Bone Regeneration on Modified Implant Surfaces: A Systematic Review

Abstract

Objective: To describe effective implant surface modifications (ISMs) that enhance bone regeneration. Methods: This systematic review involved literature searches in the PubMed, Scopus, and ScienceDirect databases to identify both in vivo and in vitro randomized controlled trials investigating bone regeneration on modified implant surfaces. The search was conducted using predefined population, intervention, comparison, outcome, and study design criteria, eligibility criteria, and relevant MeSH terms. Article selection followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses flow diagram. Results: Various ISMs were identified, including elastin-like polypeptides, hydroxyapatite, doxycycline, sandblasted large-grit acid-etched, and others. The average bone-to-implant contact (BIC) in experimental groups ranged from 60% to 70% at four weeks, indicating enhanced bone regeneration compared to control groups. Discussion: The findings of this study indicate that while various titanium ISMs, including biochemical coatings, nano-structuring, and ion treatments, consistently enhance early BIC, the overall certainty is limited by small sample sizes, methodological biases, inconsistent results, and lack of human clinical validation, indicating a need for more robust, standardized, and long-term studies to confirm their clinical efficacy. Conclusion: Modified implant surfaces show promising outcomes in accelerating bone healing and regeneration, thus promoting earlier osseointegration.

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