Influence of a state of chronic hyperglycemia on guided bone regeneration—A systematic review of studies on animal-models

• Published in: Surgery in practice and science Vol. 2; p. 100015
• Main Authors: Siddiqui, Humayun Kaleem, Azeem, Sahar, Kotsailidi, Elli Anna, Javed, Fawad
• Format: Journal Article
• Language: English
• Published: Elsevier Ltd 01.09.2020; Elsevier
• Subjects: Bone formation; Diabetes; Guided bone regeneration; Hyperglycemia; Hyperglycemia; Guided bone regeneration; Bone formation; Diabetes
• ISSN: 2666-2620; 2666-2620
• DOI: 10.1016/j.sipas.2020.100015

•The aim was to systematically review the influence of chronic hyperglycemia on GBR.•Ten studies on animal-models were included.•In animal models, GBR is effective under hyperglycemic conditions.•The clinical efficacy of GBR in hyperglycemic patients needs further investigations. The aim was to systematically review indexed literature regarding the influence of a state of chronic hyperglycemia on guided bone regeneration (GBR). The addressed focused question was "What is the influence of a state of chronic hyperglycemia on GBR?”. Databases were searched using different combinations of the following key words: “hyperglycemia”, “diabetes”, “guided bone regeneration”, “bone formation”. Full-texts of articles judged by title and abstract to be relevant were read and independently evaluated for the eligibility criteria. Letters to the editor, historic reviews, case reports, case-series and unpublished articles were excluded. Ten experimental studies involving animal-models were included. Six studies were performed in rats and four studies were performed in rabbits. Total number of subjects ranged from 14 to 68 animals with a mean age range of 4 to 22 weeks. GBR was performed on maxillary, mandibular and parietal bones in one, one and eight studies respectively. Substances used for GBR included polytetrafluoroethylene (PTFE) membrane, titanium reinforced PTFE membrane, porous chitosan scaffold, methyl methacrylate hemispheres and titanium domes. Four studies showed comparable outcomes for new bone formation (NBF), among diabetics with GBR and healthy animals. Four out of five studies showed comparable outcomes in terms of NBF at follow up among animals in the diabetic and control-groups. Two studies showed comparable amounts of NBF in animals with poorly- and well-controlled diabetes after GBR. In animal-models with experimental diabetes, GBR is effective in inducing NBF; however, the effectiveness of GBR in patients with chronic hyperglycemic conditions (such as poorly controlled diabetes and prediabetes) warrants further studies.