Bone Healing in Diabetes – Diabetic Model

Lasers Med Sci. 2015 Jul 30. [Epub ahead of print]

Photobiomodulation and bone healing in diabetic rats: evaluation of bone response using a tibial defect experimental model.

Magri AM1, Fernandes KR, Assis L, Mendes NA, da Silva Santos AL, de Oliveira Dantas E, Rennó AC.

Author information

  • 1Department of Biosciences, Federal University of São Paulo, Av. Ana Costa, 95, Vila Mathias, Santos, 11060-001, São Paulo, Brazil.

Abstract

Diabetes mellitus (DM) leads to a delay in bone healing. Thus, some therapeutic approaches have been used to accelerate the process of bone repair such as photobiomodulation (PBM). Therefore, the present study aimed to evaluate the effects of PBM, in different fluences, in bone repair in an experimental model of tibial bone defects in diabetic rats. Sixty-four Wistar rats were submitted to a surgical procedure to perform bone defect and distributed in four groups: diabetic control group (DCG), diabetic laser group 30 J/cm2 (L30), diabetic laser group 60 J/cm2 (L60), and diabetic laser group 120 J/cm2 (L120). A 808 nm Ga-Al-As (DMC Equipment, São Carlos, SP, Brazil) laser, 100 mW; 0.028 cm2; 3.57 W/cm2; 30, 60, and 120 J/cm2; 0.84, 1.68, and 3.36 J; 8, 16, and 33 s was used. Animals were euthanized 15 and 30 days after the surgery. Histological, morphometric, immunohistochemistry, and biomechanical analyses were performed. In the histological and morphometric evaluation, all laser-treated groups showed a better histological pattern and a higher amount of newly formed bone compared to DCG. An intense RUNX2 immunoexpression was observed in the laser-treated groups, 15 days after the surgery. Receptor activator of nuclear factor κ-β ligand (RANK-L) immunohistochemistry analysis showed a significant decrease in the immunoreactivity for L30 and L120, 30 days after surgery. There was no statistical difference in the biomechanical analysis among the groups. In conclusion, PBM, in all fluences used, showed an osteogenic potential in bone healing of diabetic rats.

Lasers Med Sci. 2012 Jun 15. [Epub ahead of print]

Effect of 635 nm irradiation on high glucose-boosted inflammatory responses in LPS-induced MC3T3-E1 cells.

Kwon H, Lim W, Kim J, Jeon S, Kim S, Karna S, Cha H, Kim O, Choi H.

Source

Department of Oral Pathology, School of Dentistry, Dental Science Research Institute, Chonnam National University, Bug-Gu, Gwangju, 500-757, South Korea.

Abstract

Hyperglycemia occurs in patients with poorly controlled diabetes mellitus and contributes to bone resorption and increased susceptibility to bacterial infections. Hyperglycemia can incite low-grade inflammation that can contribute to the resorption of bone, especially the periodontal bone. The increased susceptibility to periodontal infections can contribute to bone resorption through the activation of osteoclasts. In this study, the osteoblastic, clonal cell line, MC3T3-E1, was used in an in vitro model of hyperglycemia and lipopolysaccharide-induced reactive oxygen species generation to determine the potential anti-inflammatory effect of 635 nm light-emitting diode (LED) irradiation or whether 635 nm LED irradiation can be a potential anti-inflammatory treatment. LED irradiation of MC3T3-E1 cells stimulated with lipopolysaccharide in a high glucose-containing medium decreased the level of cyclooxygenase gene and protein expression and reduced the level of prostaglandin E2 expression by decreasing the amount of reactive oxygen species generation. LED irradiation also inhibited the osteoclastogenesis in MC3T3-E1 cells by regulating the receptor activator of nuclear factor kappa-B ligand and osteoprotegerin. These findings reveal the mechanisms which are important in the pathogenesis of diabetic periodontitis and highlight the beneficial effects of 635 nm LED irradiation in reducing the adverse effects of diabetic periodontitis.

Photomed Laser Surg. 2010 Jun;28(3):411-6.

Effect of biostimulation on healing of bone defects in diabetic rats.

Akyol UK, Güngörmü? M.

Ataturk University, Faculty of Dentistry, Department of Oral and Maxillofacial Surgery, Erzurum, Turkey. utkanakyol@yahoo.com

Abstract

BACKGROUND AND OBJECTIVE: The aim of this study was to investigate the effects of biostimulation on healing of bone defects in diabetic rats. STUDY DESIGN/

MATERIAL AND METHODS: Twenty-eight Wistar rats weighting 250 to 300 g were used for this study. Diabetes was chemically induced with streptozotocin, and 14 nondiabetic and 14 diabetic rats were included in the study. The distal epiphysis of the right and left femurs of the diabetic rats were perforated with a surgical bone drill. This surgical procedure was performed on the left femurs of normal rats too. The wound on the right side of each diabetic rat received laser stimulation. The left femur of each nondiabetic (normal) rat served as a control. The rats were assigned to three experimental groups: (1) normal bur (control group); (2) diabetic bur; (3) diabetic bur + biostimulation.

RESULTS: There was a significant difference among all groups in substantia spongiosa formation on day 10. According to the Mann-Whitney U test, there was a difference between Groups 1 and 2. A significant difference was noted between Groups 2 and 3 as well as between Groups 1 and 3 and between Groups 2 and 3 in union at 20 d of healing.

CONCLUSIONS: Substantia spongiosa formation was slightly more evident in Groups 1 and 3 than in Group 2. Also, there was more union in Group 3 than in the other groups on day 20. As a result, it can be concluded that low-level laser therapy (808 nm laser at 10 J/cm(2)) can have a beneficial effect on spongiosa in diabetic bone repair when five treatments are administered with 2 d intervals between treatments.

Photomed Laser Surg. 2009 Oct 27. [Epub ahead of print]

Effect of Biostimulation on Healing of Bone Defects in Diabetic Rats.

Akyol UK, Güngörmü? M.

Ataturk University , Faculty of Dentistry, Department of Oral and Maxillofacial Surgery, Erzurum, Turkey .

Abstract Background and Objective: The aim of this study was to investigate the effects of biostimulation on healing of bone defects in diabetic rats.

Study Design/Material and Methods: Twenty-eight Wistar rats weighting 250 to 300 g were used for this study. Diabetes was chemically induced with streptozotocin, and 14 nondiabetic and 14 diabetic rats were included in the study. The distal epiphysis of the right and left femurs of the diabetic rats were perforated with a surgical bone drill. This surgical procedure was performed on the left femurs of normal rats too. The wound on the right side of each diabetic rat received laser stimulation. The left femur of each nondiabetic (normal) rat served as a control. The rats were assigned to three experimental groups: (1) normal bur (control group); (2) diabetic bur; (3) diabetic bur + biostimulation.

Results: There was a significant difference among all groups in substantia spongiosa formation on day 10. According to the Mann-Whitney U test, there was a difference between Groups 1 and 2. A significant difference was noted between Groups 2 and 3 as well as between Groups 1 and 3 and between Groups 2 and 3 in union at 20 d of healing.

Conclusions: Substantia spongiosa formation was slightly more evident in Groups 1 and 3 than in Group 2. Also, there was more union in Group 3 than in the other groups on day 20. As a result, it can be concluded that low-level laser therapy (808 nm laser at 10 J/cm(2)) can have a beneficial effect on spongiosa in diabetic bone repair when five treatments are administered with 2 d intervals between treatments.

Photomed Laser Surg. 2009 Oct;27(5):703-8.

The effects of low-level laser therapy on bone in diabetic and nondiabetic rats.

 

 

Bayat M, Abdi S, Javadieh F, Mohsenifar Z, Rashid MR.

Cellular and Molecular Biology Research Center, Medical Faculty, Shahid Beheshti University, MC, Tehran, Iran. bayat_m@yahoo.com

OBJECTIVE: The aim of the present study was to examine the effects of low-level laser therapy (LLLT) on the tibia of streptozotocin-induced diabetic (STZ-D) rats.

BACKGROUND DATA: LLLT has been found to accelerate fracture healing in animals. Diabetes mellitus decreases bone volume and its biomechanical parameters.

MATERIALS AND METHODS: Twenty rats were divided randomly into four groups. Rats in the first two groups were administrated a single injection of STZ to induce diabetes, while animals in groups 3 and 4 were given a sham injection of distilled water. The right tibia in groups 1 and 2 was treated with a He-Ne laser (632.8 nm, 10 mW) of 28.6 and 382.2 J/cm(2), respectively. LLLT was performed daily for 14 consecutive days. The right tibia of rats in group 3 was treated with LLLT the same as group 2. The right tibia of rats in group 4 was used for based line studies. After 14 d, right tibiae and left tibiae (control bone) were extracted and subjected to the three-point bending test and histological study.

RESULTS: Maximum force (N) was significantly greater in laser-treated bones of groups 2 and 3 compared with their relevant control groups (paired Student t test, p = 0.05 and p = 0.007, respectively). Density of the bone lamella meshwork of compact bone in group 2 was significantly greater in comparison with its control group (paired Student t test, p = 0.005).

CONCLUSION: LLLT on tibia of STZ-D rats increased the bone lamella meshwork density of compact bone and also increased its strength.

Photomed Laser Surg. 2009 Aug;27(4):641-6.

The effects of infrared low-level laser therapy on healing of partial osteotomy of tibia in streptozotocin-induced diabetic rats.

Javadieh F, Bayat M, Abdi S, Mohsenifar Z, Razi S.

Anatomy Department, Medical Faculty, Shahid Beheshti University, MC, Tehran, Iran.

OBJECTIVE: The effects of low-level laser therapy (LLLT) on a bone defect model in streptozotocin-induced diabetic (STZ-D) rats was examined.

BACKGROUND DATA: LLLT accelerates bone fracture repair in healthy animals, but its effect in diabetic animals is unclear.

METHODS: Twenty-eight rats were divided into five groups: 1 (diabetes, no LLLT), 2 (diabetes, LLLT high dose), 3 (diabetes, LLLT low dose), 4 (no diabetes, no LLLT), and 5 (no diabetes, LLLT low dose) Diabetes was induced by a single injection of STZ in rats of groups 1, 2, and 3. A bone defect was made in the right tibia of rats in all groups. The defect in groups 2, 3, and 5 was treated with LLLT (890 nm, 70 W, 3000 Hz, circular beam shape, and 1 cm(2) spot size). Doses of 23.3 J/cm(2) (530 s) for group 2 and 11.6 J/cm(2) (265 s) for groups 3 and 5 were applied three times a week. The right tibias were collected 42 days after surgery and subjected to three-point bending test on a material testing machine (MTM) until fracture occurred. Data was automatically recorded on the MTM formed the load-deformation curve.

RESULTS: Mann-Whitney test showed that LLLT with 11.6 J/cm(2) significantly increased bending stiffness and maximum force in diabetic rats compared with group 1 (both p = 0.041).

CONCLUSION: LLLT in an experimental diabetic model enhanced bone repair with a higher bending stiffness and maximum force compared to the control group.