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Implants · single question

How does poorly-controlled diabetes mellitus contribute to peri-implantitis and impaired osseointegration?

  1. It inhibits osteoclast activity, preventing normal bone turnover
  2. It increases collagen formation around the implant
  3. It has no effect on bone, acting only on soft tissue
  4. It inhibits osteoblast activity and reduces bone formation
Show answer and explanation

Correct answer: D. It inhibits osteoblast activity and reduces bone formation

  • A. Incorrect. The opposite occurs — osteoclastic resorption is INCREASED via the AGE/RAGE pathway and elevated RANKL, accelerating peri-implant bone loss.
  • B. Incorrect. Diabetes DECREASES collagen synthesis and increases collagenase activity, which is exactly why wound healing and soft-tissue attachment are compromised.
  • C. Incorrect. Diabetes affects both compartments: microvascular disease and neutrophil dysfunction impair the soft tissue seal, while AGE accumulation impairs the bone response.
  • D. Correct. Chronic hyperglycaemia and the accumulation of ADVANCED GLYCATION END-PRODUCTS (AGEs) suppress OSTEOBLAST differentiation and function, reducing osteoid production and impairing bone-to-implant contact. At the same time RANKL-driven osteoclastic activity is up-regulated, so formation falls while resorption rises — a net negative bone balance around the implant.

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