Major clinical outcomes of cellular and molecular regulation in maxillofacial bone regeneration: a systematic review

Abstract

Introduction: The importance of knowing the constitution of this epithelium is because these hair cells play a fundamental role in the physiology of the maxillary sinus. When a dental element is lost in the posterior region of the maxilla, there is natural reabsorption of the alveolar process and, at the same time, pneumatization of the maxillary sinus will occur. Objective: It was to demonstrate, through a systematic review, the main clinical outcomes of cellular and molecular regulation in maxillofacial bone regeneration. Methods: The systematic review rules of the PRISMA Platform were followed. The research was carried out from September to October 2022 in Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. A total of 110 articles were found, 41 articles were evaluated and 31 were included in this systematic review. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 31 studies at high risk of bias and 25 studies that did not meet the GRADE. Most studies showed homogeneity in their results, with I2 =98.9% >50%. Results and Conclusion: It was found that the search for a solution to large bone defects guided the studies for regeneration therapy tissue or bone regeneration. These studies can promote the use of fillers and epithelial barriers that help in the treatment as an adjuvant to bone graft techniques, favoring greater predictability in alveolar and peri-implant reconstructions and with a good prognosis. The main filler biomaterials can be fibrin-rich plasma (FRP), Bio-Oss®. It is necessary to understand the chemical, physical and biological processes of both the biological material and the biological niche of the host. Crossing compatible information between microenvironments allows cell recognition and signaling cascades for neovascularization and regeneration and bone filling.