Plant Extracts in the Bone Repair Process: A Systematic Review

Abstract

Bone lesions are an important public health problem, with high socioeconomic costs. Bone tissue repair is coordinated by an inflammatory dynamic process mediated by osteoprogenitor cells of the periosteum and endosteum, responsible for the formation of a new bone matrix. Studies using antioxidant products from plants for bone lesion treatment have been growing worldwide. We developed a systematic review to compile the results of works with animal models investigating the anti-inflammatory activity of plant extracts in the treatment of bone lesions and analyze the methodological quality of the studies on this subject. Studies were selected in the PubMed/MEDLINE, Scopus, and Web of Science databases according to the PRISMA statement. The research filters were constructed using three parameters: animal model, bone repair, and plant extracts. 31 full-text articles were recovered from 10 countries. Phytochemical prospecting was reported in 15 studies (48.39%). The most common secondary metabolites were flavonoids, cited in 32.26% studies (n = 10). Essential criteria to in vivo animal studies were frequently underreported, suggesting publication bias. The animals treated with plant extracts presented positive results in the osteoblastic proliferation, and consequently, this treatment accelerated osteogenic differentiation and bone callus formation, as well as bone fracture repair. Possibly, these results are associated with antioxidant, regenerative, and anti-inflammatory power of the extracts. The absence or incomplete characterization of the animal models, treatment protocols, and phytochemical and toxicity analyses impairs the internal validity of the evidence, making it difficult to determine the effectiveness and safety of plant-derived products in bone repair.

Acemannan-induced tooth socket healing: A 12-month randomized controlled trial

“… 9 Studies have demonstrated the positive outcomes of plant extracts on bone healing through either of two mechanisms: osteoconductivity, which refers to the support for new bone ingrowth, or osteoinductivity, where a material stimulates cells to differentiate into osteogenic cells. 10 …”

Essential Oils for Bone Repair and Regeneration—Mechanisms and Applications

“…In this context, EOs could become ideal candidates for this purpose. However, the results described in the literature are still limited [26], and further research is required for assessing their potential in orthopedic applications. Current studies involve the use of EOs for enhancing the regeneration of bone defects and preventing or treating osteoporosis and osteoarthritis and as bioactive compounds in bone scaffolds or implants for regenerative or antimicrobial purposes.…”

“…While bone regeneration is a complex process that allows the tissue to regain and maintain its structure and function with no scar formation, certain clinical situations require an acceleration of the process. Researchers have been focusing on identifying novel therapeutic agents that could aid the bone-healing process and understand the inflammatory mechanisms that modulate this process [25,26]. Since ancient times, nature has represented a major source of bioactive compounds that exhibit therapeutic properties [27].…”

“…Plant-derived drugs are consumed by 75% of the global population and are the major form of treatment in many developing countries. As studies have shown the anti-inflammatory, antioxidant, and regenerative properties of these biocompounds, they have been widely applied in the treatment of osteoarthritis, asthma, heart diseases, hypertension, or cancer [26,28,29]. In this context, there is increasing evidence of the potential of natural biocompounds as an alternative for bone healing and regeneration, owing to their capacity for inhibiting bone resorption and tissue inflammation; increasing antioxidant defenses, tissue vascularization, and bone cell proliferation; reduced costs; and minimal side effects [26,30].…”

Safety and Effectiveness of Copaiba Oleoresin (C. reticulata Ducke) on Inflammation and Tissue Repair of Oral Wounds in Rats

“…The use of medicinal plants for healing is the oldest form of medicinal practice of mankind [7]. Contemporary science has shown that some natural compounds have high anti-inflammatory, antioxidant and regenerative effects [8]. Brazil has great biodiversity (15-20% of the world's biodiversity), with about 60,000 varieties of plants, including some known for traditional use and others still not explored [9].…”