Effect of obesity/metabolic syndrome and diabetes on osseointegration of dental implants in a miniature swine model. A Pilot Study

Publication date: Available online 1 March 2018
Source:Journal of Oral and Maxillofacial Surgery
Author(s): Paulo G. Coelho, Benjamin Pippenger, Nick Tovar, Sietse-Jan Koopmans, Natalie Plana, Dana T. Graves, Steve Engebretson, Heleen V. Beusekom, Paula G.F.P. Oliveira, Michel Dard
PurposeThe increasing prevalence of obesity/metabolic syndrome (O/MS) and diabetes mellitus (DM) remains a global health concern. Clinically relevant and practical translational models mimicking human characteristics of these conditions are lacking. This study aimed to demonstrate proof of concept of the induction of stable obesity/metabolic syndrome (O/MS) and type-2 diabetes mellitus (DM) in a Göttingen minipig model and validate both of these disease-adjusted Göttingen mini-pig models as impaired healing models for the testing of dental implants.Materials and Methods9 minipigs were split into 3 groups: control (normal diet), obese (cafeteria diet) and diabetic (cafeteria diet + Streptozotocin), and followed by placement of dental implants. Inflammatory markers including TNF-α, C-reactive protein, and cortisol were recorded for each study group. Removal torque and histomorphometric analysis (bone to implant contact (BIC) and bone area fraction occupancy (BAFO)) were performed.ResultsO/MS pigs showed, on average, a 2-fold increase in plasma C-reactive protein (p<0.05) and cortisol (p<0.09) concentrations compared to controls; DM pigs showed, on average, a 40-fold increase in plasma TNF-α (p<0.05) and a 2-fold increase in cortisol (p<0.05) concentrations compared to controls. The impact of O/MS and DM on implants was determined. Torque to interface failure was highest in control (200 Ncm), and significantly lower in O/MS (90 Ncm) and DM (60 Ncm) groups (p<0.01). Bone formation around implants was significantly greater in control than O/MS and DM (p<0.02).ConclusionsBoth O/MS and DM minipigs express human-like disease phenotype and both presented bone healing impairment around dental implants. No significant difference between type-2 diabetes and obesity/metabolic syndrome on bone formation around implants provides evidence that further investigation of the impact of obesity/metabolic syndrome is warranted.



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