Korean researchers said they have discovered a way to help diabetic patients receive dental implants more successfully.
|Professor Lee Jae-hoon of Prosthodontics Department at Yonsei University College of Dentistry|
The research team, led by Lee Jae-hoon, a professor of prosthodontics at Yonsei University College of Medicine, published a paper on Molecules, an international journal of chemistry, to explain why diabetic patients often have implant failure and how to resolve the issue.
The success of a dental implant relies on peripheral bone formation and adhesion after the procedure. The bones should grow well and be firmly attached to the implant so that the implant can function appropriately as a tooth.
Ordinary adults have a 95 percent success rate in dental implants. However, patients with uncontrolled diabetes are vulnerable to implant failure.
The researchers paid attention to hypoxia-inducible factor 1α (HIF-1α), a transcription factor. HIF-1α is expressed during bone repair after fracture or osteotomy. It mediates angiogenesis and osteogenesis to accelerate bone formation.
However, the expression of HIF-1α is unstable in diabetic patients because of uncontrolled blood sugar, the researchers said. High blood glucose inhibits the accumulation of HIF-1α.
Lee’s team set a hypothesis that exogenous HIF-1α might solve the problem and tested it in four different groups of animal models.
The four were: Group NH, normal mice with HIF-1α gel; Group NP consisted of normal mice with placebo gel; Group DH, diabetic mice with HIF-1α gel; and Group DP, diabetic mice with placebo gel.
Then, the researchers checked each group’s bone to implant contact (BIC) and bone volume (BV).
BIC shows how much and how strongly the implant was attached to the bone. BV indicates how stable the bone-supported implant is.
The results showed that BIC of the normal group with HIF-1α gel (NH) was 55 percent, compared with 45 percent BIC of the healthy group with the placebo gel (NP).
The diabetic group with HIF-1α gel (DH) had 38 percent BIC, whereas the diabetic group with the placebo (DP) had 18 percent BIC. Not only in the regular groups but in the diabetic groups, HIF-1α gel made a significant difference in the bone generation around the implant.
BV marked 50 percent, 50 percent, 47 percent, and 28 percent in NH, NP, DH, and DP, respectively. The figures signal that even if mice have diabetes, HIF-1α gel raises the level of bone formation.
“The data showed that HIF-1α had a crucial role in diabetic groups rather than normal groups,” the research team said.
The study is also noteworthy that the researchers used a protein transduction domain (PTD)-mediated DNA delivery system to inject HIF-1α gel in the implant site.
The reason Lee’s team paid particular attention to HIF-1α among various mechanisms inhibiting bone formation in diabetic patients was that HIF-1α had a low risk of complications.
“This study shows that diabetic patients will also have an opportunity to have a successful implant treatment,” Lee said. “It is meaningful because we found a method to easily deliver a transcription factor that is effective in a bone generation.”