Diabetes mellitus (DM) leads to an increased risk of tooth loss. Dental implants are a standard treatment for partial or full edentulism, and various implant surface treatments have been developed to increase their stability. However, some studies have reported that DM reduces osseointegration and dental implant success. The purpose of this study was to determine the effects of high glucose levels on hard tissue formation on an alkali treated titanium surface. Titanium disks were heated at

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... for 1 h prior to treatment with 10 M NaOH solution and incubated with type II DM rat bone marrow mesenchymal cells (BMMCs) prior to exposure to glucose at 5.5, 8.0, 12.0 or 24.0 mM. We evaluated the effect of different glucose concentrations on the osteogenesis of BMMCs on the titanium surface. Alkaline phosphatase activity decreased with increasing glucose concentration. In contrast, although osteocalcin production, calcium deposition and the calcium/phos phate ratio deposition were significantly decreased at 8.0 mM, they increased when the concentration was greater than 8.0 mM. The RANKL/OPG ratio decreased with increasing glucose concentration. Although high glucose concentrations increased hard tissue for mation, the quality of the mineralized tissue decreased.