Hyaluronic Acid in Bone Regeneration: Systematic Review and Meta-Analysis
Abstract
:1. Introduction
2. Materials and Methods
2.1. Protocol and Registration
2.2. Population, Intervention, Comparison, Outcomes, and Study Design
2.3. Inclusion and Exclusion Criteria
2.4. Types of Intervention
2.5. Outcome Measures
2.6. Search Strategy
2.7. Selection Criteria and Data Analysis
2.8. Risk of Bias
2.9. Statistical Analysis
3. Results
3.1. Included Studies
3.2. Excluded Studies
3.3. Study Characteristics
3.4. Included Studies’ Heterogeneity
3.5. New Bone Formation
3.6. Remaining Graft Particles
4. Discussion
5. Conclusions
Author Contributions
Funding
Data Availability Statement
Conflicts of Interest
References
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Study | Study Design | Number of HA Cases | % New Bone HA | % Particles HA | Number of Control Cases | % New Bone Control | % Particles Control |
---|---|---|---|---|---|---|---|
Stiller et al., 2014 [27] | Randomized split-mouth | 7 | 30.1 | 29.5 | 7 | 17.4 | 32.9 |
Velasco-Ortega et al., 2020 [28] | Randomized controlled trial | 8 | 23.29 | 7.17 | 8 | 23.85 | 7.17 |
Abaza et al., 2023 [29] | Randomized controlled trial | 12 | 56.66 | 2.63 | 12 | 24.05 | 2.71 |
Studies | Exclusion Reason |
---|---|
Ballini et al., 2009 [30] Božić et al., 2021 [31] de Santana et al., 2015 [32] Mamajiwala et al., 2021 [33] Sehdev et al., 2016 [34] Engström et al., 2001 [35] Briguglio et al., 2013 [36] Pilloni et al., 2021 [37] Vanden Bogaerde et al., [38] | The focus of these studies is periodontal surgery |
Kaya et al., 2019 [39] | The main focus was not bone regeneration |
D’Albis et al., 2022 [40] Ostos-Aguilar et al., 2023 [41] Lorenz et al., 2018 [42] | Study design different from RCTs |
Göçmen et al., 2016 [43] Eeckhout et al., 2022 [44] | HA was not mixed with biomaterials |
Husseini et al., 2023 [45] Alcântara et al., 2018 [46] Baldini et al., 2010 [47] | No histomorphometric data were reported |
Kauffmann et al., 2023 [48] | Missing statistical data to be included in meta-analysis |
Study | Bone Graft Materials | Purpose of the Study | Study Protocol | Histomorphometric Results |
---|---|---|---|---|
Stiller et al., 2014 [27] | TCP-G: CEROS TCP Granules, Mathys Ltd., Switzerland. Pure, synthetic b-TCP granules with a grain size of 700–1400 mm. TCP-P: CEROS TCP Putty, Mathys Ltd., Switzerland. Putty material composed of pure, synthetic b-TCP granules with two types of grain size ranges, i.e., 125–250 mm and 500–700 mm, embedded in a sodium HA hydrogel matrix with a b-TCP:HA ratio of 10:1. | Evaluate the effect of these two bone graft materials on bone formation, bone matrix maturation and osteoblast differentiation six months after MSA. | CBCT was performed preoperatively, post-operatively, and six months after MSA for a 3D assessment of the sinus floor anatomy and bone volume. Before the implant surgery, bone biopsies were performed for histomorphometric analyses. | Six months after SFA: TCP-G: Bone: 17.4 ± 3.3%, Particle: 32.9 ± 2.4% Marrow spaces: 49.7 ± 2.6%. TCP-P: Bone: 30.1 ± 3.1% Particle: 29.5 ± 3.0% Marrow spaces: 40.5 ± 3.2% |
Velasco-Ortega et al., 2020 [28] | Control Group: Bio-Oss Cancellous, Geistlich, Wolhusen, Switzerland. Demineralized Bovine Bone Mineral Test group: Hyadent BG, Regedent. TCP in the test group plus crosslinked HA with a ratio of 2:1. | Evaluate and compare, histomorphometrically and clinically, different bone substitutes in the MSA. | A CBCT was performed before surgery and 9 months after the MSA before the implant surgery, where bone biopsies were performed for histomorphometric analyses. | Control Group: New bone: 25.97 ± 2.79% Particle: 32.19 ± 1.52% Marrow spaces: 41.99 ± 3.44% Test: New bone: 23.29 ± 2.01% Particle: 7.47 ± 3.59% Marrow spaces: 69.80 ± 2.51% |
Abaza et al., 2023 [29] | Group 1: crosslinked HA solution (Perfecta) + cerabone®, Straumann, Germany. Group 2: cerabone®, Straumann, Germany. | Compare the effectiveness of HA in combination with xenografts for ARP versus xenografts alone. | Cone beam CT scans were performed preoperatively and 4 months post-operatively to measure radiographic bone gain. Histological assessment of core bone biopsies was performed 4 months post-operatively. | Group 1: New bone: 56.66 ± 7.35% (Mature bone: 18.26 ± 4.44%) Particle: 2.63 ± 1.27% Group 2: New bone: 24.05 ± 3.64% (Mature bone: 2.41 ± 1.36%) Particle: 2.71 ± 1.24% |
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Lorenzi, C.; Leggeri, A.; Cammarota, I.; Carosi, P.; Mazzetti, V.; Arcuri, C. Hyaluronic Acid in Bone Regeneration: Systematic Review and Meta-Analysis. Dent. J. 2024, 12, 263. https://doi.org/10.3390/dj12080263
Lorenzi C, Leggeri A, Cammarota I, Carosi P, Mazzetti V, Arcuri C. Hyaluronic Acid in Bone Regeneration: Systematic Review and Meta-Analysis. Dentistry Journal. 2024; 12(8):263. https://doi.org/10.3390/dj12080263
Chicago/Turabian StyleLorenzi, Claudia, Andrea Leggeri, Ilaria Cammarota, Paolo Carosi, Vincenzo Mazzetti, and Claudio Arcuri. 2024. "Hyaluronic Acid in Bone Regeneration: Systematic Review and Meta-Analysis" Dentistry Journal 12, no. 8: 263. https://doi.org/10.3390/dj12080263