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Open AccessReview

Synthetic Blocks for Bone Regeneration: A Systematic Review and Meta-Analysis

1
University “Gabriele D’Annunzio” of Chieti-Pescara, 66100 Chieti, Italy
2
IRCCS Istituto Ortopedico Galeazzi, 20161 Milan, Italy
3
Department of Biomedical, Surgical, and Dental Sciences, Università degli Studi di Milano, 20161 Milan, Italy
*
Author to whom correspondence should be addressed.
Int. J. Mol. Sci. 2019, 20(17), 4221; https://doi.org/10.3390/ijms20174221
Received: 12 July 2019 / Revised: 25 August 2019 / Accepted: 26 August 2019 / Published: 28 August 2019
(This article belongs to the Special Issue Regenerative Medicine: Role of Stem Cells and Innovative Biomaterials)
This systematic review is aimed at evaluating the effectiveness of synthetic block materials for bone augmentation in preclinical in vivo studies. An electronic search was performed on Pubmed, Scopus, EMBASE. Articles selected underwent risk-of-bias assessment. The outcomes were: new bone formation and residual graft with histomorphometry, radiographic bone density, soft tissue parameters, complications. Meta-analysis was performed to compare new bone formation in test (synthetic blocks) vs. control group (autogenous blocks or spontaneous healing). The search yielded 214 articles. After screening, 39 studies were included, all performed on animal models: rabbits (n = 18 studies), dogs (n = 4), rats (n = 7), minipigs (n = 4), goats (n = 4), and sheep (n = 2). The meta-analysis on rabbit studies showed significantly higher new bone formation for synthetic blocks with respect to autogenous blocks both at four-week (mean difference (MD): 5.91%, 95% confidence intervals (CI): 1.04, 10.79%, p = 0.02) and at eight-week healing (MD: 4.44%, 95% CI: 0.71, 8.17%, p = 0.02). Other animal models evidenced a trend for better outcomes with synthetic blocks, though only based on qualitative analysis. Synthetic blocks may represent a viable resource in bone regenerative surgery for achieving new bone formation. Differences in the animal models, the design of included studies, and the bone defects treated should be considered when generalizing the results. Clinical studies are needed to confirm the effectiveness of synthetic blocks in bone augmentation procedures. View Full-Text
Keywords: animal models; biomaterials; block graft; bone graft; bone regeneration; bone substitutes; histological analysis; synthetic biomaterials; systematic review animal models; biomaterials; block graft; bone graft; bone regeneration; bone substitutes; histological analysis; synthetic biomaterials; systematic review
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Tumedei, M.; Savadori, P.; Del Fabbro, M. Synthetic Blocks for Bone Regeneration: A Systematic Review and Meta-Analysis. Int. J. Mol. Sci. 2019, 20, 4221.

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