How does diabetes affect implantitis (peri-implant disease)?

Correct answer: A. Inhibit osteoblast activity

• A. Diabetes INHIBITS OSTEOBLAST ACTIVITY through: (1) Advanced Glycation End-products (AGEs) that impair osteoblast function, (2) reduced insulin/IGF-1 signaling necessary for osteoblast differentiation, (3) increased oxidative stress. This leads to impaired osseointegration, reduced bone-to-implant contact, delayed healing, and increased peri-implantitis susceptibility. Poorly controlled DM is a relative contraindication for implant placement.
• B. Diabetes DECREASES collagen synthesis by impairing fibroblast function and increasing collagen cross-linking through AGE formation. This leads to impaired wound healing, not increased collagen.
• C. Diabetes causes microvascular disease and DECREASES local vascularity — impaired angiogenesis is a major factor in poor wound healing in diabetic patients.
• D. Diabetes tends to INCREASE osteoclast activity (via RANKL/OPG pathway dysregulation) — the primary problem is DECREASED osteoblast activity (impaired bone formation).