Bone regeneration in diabetic patients. A systematic review

Abstract

Background Oral bone regeneration techniques (OBRT) attempt to provide the appropriate bone volume and density to correctly accomplish dental implant treatments. The objective was to determine whether differences exist in the clinical outcomes of these techniques between diabetic and non-diabetic patients, considering the level of scientific evidence. Material and Methods A systematic review following PRISMA statements was conducted in the PubMed, Scopus and Cochrane databases with the search terms: “Diabetes Mellitus”, “guided bone regeneration”, “bone regeneration”, “alveolar ridge augmentation”, “ridge augmentation”, bone graft*, “sinus floor augmentation”, “sinus floor elevation”, “sinus lift”, implant*. Articles were limited to those published less than 10 years ago and in English. Inclusion criteria were: human studies of all bone regeneration techniques, including at least 10 patients and the using OBRT in diabetic and non-diabetic patients. Non-human studies were excluded. They were stratified according to their level of scientific evidence related to SORT criteria (Strength of Recommendation Taxonomy). Results The initial search provided 131 articles, after reading the abstracts a total of 33 relevant articles were selected to read the full text and analyzed to decide eligibility. Finally, seven of them accomplished the inclusion criteria: two controlled clinical trials, one cohort study and four case series. Conclusions A low grade of evidence regarding the use of OBRT in diabetic patients was found. The recommendation for this intervention in diabetic patients is considered type C due to the high heterogeneity of the type of diabetic patients included and the variability of the techniques applied. Key words: Diabetes Mellitus, guided bone regeneration, bone regeneration.

Morphological Characteristics and Correction of Long Tubular Bone Regeneration under Chronic Hyperglycemia Influence

“…Research results report on high percentage (8 to 32%) of reparative osteogenesis disorders in type 2 DM patients and that hyperglycemia leads to decrease of proliferation and differentiation of cartilage and osteoblastic diferon cells involved in regeneration [14][15][16][17]. Our study revealed proliferation and differentiation disorders of osteoblastic diferon towards the formation of fibrocartilage regenerate in animals with CH.…”

Biomineralization inspired 3D printed bioactive glass nanocomposite scaffolds orchestrate diabetic bone regeneration by remodeling micromilieu

“…As reported, mineral homeostasis and osteoid production are significantly decreased in TIIDM patients [ 12 ], which might represent a new target for improving bone quality in patients. Will the scaffold-produced ionic environment modulate the biomineralization process by regulating ion metabolism?…”

“…The serum levels of osteocalcin (OCN) are decreased in DM, which alters calcium and phosphate homeostasis [ 10 ] . Additionally, the impairment of parathyroid hormone activity is also observed in DM, which could further induce disordered phosphorus and calcium (Ca–P) metabolism [ 11 , 12 ]. This disordered Ca–P metabolism further results in the alteration of osteo-differentiation into adipo-differentiation and impairs osteogenic differentiation, which inhibits bone regeneration and reduces bone quality and quantity [ 4 , 7 , 9 , 13 ].…”

Relationship between the levels of awareness and knowledge of periodontitis in diabetic patients at a Dental Hospital during the COVID-19 pandemic

“…2,7 Patients with uncontrolled diabetes frequently experience oral problems affecting the periodontal tissues, calcified tissues, and oral mucosa. 5,8 Studies have shown patients cannot achieve effective plaque control without motivational procedures based on education and information on periodontal diseases and their initiating and etiological factors. 9 Oral health education is a primary defense against periodontal diseases.…”