The effect of experimental diabetes and glycaemic control on guided bone regeneration:histology and gene expression analyses


OBJECTIVES: To investigate the effect of experimental diabetes and metabolic control on intramembranous bone healing following guided bone regeneration (GBR). MATERIAL AND METHODS: Ninety-three Wistar rats were allocated to three experimental groups, healthy (H), uncontrolled diabetes (D) and controlled diabetes (CD). Twenty one days following diabetes induction, a standardised 5-mm defect was created at the mid-portion of each parietal bone. In 75 animals (25H, 25D, 25CD), one defect was treated with an intracranial and extracranial membrane according to the GBR principle, and one defect was left empty (control); five animals per group were then randomly sacrificed at 3, 7, 15, 30 and 60 days and processed for decalcified histology. In 18 animals (6H, 6D, 6CD), both defects were treated according to the GBR principle; three animals from each group were then randomly sacrificed at 7 and 15 days of healing and employed for gene expression analysis. RESULTS: Application of the GBR therapeutic principle led to significant bone regeneration even in the D group. However, at 15 and 30 days, the osteogenesis process was impaired by uncontrolled diabetes, as shown by the significant reduction in terms of defect closure (38-42%) and newly formed bone (54-61%) compared to the healthy group. The comparison of the D vs. H group at 15 days of healing yielded the largest number of genes with significantly differential expression, among which various genes associated with the ossification process (bmp4, ltbp4, thra and cd276) were identified. CONCLUSIONS: Uncontrolled diabetes seems to affect early phases of the bone regeneration following GBR. A misregulation of genes and pathways related to cell division, energy production, inflammation and osteogenesis may account for the impaired regeneration process in D rats. Further studies are warranted to optimise the GBR process in this medically compromised patient population.

Publication DOI:
Divisions: Life & Health Sciences
Life & Health Sciences > Cell & Tissue Biomedical Research
Additional Information: This is the peer reviewed version of the following article: Retzepi, M, Calciolari, E, Wall, I, Lewis, MP, Donos, N. The effect of experimental diabetes and glycaemic control on guided bone regeneration: histology and gene expression analyses. Clin. Oral Impl. Res. 29, 2018, 139– 154, which has been published in final form at  This article may be used for non-commercial purposes in accordance With Wiley Terms and Conditions for self-archiving.
Uncontrolled Keywords: Animals,Bone Regeneration,Diabetes Mellitus, Experimental/complications,Gene Expression Profiling,Guided Tissue Regeneration,Male,Parietal Bone/growth & development,Rats,Rats, Wistar
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Related URLs: https://onlinel ... .1111/clr.13031 (Publisher URL)
PURE Output Type: Article
Published Date: 2018-02-01
Published Online Date: 2017-07-18
Accepted Date: 2017-05-23
Authors: Retzepi, M
Calciolari, E
Wall, I ( 0000-0001-6294-8348)
Lewis, M P
Donos, N



Version: Accepted Version

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