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The Influence of Type 2 Diabetes Mellitus on the Osseointegration of Titanium Implants With Different Surface Modifications—A Histomorphometric Study in High-Fat Diet/Low-Dose Streptozotocin–Treated Rats

Zhou, Wenjuan, DDS*,†; Tangl, Stefan, PhD; Reich, Karoline Maria, MSc, PhD§; Kirchweger, Franziska, MSc; Liu, Zhonghao, DDs PhD; Zechner, Werner, MD, DDS#; Christian Ulm, , MD, DDS**; Rausch-Fan, Xiaohui, MD, DDS, PhD††

doi: 10.1097/ID.0000000000000836
Basic and Clinical Research
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SDC

Objectives: Type 2 diabetes mellitus (T2DM) is a systemic disease that also compromises the bone healing capacity. In healthy individuals, surface modifications of dental implants are proven to increase bone response and implant success. The aim of this study was to clarify if the surface modifications also improve osseointegration in a setting with diabetes mellitus.

Methods: T2DM was induced in 7 rats by a high-fat diet/low-dose streptozotocin injection. All animals received a hydroxyapatite (HA) implant, a sandblasted and acid-etched (SLA) implant, and a standard machined titanium implant for control in the tibia. After 4 weeks, thin-ground sections were produced, and the volume of new bone formation (nBV/TV) and bone-to-implant contact (nB.I/Im.I) were histomorphometrically analyzed.

Results: Both surface modifications led to an increase of osseointegration compared with the machined surface implant in rats with T2DM. nBV/TV was highest in the SLA implants, whereas nB.I/Im.I was highest in the HA group. Regardless of the surface modification, a superordinate regional pattern of new bone formation over the length of the implant was observed.

Conclusions: Implants with HA coating and SLA surface modifications seem to have the potential to increase osseointegration also in T2DM rats when compared with a conventional machined surface.

*Dentist, Department of Implant Dentistry, Yantai Stomatological Hospital, Shangdong, China.

Research Fellow, Karl Donath Laboratory for Hard Tissue and Biomaterial Research, Division of Conservative Dentistry and Periodontology, Competence Center for Periodontal Research, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria.

Head of Laboratory, Karl Donath Laboratory for Hard Tissue and Biomaterial Research, Division of Oral Surgery, School of Dentistry, Austrian Cluster for Tissue Regeneration, Medical University of Vienna, Vienna, Austria.

§Research Fellow, Karl Donath Laboratory for Hard Tissue and Biomaterial Research, Division of Oral Surgery, School of Dentistry, Austrian Cluster for Tissue Regeneration, Medical University of Vienna, Vienna, Austria.

Research Associate, Karl Donath Laboratory for Hard Tissue and Biomaterial Research, Division of Oral Surgery, School of Dentistry, Medical University of Vienna, Austria and Austrian Cluster for Tissue Regeneration, Vienna, Austria.

Professor and Chairman, Department of Implant Dentistry, Yantai Stomatological Hospital, Professor, Shandong University, Shangdong, China.

#Professor and Deputy Head, Division of Oral Surgery, School of Dentistry, Medical University of Vienna, Vienna, Austria.

**Professor and Head, Division of Oral Surgery, School of Dentistry, Medical University of Vienna, Vienna, Austria.

††Professor and Head, Competence Center for Periodontal Research, Head for Periodontology and Prophylaxis, Division of Conservative Dentistry and Periodontology, School of Dentistry, Medical University of Vienna, Vienna, Austria.

Reprint requests and correspondence to: Xiaohui Rausch-Fan, MD, DDS, PhD, Competence Center of Periodontal Research, Division of Conservative Dentistry and Periodontology, School of Dentistry, Medical University of Vienna, Sensengasse 2a, Vienna 1090, Austria, Phone: +43 676 5665364, Fax: +43 1 40070, E-mail: xiaohui.rausch-fan@meduniwien.ac.at

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