title: Can stem cells enhance bone formation in the human edentulous alveolar ridge? A systematic review and meta-analysis.
abstract: Several non-biological materials are currently being used to increase the alveolar bone volume to support dental implants. Recently, stem cell therapy has emerged as a promising biological substitute or adjuvant to enhance bone healing. In order to determine if stem cell therapy has enough clinical evidence to bone ridge augmentation in humans, a systematic review and meta-analysis were conducted. Two independent investigators searched the Entrez PubMed, SCOPUS and Web of Science databases for eligible randomized clinical trials that describe stem cell therapies for alveolar bone formation. The included studies were evaluated for risk of bias. A random-effects meta-analysis model was used to evaluate the percentage of bone formation in the selected studies. Heterogeneity was evaluated using the Cochrane Chi2and I2. Nine eligible trials were included. These studies presented an overall unclear risk of bias. A comparison between the lower heterogeneity studies and the long term observational outcomes showed a slight tendency to enhance bone formation. High heterogeneity between the included studies was observed. The lack of outcome standardization made a wide-ranging comparison difficult. The application of stem cells in oral surgery and implantology appears to be promising although more standardized study designs, increased samples and long-term observations are needed to strength the clinical evidence that stem cell therapy is effective for alveolar bone formation.
authors.affiliation: Department of Oral Medicine, Discipline of Oral Pathology, Dental School, University of São Paulo (FOUSP), Av Professor Lineu Prestes, 2227, Cidade Universitária, São Paulo, SP, 05508-000, Brazil.
authors.forename: Lucyene
authors.initials: L
authors.lastname: Miguita
authors.affiliation: Department of Oral Medicine, Discipline of Oral Pathology, Dental School, University of São Paulo (FOUSP), Av Professor Lineu Prestes, 2227, Cidade Universitária, São Paulo, SP, 05508-000, Brazil.
authors.forename: Andrea
authors.initials: A
authors.lastname: Mantesso
authors.affiliation: Department of Oral Medicine, Discipline of Periodontology, Dental School, University of São Paulo (FOUSP), Av Professor Lineu Prestes, 2227, Cidade Universitária, São Paulo, SP, 05508-000, Brazil.
authors.forename: Claudio Mendes
authors.initials: CM
authors.lastname: Pannuti
authors.affiliation: Department of Oral and Maxillofacial Surgery, Discipline of Oral Surgery, Dental School, University of São Paulo (FOUSP), Av Professor Lineu Prestes, 2227, Cidade Universitária, São Paulo, SP, 05508-000, Brazil. mczdebon@usp.br.
authors.forename: Maria Cristina Zindel
authors.initials: MCZ
authors.lastname: Deboni
mesh_terms: D000539:Alveolar Process / Q000166:cytology / Q000502:physiology* / Q000601:surgery*; D000540:Alveolar Ridge Augmentation / Q000379:methods*; D003758:Dental Implantation, Endosseous / Q000379:methods*; D015921:Dental Implants; D006801:Humans; D010012:Osteogenesis; D016032:Randomized Controlled Trials as Topic; D033581:Stem Cell Transplantation / Q000379:methods*; D013234:Stem Cells / Q000166:cytology*; D016896:Treatment Outcome
chemical_list: D015921:Dental Implants
keywords: Bone formation; Bone repair; Implants; Ridge augmentation; Stem cell