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

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