The effect of hypoglycemic drugs on bone metabolism and dental implantation in type 2 diabetes mellitus patients

Patients with type 2 diabetes mellitus (T2DM) have a large demand for dental implants, but the pathologic state of T2DM patients could compromise the efficacy of implant treatment. Glycemic control can improve the success rate of implants in the T2DM population, but the early osseointegration of individuals still needs to be improved. Strengthening early osseointegration in patients with T2DM is one of the urgent problems for clinicians. The pharmacological mechanisms of hypoglycemic drugs on the market for bone metabolism are different and may require different interventions on the bone around the implant, but there is a lack of direct clinical evidence of the protective effect of hypoglycemic drugs. This review integrated the bone metabolic effect of drugs in clinical medical research and dental implant research. The aim was to provide medication guidance for T2DM patients who require implant surgery, and it is recommended to avoid the use of drugs with negative effects on bone as far as possible without violating the clinical medication guidelines, including SGLT-2 inhibitors and thiazolidinediones. Instead, they should choose glucose-lowering drugs that are beneficial to bone metabolism, such as insulin, metformin and GLP-1 receptor agonists. However, the comparative clinical effects of these drugs on periimplant bone need to be further elucidated. The researcher should select appropriate drugs (incretin drugs) to enhance the early osseointegration of implants in patients with T2DM.