Glycemic fluctuation exacerbates inflammation and bone loss and alters microbiota profile around implants in diabetic mice with experimental peri-implantitis

Abstract

Background The impact of glycemic fluctuation under diabetic condition on peri-implantitis in diabetic patients remains unclear. We hypothesized that glycemic fluctuation has greater adverse effect on experimental peri-implantitis, compared with sustained high blood glucose in diabetes. Results Maxillary left first and second molars of diabetic db/db mice were extracted and were replaced with one dental implant in the healed edentulous space. Glycemic control or fluctuation were managed by constant or interrupted oral administration of rosiglitazone to these mice. Meanwhile, experimental peri-implantitis was induced by ligation around implants. After 14 weeks, inflammatory responses, and peri-implant bone loss, together with oral microbiota profile were analyzed. Diabetic mice with glycemic fluctuation showed greater peri-implant bone loss, inflammatory cell infiltration, and osteoclastogenesis, compared with mice with sustained hyperglycemia. Compared to sustained hyperglycemia, glycemic fluctuation led to further increase in IL-1β, TNFα, RANKL, TLR2/4, IRAK1, and TRAF6 mRNA expression in peri-implant gingival tissues. Both rosiglitazone-induced glycemic control and glycemic fluctuation caused microbiota profile change in diabetic mice compared to that in uncontrolled hyperglycemic mice. Conclusions This study suggests that glycemic fluctuation may aggravate peri-implantitis inflammation and bone loss, which may be associated with a shift in peri-implant microbial profile towards dysbiotic changes and the activation of TLR2/4-IRAK1-TRAF6 signaling.

Rodent peri-implantitis models: a systematic review and meta-analysis of morphological changes

“…Details pertaining to the experimental protocols are summarized in Tables 3 , 4 , 5 , and 6 . Several histological features of peri-implantitis were reported, including the apical migration and formation of pocket epithelium [ 19 22 ], degradation of collagen fibers [ 20 23 ] with concomitant inflammatory cell infiltration of the connective tissue [ 19 24 25 ], increased osteoclastogenesis [ 20 22 23 26 27 ], and MBL [ 11 13 15 17 18 19 20 21 22 23 25 27 28 29 30 ]. Although histology was performed in 22 studies, histomorphometric measurements of the MBL and supracrestal soft tissue alterations were reported in only 5 and 2 studies, respectively.…”

“…Thus, rodent models can be potentially used to explore the interactions between these diseases and peri-implantitis. As discussed in this review, rodent models have been used to determine the impact of diabetes mellitus [ 17 21 27 ] and xerostomia [ 18 ] on peri-implantitis. While an association between diabetes mellitus and peri-implantitis has been described, this relationship is poorly defined [ 2 ].…”

CCK regulates osteogenic differentiation through TNFα/NF-κB in peri-implantitis

“…Additionally, inflammation and bone loss play essential roles in the occurrence and development of peri-implantitis. 27 Inflammation inhibits osteogenic differentiation, causing peri-implantitis and the loosening of implants. The inflammatory microenvironment of peri-implantitis can also reduce the proliferation and differentiation of mandibular osteoblasts.…”

Evaluation of Periodontopathogenic Bacteria Levels of Peri-Implants in Patients with Type 2 Diabetes Mellitus

“…Li ve ark. 28 yaptıkları deneysel çalışmada, diyabetlı bireylerde peri-implantitis gelişiminde glisemik kontrol seviyesinin esas olduğunu ve diyabetli bireylerde tükürükte ve implant çevresindeki bakteriyel kompozisyonda değişiklik meydana gelebileceğini ve bu spesifik türlerin ise diyabetli bireylerde peri-implantitis gelişimi için öncül olabileceğini bildirmiştir. Diğer yapılan bir çalışmada ise, Tatarakis ve ark.…”

“…Çalışmamızdaki diyabetli bireylerdeki Pg ve Td miktarındaki artış Li ve ark. 28 belirttiği gibi diyabetik bireylerde 7. ayda HbA1c seviyesinde görülmüş olan yükselmenin sonucunda görülmüş olabilir. Dikkat edilmesi gereken en önemli faktörlerden biri ise bireylerin oral hijyen durumları olup, takip dönemlerinde hastalara oral hijyen eğitimleri tekrarlanmıştır.…”