Research progress of influence mechanism of reactive oxygen species on implant osseointegration in diabetic patients

Diabetes mellitus is a group of metabolic diseases characterized by hyperglycemia, often accompanied by bone metabolic disorders, microvascular diseases, etc. At present, it is still controversial whether diabetes will reduce the survival rate of implants, but studies have shown that diabetes can damage the bone tissue around the implants and interfere with the process of osseointegration by producing excessive reactive oxygen species(ROS). In this paper, combined with the literature published worldwide in recent years, the effect and mechanism of ROS on the osteointegration of implants of diabetic patients and the measures to improve the osteointegration under the condition of diabetes are reviewed. The results of literature review showed that excessive ROS induced by diabetes can damage osseointegration through adenosine 5′-monophosphate -activated protein kinase, Wnt/catenin, phosphatidylinositol 3-kinase-protein kinase B, mitogen activated protein kinase and other signaling pathways, as well as vascular injury. In animal models of diabetes, some drugs, such as insulin, curcumin, 1,25-dihydroxyvitamin D3, and metformin, have been shown to improve the osseointegration of implants to some extent by reducing ROS levels. These results suggest that ROS may be a key therapeutic target for improving success rate of dental implant treatment in diabetic patients.