Skip to main content Skip to main navigation menu Skip to site footer
Review
Published: 2022-05-15

Major cellular and molecular processes and clinical outcomes in bone regeneration for successful dental implantation: a systematic review

UNORTE - University Center of Northern São Paulo - Dentistry department, Sao Jose do Rio Preto, Sao Paulo, Brazil / UNIPOS - Post graduate and continuing education, Dentistry department, Sao Jose do Rio Preto, Sao Paulo, Brazil
UNORTE - University Center of Northern São Paulo - Dentistry department, Sao Jose do Rio Preto, Sao Paulo, Brazil / UNIPOS - Post graduate and continuing education, Dentistry department, Sao Jose do Rio Preto, Sao Paulo, Brazil
UNORTE - University Center of Northern São Paulo - Dentistry department, Sao Jose do Rio Preto, Sao Paulo, Brazil / UNIPOS - Post graduate and continuing education, Dentistry department, Sao Jose do Rio Preto, Sao Paulo, Brazil
UNORTE - University Center of Northern São Paulo - Dentistry department, Sao Jose do Rio Preto, Sao Paulo, Brazil / UNIPOS - Post graduate and continuing education, Dentistry department, Sao Jose do Rio Preto, Sao Paulo, Brazil
Bone regeneration Molecular and cellular processes Osseous integration Dental implants

Abstract

Introduction: In the context of bone regeneration, bone defects still represent a major challenge in oral and maxillofacial clinical and surgical treatment. The biomimetic design of biomaterials by simulating the natural structure and composition of bone tissue has gradually become a point of research interest due to its advantages of simplicity and efficiency. Objective: It was to carry out a systematic review on cellular and molecular processes, as well as to present the main clinical approaches of bone regeneration for dental implants. Methods: The present study followed a systematic review model, following the rules of systematic review – PRISMA. The search strategy was performed in the PubMed, Cochrane Library, Web of Science and Scopus, and Google Scholar databases. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results: A total of 142 articles were found. A total of 84 articles were fully evaluated and 33 were included in this study. Literary findings have shown that the lack of bone in the alveolar ridges has been a major problem in functional aesthetic recovery in patients who have suffered dentoalveolar trauma. The osteoinduction process is influenced by several factors, requiring the presence of inducers, which include β-glycerolphosphate, ascorbic acid, and dexamethasone. Mesenchymal stem cells acquire the morphology and components of osteoblastic membranes and begin to express alkaline phosphatase to deposit extracellular matrix rich in calcium and certain proteins, such as osteopontin and osteocalcin. The Bio Oss® (Geistlich) biomaterial, because it is biodegradable, biocompatible, non-toxic, and has low immunogenicity and bio stimulators, can act in the regeneration of bone tissue. Application of FRP and implant placement provides stable clinical results for severely atrophic maxilla 2-4 mm. Bovine xenograft alone and in combination with liquid FRP are both successful in achieving bone augmentation around implants and produce a small change in marginal bone level and a high implant survival rate after loading. Conclusion: Through the results of the present study, it was evidenced that the success of the dental implant is directly related to successful osseointegration.

References

  1. Jiang XQ. Advances in biomimetic modification of materials for oromaxillofacial bone regeneration and dental implant]. Hua Xi Kou Qiang Yi Xue Za Zhi. 2021 Apr 1;39(2):123-128. Chinese. doi: 10.7518/hxkq.2021.02.001. PMID: 33834665; PMCID: PMC8055768.
  2. Zaki J, Yusuf N, El-Khadem A, Scholten RJPM, Jenniskens K. Efficacy of bone-substitute materials use in immediate dental implant placement: A systematic review and meta-analysis. Clin Implant Dent Relat Res. 2021 Aug;23(4):506-519. doi: 10.1111/cid.13014. Epub 2021 Jun 12. PMID: 34118175; PMCID: PMC8453723.
  3. Almansoori AA, Kwon OJ, Nam JH, Seo YK, Song HR, Lee JH. Mesenchymal stem cells and platelet-rich plasma-impregnated polycaprolactone-β tricalcium phosphate bio-scaffold enhanced bone regeneration around dental implants. Int J Implant Dent. 2021 May 5;7(1):35. doi: 10.1186/s40729-021-00317-y. PMID: 33948811; PMCID: PMC8096877.
  4. Gugliandolo A, Fonticoli L, Trubiani O, Rajan TS, Marconi GD, Bramanti P, Mazzon E, Pizzicannella J, Diomede F. Oral Bone Tissue Regeneration: Mesenchymal Stem Cells, Secretome, and Biomaterials. Int J Mol Sci. 2021 May 15;22(10):5236. doi: 10.3390/ijms22105236. PMID: 34063438; PMCID: PMC8156243.
  5. Mazzoneto, R. Reconstruções em Implantodontia – Protocolos clínicos para o sucesso e a previsibilidade. Ed. Napoleão, 2009, 1ª Edição. Nova Odessa – SP, Brasil.
  6. Cheah CW, Al-Namnam NM, Lau MN, Lim GS, Raman R, Fairbairn P, Ngeow WC. Synthetic Material for Bone, Periodontal, and Dental Tissue Regeneration: Where Are We Now, and Where Are We Heading Next? Materials (Basel). 2021 Oct 15;14(20):6123. doi: 10.3390/ma14206123. PMID: 34683712; PMCID: PMC8537464.
  7. Nícoli LG, Pigossi SC, Araújo RFdSB, Marcantonio C, Marcantonio E, Marcantonio JR. E. Multidisciplinary approach to oral rehabilitation with dental implants after gunshot injury. A clinical report. The Journal of Prothestic Dentistry. 2018; 119 (3): 329 – 33.
  8. Zhao R, Yang R, Cooper PR, Khurshid Z, Shavandi A, Ratnayake J. Bone Grafts and Substitutes in Dentistry: A Review of Current Trends and Developments. Molecules. 2021 May 18;26(10):3007. doi: 10.3390/molecules26103007. PMID: 34070157; PMCID: PMC8158510.
  9. Dohan DM, Choukroun J, Diss A, Dohan SL, Dohan AJJ, Mouhyi J, et al. Platelet-rich-fibrin (FRP); A second generation concentrate. Part I: Tecnological concepts and evolution. Oral Sugery, Oral Medicine, Oral Pathology, Oral Radiology and Endodontology. 2006; 101 (3): e 37- e 44.
  10. Xuan F, Lee CU, Son JS, Jeong SM, Choi BH. A comparative study of the regenerative effect of sinus bone grafting with platelet-rich fibrin-mixed Bio-Oss® and commercial fibrin-mixed Bio-Oss®: an experimental study. J Craniomaxillofac Surg. 2014 Jun;42(4):e47-50. doi: 10.1016/j.jcms.2013.05.029. Epub 2013 Aug 2].
  11. Moreira AC, Silva JR, Samico RP, Nishioka GNM, Nishioka RS. Application of Bio-Oss in tissue regenerative treatment prior to implant installation: literature review. Braz Dent Sci. 2019, 22(2).
  12. Calasans MD, Fernandes GVO, Granjeiro JM. Preservação alveolar com enxertos após exodontias e previamente à instalação de implantes. Revista Implantnews, 2011, 6: 583-590.
  13. Fardin AC et al. Enxerto Ósseo em Odontologia: Revisão de Literatura. Innov Implant J, Biomater Esthet, São Paulo, 2010, 5 (3): 48-52.
  14. Fontanari LA; Manne JM; Junior WT. Utilização de enxerto homógenos para reconstrução em áreas atróficas pré-implante: banco de ossos. Revista Implantnews, 2007, 5 (6) : 539-597.10
  15. Aubin JE, Liu F. The osteoblast lineage. In: Bilizekian, J., Raisz, L., and Rodan, G., editors. Principles of Bone Biology. San Diego, CA: Academic Press: 1996, 39-50.
  16. Nardi NB, Meirelles SL. Mesenchymal stem cells: isolation, in vitro expansion and characterization. HEP 2006; 174 : 249-82.
  17. Vacanti JP, Langer R. Tissue engineering: The design and fabrication of living replacement devices for surgical reconstruction and transplantation. Lancet,1999; 354: 32–34.
  18. Mesimäki K, Lindroos B, Törnwall J, Mauno J, Lindqvist C, Kontio R, Miettinen S, Suuronen R: Novel maxillary reconstruction with ectopic bone formation by GMP adipose stem cells. Int J Oral Maxillofac Surg 2009, 38 : 201-209.
  19. Zotarelli Filho IJ, Frascino LF, Greco OT, Araujo JDD, Bilaqui A, Kassis EN, Ardito RV and Bonilla-Rodriguez GO. Chitosan-collagen scaffolds can regulate the biological activities of adipose mesenchymal stem cells for tissue engineering. J Regen Med Tissue Eng. 2013; 2:12. http://dx.doi.org/10.7243/2050-1218-2-12.
  20. Ehrenfest, D., Rasmusson, L. e Albrektsson, T. Classification of platelet concentrates: from pure platelet-rich plasma (P-PRP) to leucocyte- and platelet-rich fibrin (L-FRP). Cell Press, 2009; 27.
  21. Lopez-Vidriero, E., et al. The use of platelet-rich plasma in arthroscopy and sports medicine: optimizing the healing environment. Arthroscopy, 2010; 26:269-278.
  22. Lynch, S., et al. The Effects of Short-Term Application of a Combination of Platelet-Derived and Insulin-Like Growth Factors on Periodontal Wound Healing. Journal of Periodontology, 1991; 62:458-467.
  23. Messora M et al. Análise da eficiência do protocolo de dupla centrifugação para o preparo do plasma rico em plaquetas (PRP) – estudo experimental em coelhos. RSBO- Revista Sul-Brasileira de Odontologia, 2010; 6:291-296.
  24. Messora M., et al. A standardized research protocol for plateletrich plasma (PRP) preparation in rats. Revista Sul-Brasileira de Odontologia, 2011; 8:299-304.
  25. Perez M, et al. Relevant Aspects of Centrifugation Step in the Preparation of Platelet-Rich Plasma. International Scholarly Research Notices of Hematology, 2014; 8:1-8.
  26. Tejero R, Anitua E, Orive G. Toward the biomimetic implant surface: Biopolymers on titanium-based implants for bone regeneration. Journal of Progress in Polimeral Science, 2014; 39:1406-1447.
  27. Liu Y, Clark RAF, Huang L, Rafailovich MH. Hyaluronic acid-gelatin fibrous scaffold produced by electrospinning of their aqueous solution for tissue engineering applications. In Advances in Material Design for Regenerative Medicine, Drug Delivery and Targeting/ Imaging 2010; 1140:131-136.
  28. Maiorana C, Sommariva L, Brivio P, Sigurtà D, Santoro F. Maxillary sinus augmentation with anorganic bovine bone (Bio-Oss®) and autologous platelet-rich plasma: preliminary clinical and histologic evaluations. Int J Periodontics Restorative Dent 2003 Jun;23 (3): 227-235.
  29. Tatullo M, Marrelli M, Cassetta M, Pacifici A, Stefanelli LV, Scacco S, Dipalma G, Pacifici L, Inchingolo F. Platelet Rich Fibrin (P.R.F.) in Reconstructive Surgery of Atrophied Maxillary Bones: Clinical and Histological Evaluations. International Journal of Medical Sciences. 2012; 9(10):872-880. doi: 10.7150/ijms.5119.
  30. Angelo T, Marcel W, Andreas, K, Izabela, S. Biomechanical Stability of Dental Implants in Augmented Maxillary Sites: Results of a Randomized Clinical Study with Four Different Biomaterials and FRP and a Biological View on Guided Bone Regeneration. Hindawi Publishing Corporation BioMed Research International, 2015, http://dx.doi.org/10.1155/2015/850340.
  31. Chen, Y, Cai,Z, Zheng, D, Lin,P, Cai,Y, Hong, S, Lai & Dong Wu, Y. Inlay osteotome sinus floor elevation with concentrated growth factor application and simultaneous short implant placement in severely atrophic maxilla. Scientific Reports 2016, 6:27348 DOI: 10.1038/srep27348.
  32. Kumar, NK, Shaik ,M, Rao Nadella,K, Chintapalli, BM. Comparative Study of Alveolar Bone Height and Implant Survival Rate Between Autogenous Bone Mixed with Platelet Rich Plasma Versus Venous Blood for Maxillary Sinus Lift Augmentation Procedure. J. Maxillofac. Oral Surg. (Apr–June 2015) 14(2):417–422 DOI 10.1007/s12663-014-0643-7.
  33. Işık G, Özden Yüce M, Koçak-Topbaş N, Günbay T. Guided bone regeneration simultaneous with implant placement using bovine-derived xenograft with and without liquid platelet-rich fibrin: a randomized controlled clinical trial. Clin Oral Investig. 2021 Sep;25(9):5563-5575. doi: 10.1007/s00784-021-03987-5. Epub 2021 May 28. PMID: 34047835.

How to Cite

Gonzaga, K. da S., Silva, S. A., Munhos, M. M., & Kassis, E. N. (2022). Major cellular and molecular processes and clinical outcomes in bone regeneration for successful dental implantation: a systematic review. MedNEXT Journal of Medical and Health Sciences, 3(S3). https://doi.org/10.54448/mdnt22S317