Bioactive treatments in bone grafts for implant-based rehabilitation: Systematic review and meta-analysis

Clin Implant Dent Relat Res. 2018 Apr;20(2):251-260. doi: 10.1111/cid.12552. Epub 2017 Nov 6.

Abstract

Background: The use of bioactive proteins, such as rhBMP-2, may improve bone regeneration in oral and maxillofacial surgery.

Purpose: Analyze the effect of using bioactive proteins for bone regeneration in implant-based rehabilitation.

Materials and methods: Seven databases were screened. Only clinical trials that evaluated the use of heterologous sources of bioactive proteins for bone formation prior to implant-based rehabilitation were included. Statistical analyses were carried out using a random-effects model by comparing the standardized mean difference between groups for bone formation, and risk ratio for implant survival (P ≤ .05).

Results: Seventeen studies were included in the qualitative analysis, and 16 in the meta-analysis. For sinus floor augmentation, bone grafts showed higher amounts of residual bone graft particles than bioactive treatments (P ≤ .05). While for alveolar ridge augmentation bioactive treatments showed a higher level of bone formation than control groups (P ≤ .05). At 3 years of follow-up, no statistically significant differences were observed for implant survival (P > .05).

Conclusions: Bioactive proteins may improve bone formation in alveolar ridge augmentation, and reduce residual bone grafts in sinus floor augmentation. Further studies are needed to evaluate the long-term effect of using bioactive treatments for implant-based rehabilitation.

Keywords: bone morphogenetic protein; bone transplantation; dental implants; review.

Publication types

  • Meta-Analysis
  • Review
  • Systematic Review

MeSH terms

  • Alveolar Ridge Augmentation / methods
  • Bone Regeneration*
  • Bone Transplantation*
  • Dental Implantation, Endosseous / methods*
  • Evaluation Studies as Topic
  • Humans
  • TGF-beta Superfamily Proteins / therapeutic use*

Substances

  • TGF-beta Superfamily Proteins