Effect of high glucose levels and lipopolysaccharides-induced inflammation on osteoblast mineralization over sandblasted/acid-etched titanium surface.

Background And Purpose: Poorly controlled diabetes mellitus has been related to higher risk of implant treatment complications due to increased susceptibility to infection and delayed wound healing. Lipopolysaccharides (LPS) stimulate cytokine production leading to chronic inflammation and immunological host response that accentuates the destruction of periodontal tissues. This study aimed to evaluate the effect of different glycemic conditions on secretion and mineralization of bone matrix under sterile inflammation induced by LPS on osteoblasts seeded over sandblasted/acid-etched (SLA) titanium surface.

Materials And Methods: Osteoblast cell viability was performed to determine the influence of different glucose concentrations (5.5, 8, 12, and 24 mM), which were chosen to reflect normal, postprandial, and high glucose values, similar to those typically seen in Diabetes mellitus under clinical conditions. Cells were seeded on titanium SLA discs (Straumann AG, Waldenburg, Switzerland) and exposed to glucose concentrations and LPS (1μg/mL) in order to test inflammatory response (qPCR) and mineralization (Alizarin Red staining).

Results: Osteoblast viability was severely decreased when exposed to higher glucose levels (≥12 mM) and LPS (P < .05) compared to control. When the osteoblasts were exposed to LPS and glucose at ≥8 mM, the gene transcripts of inflammatory cytokines were ≈2.5-fold upregulated, while ≤8 mM glucose elicited no significant change compared to control without glucose treatment (P > .05). Osteoblasts exposed to LPS produced sparse extracellular matrix mineralization, especially combined with higher glucose values (≥12 mM), together with decreased calcium deposition compared to control (P < .05).

Conclusions: High glucose levels combined with LPS inflammatory stimulation elicited an adverse effect on the volume and quality of mineralized hard tissue formation on SLA titanium surfaces in vitro. Hence, both normal glucose levels and infection control including low levels of circulating LPS during initial osseointegration period may be required to increase the success rate of dental implants.