Role of Stem Cells in Augmenting Dental Implant Osseointegration: A Systematic Review

Shankargouda Patil,A Thirumal Raj,Luca Testarelli,Manea Musa Al-Ahmari,Thodur Balaji Madapusi,Rodolfo Reda,Maryam H Mugri,Saranya Varadarajan,Shilpa Bhandi,Mohammed E Sayed,Mazen A Almasri

doi:10.3390/coatings11091035

Abstract

Dental implants are a widely used treatment modality for oral rehabilitation. Implant failures can be a result of many factors, with poor osseointegration being the main culprit. The present systematic review aimed to assess the effect of stem cells on the osseointegration of dental implants. An electronic search of the MEDLINE, LILACS, and EMBASE databases was conducted. We examined quantitative preclinical studies that reported on the effect of mesenchymal stem cells on bone healing after implant insertion. Eighteen studies that fulfilled the inclusion criteria were included. Various surface modification strategies, sites of placement, and cell origins were analyzed. The majority of the selected studies showed a high risk of bias, indicating that caution must be exercised in their interpretation. All the included studies reported that the stem cells used with graft material and scaffolds promoted osseointegration with higher levels of new bone formation. The mesenchymal cells attached to the implant surface facilitated the expression of bio-functionalized biomaterial surfaces, to boost bone formation and osseointegration at the bone–implant interfaces. There was a promotion of osteogenic differentiation of human mesenchymal cells and osseointegration of biomaterial implants, both in vitro and in vivo. These results highlight the significance of biomodified implant surfaces that can enhance osseointegration. These innovations can improve the stability and success rate of the implants used for oral rehabilitation.

Highlights

Dental implants are an effective treatment strategy for the replacement of missing teeth, enhancing function and aesthetics [1]
Bone implant contact was highest in puppy DTSCs (pDTSCs) = Platelet-rich plasma (PRP) group > cDPSCs = PRP group, cBMMSCs = PRP group
Osteoblasts are necessary for bone formation; while mesenchymal stem cells may promote osseointegration [45], MSCs influence osteogenesis through their molecular signals that favor the osteoblastic differentiation of MSCs [31,37,46,47]

Summary

Introduction

Dental implants are an effective treatment strategy for the replacement of missing teeth, enhancing function and aesthetics [1]. A surgical bone grafting procedure to augment the bone would be necessary before placement. This would improve the prognosis, and enhance the stability and success [5]. Bone regeneration after grafting is a complex process that is an interplay of a variety of specialized cells and polypeptide growth factors to recreate the lost bone [6]. Traditional bone-substitute materials were believed to guide osteoblastic lineage cells for osteogenesis, aiding in bone regeneration. The materials that aided in in vitro bone formation were not as effective in vivo. This may be due to the immune responses evoked by the material. It is important to examine a bone biomaterial’s immunogenicity, along with its osteogenic and osseointegrative capabilities [8,9,10]

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Discussion

Conclusion