Alveolar bone tissue engineering in critical‐size defects of experimental animal models: a systematic review and meta‐analysis

摘要: Regeneration of large, 'critical-size' bone defects remains a clinical challenge. Bone tissue engineering (BTE) is emerging as promising alternative to autogenous, allogeneic and biomaterial-based grafting. The objective this systematic review was answer the focused question: in animal models, do cell-based BTE strategies enhance regeneration alveolar critical-size (CSDs), compared with grafting only biomaterial scaffolds or autogenous bone? Following PRISMA guidelines, electronic databases were searched for controlled studies reporting maxillary mandibular CSD implantation mesenchymal stem cells (MSCs) osteoblasts (OBs) seeded on scaffolds. A random effects meta-analysis performed outcome histomorphometric new formation (%NBF). Thirty-six included that reported large- (monkeys, dogs, sheep, minipigs) small-animal (rabbits, rats) models. On average, presented an unclear-to-high risk bias short observation times. In most studies, MSCs OBs used combination alloplastic mineral-phase five modified by ex vivo gene transfer morphogenetic proteins (BMPs). indicated statistically significant benefits favour of: (1) cell-loaded vs. cell-free [weighted mean difference (WMD) 15.59-49.15% 8.60-13.85% NBF respectively]; (2) BMP-gene-modified unmodified (WMD 10.06-20.83% models). Results inconclusive. Overall, heterogeneity high (I2  > 90%). summary, enhanced addition osteogenic direction estimates treatment effect are useful predict therapeutic efficacy guide future trials BTE. Copyright © 2016 John Wiley & Sons, Ltd.