.

Hematoxylin and eosin-stained sections of bone implant interface 4 weeks after implantation.(original magnification ×40) Decreased bone apposition was observed in the diabetic group, which suggest an impaired osteoblastic function or mineralization defect. A. Control group. B. Diabetic group. C. Insulin-treated group.

Fig. 5.

Hematoxylin and eosin-stained sections of bone implant interface 4 weeks after implantation.(original magnification ×200) Calcified mature woven bone with the marked restitution of marrow can be observed in the control and insulin-treated groups. A. Control group. B. Diabetic group. C. Insulin-treated group.

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