Histological Analysis of the Mandible in Patients with Type 2 Diabetes Mellitus for Implant-Prosthetic Rehabilitation. A Pilot Case-Control Study

  • Daniela Popa Department of Prosthetic Dentistry, “Iuliu Haţieganu” UMPh, 32 Clinicilor Street, Cluj-Napoca, 400006, Romania
  • Raluca Iulia Juncar Faculty of Medicine and Pharmacy, University of Oradea, 10 Piața 1 Decembrie Street, 410073, Oradea, Romania
  • Mihai Juncar Faculty of Medicine and Pharmacy, University of Oradea, 10 Piața 1 Decembrie Street, 410073, Oradea, Romania
Keywords: diabet mellitus, implant-prosthetic rehabilitation, mandible, histology

Abstract

Diabetes mellitus has a major impact on the metabolic activity of a significant number of tissues. Its impact on the jaw bones cannot be neglected, especially if rehabilitation using prosthetic restorations supported on dental implants is intended. The aim of this study is to comparatively analyze vascularization, the degree of mineralization and the cellular component of the mandible in type 2 diabetes mellitus patients undergoing dental implant placement. For this study, eight patients assigned to two groups were selected. The study group included four patients with type 2 diabetes mellitus in whom dental implants were placed, and the control group comprised 4 patients without systemic pathology. The bone debris obtained after dental implant placement were collected and analyzed using hematoxylin-eosin and PAS–Alcian Blue staining. The results obtained indicated the presence of diabetic angiopathy in the mandible, a higher cellular density in the diabetic bone, and a lower degree of mineralization in the bone taken from patients of the study group. In conclusion, histological changes can be detected in the mandible of patients with type 2 diabetes mellitus compared to those without systemic disease, but their effect on bone healing cannot be quantified.

References

Thomas WO, Guy H-B, Vargas A, Alexander P, Feine J, Critical Review of Diabetes, Glycemic Control and Dental Implant Therapy Clin Oral Implants Res, vol. 24, nr.2, pp. 117-127, Feb 2013

Thomas W. Oates Jr, Patrick Galloway, Peggy Alexander, Adriana Vargas Green, Guy Huynh-Ba, Jocelyn Feine, C. Alex McMahan. The effects of elevated hemoglobin A1c in patients with type 2 diabetes mellitus on dental implants. Survival and stability at one year. JADA, vol. 145, nr.12, pp.1218-1226, 2014

Yamauchi M. Assessment of bone quality in lifestyle-related diseases. Clin Calcium, vol. 26, nr.1, pp. 65-72, Jan 2016

Piscitelli P, Neglia C, Vigilanza A, Colao A. Diabetes and bone: biological and environmental factors. Curr Opin Endocrinol Diabetes Obes., vol. 22, nr.6, pp. 439-445, Dec 2015

Maureen Rcourtney, Edward J Moler, John Aosborne. Geoff Whitney. Scott Econard. Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy, vol 8, pp. 447-453, 2015

Juncar RI, Juncar M, Onişor-Gligor F, Popa AR. Effect of masticatory forces transmitted by dental implants on the mandibular bone of patients with type 2 diabetes mellitus. Rom J Diabetes Nutr Metab Dis., vol. 22, nr. 4, pp.419-424, 2017

Anthony S. Fauci et al. Harrison’s principles of internal medicine. 17th ed. New York: McGraw Hill, Health Professions Division; 2008.

Juncar RI, Juncar M, Onişor-Gligor F, Popa AR. Effect of masticatory forces transmitted by dental implants on the mandibular bone of patients with type 2 diabetes mellitus. Rom J Diabetes Nutr Metab Dis., vol. 22, nr. 4, pp.419-424, 2017

Navarro-Sanchez AB, Faria-Almeida R, Bascones-Martinez A. Effect of non-surgical periodontal therapy on clinical and immunological response and glycaemic control in type 2 diabetic patients with moderate periodontitis. J Clin Periodontol., vol.34, nr. 10, pp.835-843, 2007

Jimenez M, Hu FB, Marino M, Yi Li, Joshipura KJ. Type 2 diabetes mellitus and 20 year incidence of periodontitis and tooth loss. Diabetes Research and Clinical Practice, vol.98, pp.494-500, 2012

Zhou W, Tangl S, Reich KM, Kirchweger F, Liu Z, Zechner W, Ulm C, Rausch-Fan X. 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. Implant Dent., vol.28, nr.1, pp.11-19, Feb 2019

Yang Y, Zeng C, Lu X, Song Y, Nie J, Ran R, Zhang Z, He C, Zhang W, Liu SM 5-Hydroxymethylcytosines in Circulating Cell-Free DNA Reveal Vascular Complications of Type 2 Diabetes. Clin Chem., Oct 2019

Hayden MR. Type 2 Diabetes Mellitus Increases The Risk of Late-Onset Alzheimer's Disease: Ultrastructural Remodeling of the Neurovascular Unit and Diabetic Gliopathy. Brain Sci., vol. 9, nr.10, pp. 262, Sep 2019

Piscitelli P, Neglia C, Vigilanza A, Colao A. Diabetes and bone: biological and environmental factors. Curr Opin Endocrinol Diabetes Obes., vol.22, nr. 6, pp.439-445, Dec 2015

Bilezikian JP, Watts NB, Usiskin K, Polidori D, Fung A, Sullivan D, Rosenthal N. Evaluation of Bone Mineral Density and Bone Biomarkers in Patients With Type 2 Diabetes Treated With Canagliflozin. J Clin Endocrinol Metab., vol.101, nr.1, pp.44-51, Jan 2016

de Oliveira-Neto OB, Santos IO, Barbosa FT, de Sousa-Rodrigues CF, de Lima FJ. Quality assessment of systematic reviews regarding dental implant placement on diabetic patients: an overview of systematic reviews. Med Oral Patol Oral Cir Bucal., vol.24, nr.4, pp.483-490, Jul 2019

Sundar G, Sridharan S, Sundaram RR, Prabhu S, Rao R, Rudresh V. Impact of well-controlled type 2 diabetes mellitus on implant stability and bone biomarkers. Int J Oral Maxillofac Implants., Jun 201

Published
2019-11-09
Section
Articles