# Bioactive Glass-Inspired Coating for Implants via Plasma Electrolytic Oxidation: A Preclinical Approach to Enhance Bone Repair in Healing-Impaired Conditions Associated with Diabetes

## TL;DR

This study shows that a bioactive glass-inspired coating on implants can improve bone repair in diabetic conditions, which often hinder healing.

## Contribution

The novel contribution is demonstrating the osteoinductive potential of plasma electrolytic oxidation-derived bioactive glass coatings in diabetic bone regeneration.

## Key findings

- PEO-BG coating showed enhanced surface roughness and wettability compared to controls.
- PEO-BG implants promoted greater new bone formation and improved bone-implant contact in diabetic rats.
- Expression of osteogenic markers indicated accelerated bone repair in PEO-BG-treated implants.

## Abstract

Diabetes mellitus is a globally prevalent metabolic disorder
that
impairs wound healing and bone regeneration, compromising outcomes
in implant therapies that rely on osseointegration. Advances in precision
medicine and bioengineering have driven the development of functionalized
implant surfaces to overcome these limitations. Among them, bioactive
glass (BG) coatings have emerged as promising candidates to enhance
biological responses. Building upon this rationale, we unveiled the
osteoinductive potential of a BG-based coating synthesized via plasma
electrolytic oxidation (PEO) and its effects on peri-implant bone
regeneration in a diabetic rat model. Titanium implants were treated
with PEO using a formulation mimicking BG composition (∼45.0
Si, 24.5 Ca, 24.5 Na, 6.0 P; m/v %), and the resulting coating was
characterized. Implants with a sandblasted and acid-etched (SLA) surface
served as the control. In vivo evaluation was conducted
in Wistar rats with streptozotocin-induced diabetes mellitus, followed
by tibial implant placement. At 14 and 28 days postimplantation, samples
were harvested for histological, immunohistochemical, micro-CT, and
histomorphometric analyses. Physicochemical characterization confirmed
the synthesis of the PEO-BG coating, which exhibited enhanced surface
roughness and wettability compared to SLA controls. A significantly
greater area of newly formed bone, increased bone–implant contact,
and favorable bone turnover were noted in the PEO-BG group. The expression
profiles of BMP-2, RANKL, OPG, and OCN indicated modulation of osteogenic
and inflammatory pathways consistent with accelerated bone repair.
These findings demonstrate that PEO-BG coating confers robust osteoinductive
potential, enhancing peri-implant bone regeneration under compromised
diabetic conditions, and highlight its potential for translational
application in high-risk populations.