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

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.

Implant Stability Parameters & Bone Density Values of Different Graft Materials with Immediately Placed Dental Implants

“…Similar to group A bone density showed significant increase (P ≤ 0.05) at three months postoperatively (1034.50 ±75.15HU) in comparison to two weeks interval (881.17±31.32HU) & significant decrease (P ≤ 0.05) of bone density measurements at six months postoperatively (781.83±46.84 HU) in comparison to the three months postoperative record. Table (6) When the three groups were compared to each other there was significant difference (P ≤0.…”

“…(3,4) with high survival rates reaching more than 95%. (3,(5)(6)(7) Authors described primary implant stability as a guiding factor for long term success predictability of immediate implants. (1,8) Clinical & experimental studies reported dimensional changes of the alveolar bone following tooth extraction with varying degrees of vertical & horizontal bone loss.…”