Tan Sze Jun, Baharin Badiah, Mohd Nurulhuda, Nabil Syed
KPJ Ambulatory Care Centre Kinrara, 33, 35 & 37, Jalan BK 5a/2, Bandar Kinrara, Puchong 47180, Malaysia.
Department of Restorative Dentistry, Faculty of Dentistry, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia.
Pharmaceuticals (Basel). 2022 Dec 5;15(12):1518. doi: 10.3390/ph15121518.
Animal studies have ascertained that hyperglycemia adversely affects bone metabolism and dental implant osseointegration. However, diabetic patients show low occurrence of unfavorable hard or soft peri-implant tissue changes, differences that are possibly due to treatment with anti-diabetic medications. This scoping review aimed to systematically examine the effects of these drugs on implant outcomes and explore the predictive modality of animal studies for clinical practice according to type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM). Three electronic databases (MEDLINE, EBSCOHost, and Cochrane) were searched according to the PRISMA-ScR standards for studies on diabetic animals that received titanium implants and anti-diabetic treatments. Risk assessment was performed using the SYRCLE Risk-of-Bias (RoB) tool. Twenty-one papers were included, encompassing six types of medications. Fifteen studies were on T1DM animals, and only six involved T2DM models. T1DM animals were treated with non-insulin drugs in four investigations, while insulin was utilized in 11 other studies. In T2DM experiments, five administered non-insulin drugs, and only one applied locally delivered insulin. Only insulin in T1DM studies produced a positive influence on bone-implant contact (BIC), bone mineral content, and removal torque values. Inappropriate drug selection, inadequate glycemic control, and high RoB depict a mismatch between the research focus and the translational rationale to clinical practice. There remains a knowledge gap regarding T2DM investigations due to the lack of studies. More data are needed concerning intraoral implants and the performance of osseointegrated implants in patients with a later onset of diabetes. Future research should reflect the pathophysiology and treatment of each type of diabetes to ensure clinical applicability.
动物研究已确定高血糖会对骨代谢和牙种植体骨整合产生不利影响。然而，糖尿病患者种植体周围软硬组织出现不良变化的发生率较低，这种差异可能归因于抗糖尿病药物治疗。本综述旨在系统研究这些药物对种植体结局的影响，并根据1型糖尿病（T1DM）和2型糖尿病（T2DM）探索动物研究对临床实践的预测模式。根据PRISMA-ScR标准，检索了三个电子数据库（MEDLINE、EBSCOHost和Cochrane），以查找接受钛种植体和抗糖尿病治疗的糖尿病动物研究。使用SYRCLE偏倚风险（RoB）工具进行风险评估。纳入了21篇论文，涵盖六种药物。15项研究针对T1DM动物，只有6项涉及T2DM模型。在四项研究中，T1DM动物接受非胰岛素药物治疗，而在其他11项研究中使用胰岛素。在T2DM实验中，五项使用非胰岛素药物，只有一项局部应用胰岛素。在T1DM研究中，只有胰岛素对骨-种植体接触（BIC）、骨矿物质含量和去除扭矩值产生了积极影响。药物选择不当、血糖控制不佳和高RoB表明研究重点与临床实践的转化原理不匹配。由于缺乏研究，T2DM研究仍存在知识空白。需要更多关于口腔内种植体以及糖尿病发病较晚患者中骨整合种植体性能的数据。未来的研究应反映每种类型糖尿病的病理生理学和治疗方法，以确保临床适用性。
