The effect of local delivery of various hormonal drugs along with bone grafts to improve osteogenesis: a systematic review

Abstract

Objective: Jaw and facial bone may suffer from inflammation, trauma, tumors and congenital diseases. Alveolar bone is vital in supporting natural teeth, dental implants, removable and fixed dental prostheses. Dental implants are a suitable alternative for prosthetic reconstruction of edentulous patients. However, sometimes in cases of severely atrophic or porous bone, implant treatment becomes a challenge. Various bone graft materials such as autograft, allogeneic bone, xenograft and synthetic biomaterials have been widely investigated. Autografts are considered as the gold standard for bone regeneration, but their use is limited due to higher costs, long hospitalization time, additional surgeries and possible complications at the donor site. Growth factors and hormones have also been used to improve bone response around the implant. Currently, the effects of different hormonal mediators to induce ossification in different clinical and laboratory conditions have been investigated. Therefore, the aim of this study is to investigate the effect of using different hormonal drugs locally in improving bone formation in the form of a systematic review.

Materials and methods: A systematic literature search was performed without restriction in publication start date until December 2022 using PubMed following PRISMA guidelines. A structured search was performed to identify in-vivo and in-vitro studies. After screening the articles by title and abstract, 21 studies were included.

Results: All of the studies included were animal in-vivo studies or in-vitro studies and used growth hormone (GH), parathyroid hormone (PTH) and calcitonin (CT). 87.5% of the studies which used GH reported better outcomes relative to the control groups. 66.7% of the studies which used PTH reported better outcomes in comparison with the control groups. 50% of the studies which used CT reported better outcomes in comparison with the control groups.

Conclusion: Locally administered hormonal drugs may stimulate bone healing in surgical bone defects and enhance peri-implant bone response.