Osseointegration of implant surfaces in metabolic syndrome and type‐2 diabetes mellitus

• Published in: Journal of biomedical materials research. Part B, Applied biomaterials Vol. 112; no. 2; p. e35382
• Main Authors: Bergamo, Edmara T. P., de Oliveira, Paula G. F. P., Campos, Tiago M. B., Bonfante, Estevam A., Tovar, Nick, Boczar, Daniel, Nayak, Vasudev Vivekanand, Coelho, Paulo G., Witek, Lukasz
• Format: Journal Article
• Language: English
• Published: United States Wiley Subscription Services, Inc 01.02.2024
• Subjects: Animals; Bone healing; Bone implants; Dental Implantation, Endosseous; Dental Implants; Diabetes; Diabetes mellitus; Diabetes Mellitus, Type 2; Diet; Durapatite - pharmacology; Humans; Hydroxyapatite; Ilium; In vivo methods and tests; Metabolic disorders; Metabolic Syndrome; Obesity; Osseointegration; Streptozocin; Surface Properties; Swine; Swine, Miniature; Titanium; Topography; metabolic diseases; osseointegration; dental implants
• ISSN: 1552-4973; 1552-4981; 1552-4981
• DOI: 10.1002/jbm.b.35382

This in vivo study evaluated the bone healing response around endosteal implants with varying surface topography/chemistry in a preclinical, large transitional model induced with metabolic syndrome (MS) and type‐2 diabetes mellitus (T2DM). Fifteen Göttingen minipigs were randomly distributed into two groups: (i) control (normal diet, n  = 5) and (ii) O/MS (cafeteria diet for obesity induction, n  = 10). Following obesity induction, five minipigs from the obese/metabolic syndrome (O/MS) group were further allocated, randomly, into the third experimental group: (iii) T2DM (cafeteria diet + streptozotocin). Implants with different surface topography/chemistry: (i) dual acid‐etched (DAE) and (ii) nano‐hydroxyapatite coating over the DAE surface (NANO), were placed into the right ilium of the subjects and allowed to heal for 4 weeks. Histomorphometric evaluation of bone‐to‐implant contact (%BIC) and bone area fraction occupancy (%BAFO) within implant threads were performed using histomicrographs. Implants with NANO surface presented significantly higher %BIC (~26%) and %BAFO (~35%) relative to implants with DAE surface (%BIC = ~14% and %BAFO = ~28%, p  < .025). Data as a function of systemic condition presented significantly higher %BIC (~28%) and %BAFO (~42%) in the control group compared with the metabolically compromised groups (O/MS: %BIC = 14.35% and %BAFO = 26.24%, p  < .021; T2DM: %BIC = 17.91% and %BAFO = 26.12%, p  < .021) with no significant difference between O/MS and T2DM ( p  > .05). Statistical evaluation considering both factors demonstrated significantly higher %BIC and %BAFO for the NANO surface relative to DAE implant, independent of systemic condition ( p  < .05). The gain increase of %BIC and %BAFO for the NANO compared with DAE was more pronounced in O/MS and T2DM subjects. Osseointegration parameters were significantly reduced in metabolically compromised subjects compared with healthy subjects. Nanostructured hydroxyapatite‐coated surfaces improved osseointegration relative to DAE, regardless of systemic condition.