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

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 super-ordinate 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.