Hyperlipidemia is recently recognised as a factor that could impair bone regeneration and dental implant osseointegration. High fat diets raise oxidised lipid levels in blood, which accumulate in bone and suppress osteoblast function, tipping the balance toward bone resorption. Excess lipids also induce oxidative stress and inflammatory cytokine production in bone, further inhibiting bone formation. These changes may affect implant osseointegration. At the cellular level, high lipid levels cause overproduction of reactive oxygen species and inhibit Wnt/β-catenin signalling in osteoblasts. Health promotion strategies should address these mechanisms. Lipid lowering drugs such as statins may improve bone healing ability both by reducing blood lipids and by directly stimulating bone formation. Antioxidant nutrients or drugs may counteract lipid driven ROS and inflammation. Emerging approaches include epigenetic interventions to boost osteoblast gene expression and dampen inflammatory pathways. Improving lipid control alongside these future targeted therapies may help preserve bone health and implant success in patients with hyperlipidemia associated oxidative stress. While very exploratory, incorporating molecular level approaches into continuing clinical protocols could represent a path towards future therapies. Maximizing postoperative management is essential in order to limit the effects of hyperlipidemia induced negative microenvironment at implant sites. This could include controlling laboratory levels of lipids prior to surgery.
Koutsoupia et al. (Wed,) studied this question.