The present study was designed to compare the amount and regional distribution of bone formation around hydroxyapatite (HA) implants in normal (control) rats with that of animals with diabetes mellitus (DM), induced by streptozotocin 2 weeks prior to implant placement. Calcein (CAL), alizarin complexone (AL), and tetracycline (TC) were injected on the 7th, 14th, and 21st days after implantation, respectively, and the rats were sacrificed on the 28th day after implantation. Seventy-μm undecalcified sections of the HA-bone interface in both groups were then prepared for confocal laser scanning microscopy (CLSM) observation. In both groups, bone formation developed from the HA surface to the endosteum, periosteum, or bone marrow. In the control group, around the HA close to the endosteum and periosteum, the new bone showed an extensive lamination pattern of three color layers (CAL, AL, and TC), but in the DM group the labeling density of TC on the 21st day was low. In contrast, on the lateral part of the HA surface (away from the endosteum and periosteum), there was considerably less bone formation in the control group, and in the DM group it was almost completely suppressed. These findings indicate that bone formation around the HA was initiated from the HA surface in the control group, while in the DM group, bone formation along the lateral part of the HA away from the endosteum and periosteum was almost completely suppressed. Furthermore, it is also suggested that in the new bone along the HA close to the endosteum and periosteum, only calcification on the 21st day was depressed.
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