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Efficacy of growth factors for the treatment of peri-implant diseases: a systematic review and meta-analysis

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Abstract

Objectives

The aim of this study was to conduct a systematic review and meta-analysis on the efficacy of growth factors (GF) on clinical outcomes after treatment (surgical/non-surgical) of peri-implant diseases (peri-implant mucositis and peri-implantitis).

Materials and methods

A protocol was developed to answer the following focused question: Is there any difference for the use of GF for treatment of peri-implant diseases versus comparative GF treatment or without GF? Electronic database and manual searches were independently conducted to identify randomized controlled trials (RCTs). Publications were selected based on eligibility criteria and then assessed for risk-of-bias using the Cochrane Handbook. The primary outcome was probing depth (PD) and bleeding on probing (BOP) reduction along with changes in vertical defect depth (VDD). Changes in clinical attachment level, gingival recession, and plaque index, among others, were studied as secondary outcomes. Based on primary outcomes, random-effects meta-analysis was conducted.

Results

A total of five RCTs were included. GF enhance the reduction of PD (standardized mean difference (SMD) = − 1.28; 95% confidence interval (CI) − 1.75, − 0.79; p = < 0.0001) and BOP (SMD = − 1.23; 95% CI − 1.70, − 0.76; p = < 0.0001) in the management of peri-implant mucositis. For the treatment of peri-implantitis, the use of GF yielded to significantly greater improvement in VDD (SMD = 0.68; 95% CI 0.22, 1.14; p = 0.004); however, there were no significant differences in terms of PD (SMD = 0.08; 95% CI − 1.08, 1.26; p = 0.887) and BOP (SMD = 0.211; 95% CI − 0.20, 0.63; p = 0.317). The overall risk of bias of the included studies was low to unclear.

Conclusion

The results of the present systematic review suggest that the addition of GF might enhance the outcomes in the treatment of peri-implant mucositis. However, there is a lack of evidence for supporting additional benefit of GF managing peri-implantitis.

Clinical relevance

Within the limitations of the current systematic review and based on the meta-analyses, (1) the addition of GF for the treatment peri-implant mucositis might be associated with better outcomes in terms of PD and BOP, and (2) an additional benefit of GF for the treatment peri-implantitis could not be determined on the basis of the selected evidence.

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Acknowledgments

The authors are grateful to Mr. Richard McGowan (NYU Health Sciences Library Liaison and NYU College of Dentistry) for his assistance with the electronic database search process.

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Authors and Affiliations

  1. Bluestone Center for Clinical Research, New York University College of Dentistry, 421 First Avenue – BCCR 2W, New York, NY, 10010, USA

    Ismael Khouly & Simon Pardiñas-López

  2. Department of Oral and Maxillofacial Surgery, New York University College of Dentistry, New York, NY, USA

    Ismael Khouly

  3. Cell Therapy and Regenerative Medicine Group, Centre for Advanced Scientific Research (CICA), A Coruña, Spain

    Simon Pardiñas-López

  4. Biomedical Research Institute of A Coruña (INIBIC) strategic group, Galician Health Service (SERGAS), Universidade da Coruña (UDC), University Hospital Complex of A Coruña (CHUAC), A Coruña, Spain

    Simon Pardiñas-López

  5. Department of Epidemiology & Health Promotion, New York University College of Dentistry, New York, NY, USA

    Ryan Richard Ruff

  6. New York University College of Global Public Health, New York, NY, USA

    Ryan Richard Ruff

  7. Department of Oral Biology, School of Dentistry, Medical University of Vienna, Vienna, Austria

    Franz-Josef Strauss

  8. Department of Conservative Dentistry, School of Dentistry, University of Chile, Santiago, Chile

    Franz-Josef Strauss

  9. Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland

    Franz-Josef Strauss

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  1. Ismael Khouly
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I. Khouly and Pardiñas-López contributed to review design, data acquisition, analysis and interpretation, and drafting and revision of the manuscript; F.J. Strauss contributed to data interpretation and drafting and revision of the manuscript; R.R. Ruff contributed to data analysis and interpretation, and drafting and revision of the manuscript. All authors gave final approval and agree to be accountable for all aspects of the work.

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Correspondence to Ismael Khouly.

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Drs. Pardiñas-López and Strauss declare that they have no conflict of interest. Dr. Ruff reports grants from NIH, and Dr. Khouly from OsteoScience Foundation, Sweden and Martina SpA and Dentsply Sirona, during the conduct of the review. The review was self-funded by the authors.

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Khouly, I., Pardiñas-López, S., Ruff, R.R. et al. Efficacy of growth factors for the treatment of peri-implant diseases: a systematic review and meta-analysis. Clin Oral Invest 24, 2141–2161 (2020). https://doi.org/10.1007/s00784-020-03240-5

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