Association between peri-implantitis and diabetes

Background + Aims

• Peri-implantitis is a plaque-associated inflammatory disease affecting tissues surrounding dental implants, with progressive loss of supporting bone. It differs from peri-implant mucositis, where inflammation is confined to the soft tissues without progressive supporting bone loss.
• This study aimed to:
  • Investigate how diabetes influences bone destruction and tissue responses during experimental peri-implantitis.

Materials + Methods

• 27 male mice received titanium implants and were allocated to control, peri-implantitis, or diabetes + peri-implantitis groups.
• Diabetes was induced using streptozotocin; peri-implantitis was induced with silk ligatures for 2-weeks.
• Micro-CT assessed linear and volumetric bone loss.
• Tissue analyses examined inflammatory cells, osteoclasts, collagen and matrix-remodelling proteins.
• Bone analyses included 9 mice per group
• Histological analyses generally included 3 per group.

Results

• Diabetes + peri-implantitis group had increased linear and volumetric bone loss compared with peri-implantitis alone.
• Diabetic mice showed more osteoclasts (the cells responsible for bone resorption) and greater inflammatory-cell accumulation.
• MMP-2 and MMP-8 expression increased, while TIMP-2 expression decreased.
  • NB: MMPs, or matrix metalloproteinases, are enzymes involved in breaking down the extracellular matrix (the structural network supporting cells). MMP-8 is a collagenase, while MMP-2 is a gelatinase. TIMPs are natural regulators that restrain metalloproteinase activity. Their balance helps regulate normal tissue turnover; disruption can favour excessive tissue degradation. However, measuring protein expression does not directly establish enzymatic activity
• Collagen organisation was more disrupted in diabetic peri-implant tissues.

Limitations