Abstract
BackgroundOral bone regeneration techniques (OBRT) attempt to provide the appropriate bone volume and density to correctly accomplish dental implant treatments. The objective was to determine whether differences exist in the clinical outcomes of these techniques between diabetic and non-diabetic patients, considering the level of scientific evidence.Material and MethodsA systematic review following PRISMA statements was conducted in the PubMed, Scopus and Cochrane databases with the search terms: “Diabetes Mellitus”, “guided bone regeneration”, “bone regeneration”, “alveolar ridge augmentation”, “ridge augmentation”, bone graft*, “sinus floor augmentation”, “sinus floor elevation”, “sinus lift”, implant*. Articles were limited to those published less than 10 years ago and in English. Inclusion criteria were: human studies of all bone regeneration techniques, including at least 10 patients and the using OBRT in diabetic and non-diabetic patients. Non-human studies were excluded. They were stratified according to their level of scientific evidence related to SORT criteria (Strength of Recommendation Taxonomy).ResultsThe initial search provided 131 articles, after reading the abstracts a total of 33 relevant articles were selected to read the full text and analyzed to decide eligibility. Finally, seven of them accomplished the inclusion criteria: two controlled clinical trials, one cohort study and four case series.ConclusionsA low grade of evidence regarding the use of OBRT in diabetic patients was found. The recommendation for this intervention in diabetic patients is considered type C due to the high heterogeneity of the type of diabetic patients included and the variability of the techniques applied. Key words:Diabetes Mellitus, guided bone regeneration, bone regeneration.
Highlights
Alveolar crest volume reduction is a common consequence of tooth loss and can be, a difficulty for the treatment planning, and a contraindication for dental implants placement
One of the most prevalent systemic diseases worldwide is diabetes mellitus (DM), a chronic metabolic disorder composed of two subtypes: Type 1 DM involves 5-10% of diabetic patients and is an autoimmune disorder related to the destruction of pancreatic β-cells and the consequent deficit in insulin production; Type 2 DM, involves 90-95% of diabetic patients and is a multifactorial disease caused by environmental factors which lead to peripheral or cellular insulin resistance in genetically predisposed cases (4)
Chronic hyperglycemia affects different tissue structures and produces an inflammatory effect, which results in a negative imbalance in the process of bone remodelation due to a decrease in bone formation rather than an increase in reabsorption as a consequence of the inhibitory effect of hyperglycemia on osteoblastic differentiation, impairment of parathyroid hormone activity which regulates phosphorus and calcium metabolisms (7) and a reduction in adherence, growth and accumulation of the extracellular matrix, as it has been demonstrated in experimental models that mineral homeostasis and osteoid production are significantly decreased in DM patients (6)
Summary
Alveolar crest volume reduction is a common consequence of tooth loss and can be, a difficulty for the treatment planning, and a contraindication for dental implants placement. Chronic hyperglycemia affects different tissue structures and produces an inflammatory effect, which results in a negative imbalance in the process of bone remodelation due to a decrease in bone formation rather than an increase in reabsorption as a consequence of the inhibitory effect of hyperglycemia on osteoblastic differentiation, impairment of parathyroid hormone activity which regulates phosphorus and calcium metabolisms (7) and a reduction in adherence, growth and accumulation of the extracellular matrix, as it has been demonstrated in experimental models that mineral homeostasis and osteoid production are significantly decreased in DM patients (6) Such models showed that a persistent normoglycemic levels is directly correlated with an increased bone matrix and osteoid generation at a rate similar to controls, increasing bone formation around the dental implants (6-9). The recommendation for this intervention in diabetic patients is considered type C due to the high heterogeneity of the type of diabetic patients included and the variability of the techniques applied
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
