NDLI: Clinical applications of cell-based approaches in alveolar bone augmentation: a systematic review.

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Clinical applications of cell-based approaches in alveolar bone augmentation: a systematic review.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Shanbhag, Siddharth Shanbhag, Vivek
Description	Country affiliation: India Author Affiliation: Shanbhag S ( Private practice, Mumbai, India.)
Abstract	BACKGROUND: Cell-based approaches, utilizing adult mesenchymal stem cells (MSCs), are reported to overcome the limitations of conventional bone augmentation procedures. PURPOSE: The study aims to systematically review the available evidence on the characteristics and clinical effectiveness of cell-based ridge augmentation, socket preservation, and sinus-floor augmentation, compared to current evidence-based methods in human adult patients. MATERIALS AND METHODS: MEDLINE, EMBASE, and CENTRAL databases were searched for related literature. Both observational and experimental studies reporting outcomes of 'tissue engineered' or 'cell-based' augmentation in ≥5 adult patients alone, or in comparison with non-cell-based (conventional) augmentation methods, were eligible for inclusion. Primary outcome was histomorphometric analysis of new bone formation. Effectiveness of cell-based augmentation was evaluated based on outcomes of controlled studies. RESULTS: Twenty-seven eligible studies were identified. Of these, 15 included a control group (8 randomized controlled trials [RCTs]), and were judged to be at a moderate-to-high risk of bias. Most studies reported the combined use of cultured autologous MSCs with an osteoconductive bone substitute (BS) scaffold. Iliac bone marrow and mandibular periosteum were frequently reported sources of MSCs. In vitro culture of MSCs took between 12 days and 1.5 months. A range of autogenous, allogeneic, xenogeneic, and alloplastic scaffolds was identified. Bovine bone mineral scaffold was frequently reported with favorable outcomes, while polylactic-polyglycolic acid copolymer (PLGA) scaffold resulted in graft failure in three studies. The combination of MSCs and BS resulted in outcomes similar to autogenous bone (AB) and BS. Three RCTs and one controlled trial reported significantly greater bone formation in cell-based than conventionally grafted sites after 3 to 8 months. CONCLUSIONS: Based on limited controlled evidence at a moderate-to-high risk of bias, cell-based approaches are comparable, if not superior, to current evidence-based bone grafting methods, with a significant advantage of avoiding AB harvesting. Future clinical trials should additionally evaluate patient-based outcomes and the time-/cost-effectiveness of these approaches.
File Format	HTM / HTML
ISSN	15230899
Issue Number	Suppl 1
Journal	Clinical Implant Dentistry and Related Research
Volume Number	17
e-ISSN	17088208
Language	English
Publisher	Wiley
Publisher Date	2015-01-01
Publisher Place	United States
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Discipline Dentistry
Content Type	Text
Resource Type	Article
Subject	Oral Surgery

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