Laboratory for Anthropology and Skeletal Biology, Institute for Anatomy, School of Medicine, University of Belgrade, Dr Subotica starijeg 4, Belgrade, 11000, Serbia.
Institute for Osteology and Biomechanics, University Medical Center Hamburg- Eppendorf, Lottestrasse 55, 22529, Hamburg, Germany.
Clin Oral Investig. 2021 Jul;25(7):4377-4400. doi: 10.1007/s00784-020-03751-1. Epub 2021 Mar 11.
With the higher risk of dental implant failure with type 2 diabetes mellitus (T2DM), there is a need to characterize the jaw bones in those individuals. The aim of this post mortem study was to compare jaw bone quality of individuals with T2DM to healthy controls.
Bone cores from the edentulous lower first molar region and the region of mandibular angle were collected from male individuals with T2DM (n = 10, 70.6 ± 4.5 years) and healthy controls (n = 11, 71.5 ± 3.8 years) during autopsy. Within the T2DM, a subgroup treated with oral antidiabetics (OAD) and one on insulin were identified. Bone quality assessment encompassed evaluation of bone microstructure, matrix composition, and cellular activity, using microcomputed tomography (micro-CT), quantitative backscattered electron imaging (qBEI), Raman spectroscopy, and bone histomorphometry.
In the mandibular angle, T2DM showed 51% lower porosity of the lingual cortex (p = 0.004) and 21% higher trabecular thickness (p = 0.008) compared to control. More highly mineralized bone packets were found in the buccal cortex of the mandibular angle in insulin-treated compared to OAD-treated T2DM group (p = 0.034). In the molar region, we found higher heterogeneity of trabecular calcium content in T2DM insulin compared to controls (p = 0.015) and T2DM OAD (p = 0.019). T2DM was associated with lower osteocyte lacunar size in the trabecular bone of the molar region (vs. control p = 0.03).
Alterations in microstructure, mineralization, and osteocyte morphology were determined in jaw bone of individuals with T2DM compared to controls.
Future studies will have to verify if the mild changes determined in this study will translate to potential contraindications for dental implant placements.
由于 2 型糖尿病（T2DM）患者种植牙失败的风险较高，因此需要对这些患者的颌骨进行特征描述。本尸检研究的目的是比较 T2DM 患者与健康对照组的颌骨质量。
从 T2DM 男性患者（n=10，70.6±4.5 岁）和健康对照组（n=11，71.5±3.8 岁）的无牙下颌第一磨牙区和下颌角区采集骨芯。在 T2DM 中，确定了接受口服降糖药（OAD）治疗和接受胰岛素治疗的亚组。使用微计算机断层扫描（micro-CT）、定量背散射电子成像（qBEI）、拉曼光谱和骨组织形态计量学评估骨质量评估，包括评估骨微结构、基质组成和细胞活性。
在下颌角，T2DM 患者的舌侧皮质骨的孔隙率比对照组低 51%（p=0.004），而小梁厚度比对照组高 21%（p=0.008）。与 OAD 治疗的 T2DM 组相比，胰岛素治疗的 T2DM 患者的下颌角颊侧皮质中有更多矿化程度更高的骨束（p=0.034）。在磨牙区，我们发现 T2DM 胰岛素组的小梁钙含量异质性高于对照组（p=0.015）和 T2DM OAD 组（p=0.019）。与对照组相比，T2DM 患者磨牙区小梁骨中的破骨细胞腔隙较小（p=0.03）。
与对照组相比，T2DM 患者颌骨的微观结构、矿化和破骨细胞形态发生了变化。
未来的研究将不得不验证本研究中确定的轻微变化是否会转化为种植牙放置的潜在禁忌症。
