Abstract
This systematic review aims to assess the efficacy of titanium (Ti) implant surfaces with or without strontium (Sr) incorporation on osseointegration in animal experimental studies. An electronic search was conducted using databases of PubMed and EMBASE up to November 2016 to identify studies focusing on osseointegration of strontium-modified titanium implants following PRISMA criteria. The primary outcome was the percentage of bone-to-implant contact (BIC) around the implants with or without strontium-modified surface. Of the 1320 studies, 17 studies fulfilling the inclusion criteria were finally included. A random effect meta-analysis was conducted based on BIC in 17 studies, and the results demonstrated considerable heterogeneity (I² = 79%). A sensitivity analysis found that three studies using the same surface modification method were the major source of the heterogeneity. Therefore, exploratory subgroup analysis was performed. Subgroup one including 14 studies showed a standard mean differences (SMD) of 1.42 (95% CI, 1.13–1.71) with no heterogeneity (I² = 0.0%), while subgroup two including the other three studies showed a SMD of 9.49.95% CI, 7.51–11.47) with low heterogeneity (I² = 0.1%). Sr-modified implants in both subgroups showed significantly higher BIC than unmodified implants (P < 0.01). The results showed a statistically significant effect of Sr-modified titanium implant surfaces on osseointegration and bone apposition in animal models.
Highlights
Background informationReasons for animal model Hypothesis 1
Three studies were excluded due to no Sr-only experimental group[21,22,23]. Another three studies were excluded because bone-implant contact rate (BIC) was not reported[8,24,25]
A random effect meta-analysis was conducted based on BIC in 17 studies, and the overall results demonstrated considerable heterogeneity (I2 = 79%)
Summary
After manual searching bibliographies of the selected studies, 5 studies were added to full-text evaluation. Three studies were excluded due to no Sr-only experimental group[21,22,23] Another three studies were excluded because BIC was not reported[8,24,25]. All studies reported adequate information concerning title, abstract, introduction, ethical statement, species, surgical procedure, outcome evaluation, statistical analysis and results. 200 °C for 1 or 3 h electrochemical deposition electrochemical deposition electrochemical deposition magnetron sputtering magnetron sputtering process magnetron co-sputtering plasma spray techniques HTP with mixed solution of SrO and NaOH dissolved in deionized water 180 °C for 2 h micro-arc oxidation biomimetic process electrochemical deposition HTP with 0.02 M Sr(OH)[2 60] mL solution. 200 °C for 1 or 3 h electrochemical deposition electrochemical deposition electrochemical deposition magnetron sputtering magnetron sputtering process magnetron co-sputtering plasma spray techniques HTP with mixed solution of SrO and NaOH dissolved in deionized water 180 °C for 2 h micro-arc oxidation biomimetic process electrochemical deposition
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