Bioactive surface modifications on dental implants: a systematic review and meta-analysis of osseointegration and longevity

• Published in: Clinical oral investigations 2024-10, Vol.28 (11), p.592, Article 592
• Main Authors: Shayeb, Maher AL, Elfadil, Sittana, Abutayyem, Huda, Shqaidef, Abedalrahman, Marrapodi, Maria Maddalena, Cicciù, Marco, Minervini, Giuseppe
• Format: Article
• Language: English
• Subjects: Bone implants; Clinical outcomes; Coated Materials, Biocompatible - chemistry; Collagen (type I); Dental Implantation, Endosseous - methods; Dental Implants; Dental Prosthesis Design; Dental prosthetics; Dental Restoration Failure; Dentistry; Humans; Life span; Longevity; Medicine; Meta-analysis; Osseointegration; Osseointegration - drug effects; Review; Reviews; Surface Properties; Systematic review; Titanium; Titanium - chemistry
• ISSN: 1436-3771; 1432-6981; 1436-3771
• DOI: 10.1007/s00784-024-05958-y

Background Bioactive surface modifications have been proposed to enhance osseointegration and longevity of dental implants. This study aimed to systematically review and perform a meta-analysis on the effectiveness of various bioactive coatings in promoting bone integration and improving implant longevity. Methods A systematic review was conducted, including studies that investigated bioactive surface modifications on titanium dental implants. Outcomes of interest were bone-to-implant contact (BIC) and implant longevity over a 30-day period. Data were extracted and analyzed using RevMan 5 (version 5.4.1), with forest plots generated to represent the mean difference (MD) and 95% confidence intervals (CI) under a random effects model. Results The meta-analysis showed a significant improvement in BIC for surface-modified implants, with an overall MD of 7.29 (95% CI [2.94, 11.65]). Heterogeneity analysis indicated moderate heterogeneity (Tau² = 18.57, Chi² = 16.08, df = 8, P  = 0.04, I² = 50%). The test for overall effect yielded Z = 3.28 ( P  = 0.001). For implant longevity, the overall MD was 7.52 (95% CI [3.18, 11.85]), with moderate heterogeneity (Tau² = 17.28, Chi² = 14.95, df = 8, P  = 0.06, I² = 47%). The test for overall effect yielded Z = 3.40 ( P  = 0.0007). Conclusion Bioactive surface changes significantly improved osseointegration and lifespan of dental implants. Collagen-based coatings consistently encouraged early bone integration, while BMP-2 combinations were effective for osseointegration. Optimizing bioactive agent doses and combinations was critical for achieving desired outcomes.