Evaluation of the Effect of Stem Cell-based Scaffolds on Bone Regeneration and Formation in Maxillofacial Bone Disorders: A Systematic Review and Meta-analysis

Document Type : Review Article

Authors

1 Department of Oral and Maxillofacial Surgery, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran

2 Department of Periodontics, Faculty of Dentistry, Islamic Azad University, Isfahan (Khorasgan) Branch, Isfahan, Iran

3 Department of Operative Dentistry, Faculty of Dentistry, Islamic Azad University, Isfahan (Khorasgan) Branch, Isfahan, Iran

4 Department of Oral and Maxillofacial Radiology, School of Dentistry, Islamic Azad University, Isfahan (Khorasgan) Branch, Isfahan, Iran

5 Department of Periodontology, School of Dentistry, Ahwaz Jundishapur University of Medical Sciences, Ahwaz, Iran

6 Department of Periodontics, Faculty of of Dentistry, Islamic Azad University, Isfahan (Khorasgan) Branch, Isfahan, Iran

Abstract

Background and aim: Tissue engineering has provided many hopes for reconstructing bone lesions. For bone engineering, stem cells are cultured on suitable scaffolds under controlled stimulation conditions with growth factors. A scaffold is a temporary matrix for bone growth that provides a specific environment for tissue development and facilitates cell adhesion, growth, and differentiation. The present study aimed to evaluate the effect of stem cell base scaffolds on bone regeneration and formation in maxillofacial bone disorders.
Material and methods: Searching international databases PubMed, Web of Science, Scopus, Science Direct, Web of Knowledge, EBSCO, Wiley, ISI, Elsevier, Embase databases, and Google Scholar search engine based on PRISMA 2020-27-item checklist and keywords Related to the objectives of the study, it was carried out from 2013 to January 2024. The prevalence was equivalent to the rate ratio of bone formation. A model with fixed effect and inverse–variance method was used. All statistical analyses are done using STATA/MP software. v17 was done considering the significance of less than 0.05.
Results: Nine studies were selected according to the inclusion criteria. The fixed-effects rate ratio of bone formation meta-analysis showed that ES = 0.39, 95% CI; 0.34-0.45, p-value < 0.001. the test of group differences showed no statistically significant difference between types of stem cells in the rate ratio of bone formation in maxillofacial bone disorders, and all three types have similar findings (p=0.08).
Conclusions: All three types of stem cells (DPSCs, ADSCs, BMSCs) used in Maxillofacial Bone Disorders showed similar findings in the ratio of bone formation.

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[1] Derebaşınlıoğlu H, Cankorkmaz L. Age distribution of mandibular fractures and concomitant injuries. European Journal of Plastic Surgery. 2022;45(5):747-53. https://doi.org/10.1007/s00238-022-01967-w.
[2] Wusiman P, Maimaitituerxun B, Saimaiti A, Moming A. Epidemiology and pattern of oral and maxillofacial trauma. Journal of Craniofacial Surgery. 2020;31(5):e517-20. https://doi.org/10.1097/SCS.0000000000006719.
[3] Juncar M, Tent PA, Juncar RI, Harangus A, Mircea R. An epidemiological analysis of maxillofacial fractures: a 10-year cross-sectional cohort retrospective study of 1007 patients. BMC oral health. 2021;21(128):1-10. https://doi.org/10.1186/s12903-021-01503-5.
[4] Omi M, Mishina Y. Roles of osteoclasts in alveolar bone remodeling. genesis. 2022;60(8-9):e23490. https://doi.org/10.1002/dvg.23490.
[5] Moussa N, Fan Y, Dym H. Maxillofacial bone grafting materials: 2021 Update. Dental Clinics. 2021;65(1):167-95. https://doi.org/10.1016/j.cden.2020.09.012.
[6] Moussa NT, Dym H. Maxillofacial bone grafting materials. Dental Clinics. 2020;64(2):473-90. https://doi.org/10.1016/j.cden.2019.12.011.
[7] Zhang S, Xie D, Zhang Q. Mesenchymal stem cells plus bone repair materials as a therapeutic strategy for abnormal bone metabolism: Evidence of clinical efficacy and mechanisms of action implied. Pharmacological Research. 2021;172:105851. https://doi.org/10.1016/j.phrs.2021.105851.
[8] Xia B, Deng Y, Lv Y, Chen G. Stem cell recruitment based on scaffold features for bone tissue engineering. Biomaterials Science. 2021;9(4):1189-203. https://doi.org/10.1039/D0BM01591A.
[9] Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. Bmj. 2021;372. https://doi.org/10.1136/bmj.n71.
[10] Hooijmans CR, Rovers MM, De Vries RB, Leenaars M, Ritskes-Hoitinga M, Langendam MW. SYRCLE’s risk of bias tool for animal studies. BMC medical research methodology. 2014;14(43):1-9. https://doi.org/10.1186/1471-2288-14-43.
[11] Sokouti M, Shafiee-Kandjani AR, Sokouti M, Sokouti B. A meta-analysis of systematic reviews and meta-analyses to evaluate the psychological consequences of COVID-19. BMC psychology. 2023;11(1):279. https://doi.org/10.1186/s40359-023-01313-0.
[12] Da Cunha MR, Maia FL, Iatecola A, Massimino LC, Plepis AM, Martins VD, et al. In vivo evaluation of collagen and chitosan scaffold, associated or not with stem cells, in bone repair. Journal of Functional Biomaterials. 2023;14(7):357. https://doi.org/10.3390/jfb14070357.
[13] Lee JS, Park TH, Ryu JY, Kim DK, Oh EJ, Kim HM, et al. Osteogenesis of 3D-printed PCL/TCP/bdECM scaffold using adipose-derived stem cells aggregates; an experimental study in the canine mandible. International Journal of Molecular Sciences. 2021;22(11):5409. https://doi.org/10.3390/ijms22115409.
[14] Zhang W, Shi W, Wu S, Kuss M, Jiang X, Untrauer JB, et al. 3D printed composite scaffolds with dual small molecule delivery for mandibular bone regeneration. Biofabrication. 2020;12(3):035020. https://doi.org/10.1088/1758-5090/ab906e.
[15] Prahasanti C, Nugraha AP, Saskianti T, Suardita K, Riawan W, Ernawati DS. Exfoliated human deciduous tooth stem cells incorporating carbonate apatite scaffold enhance BMP-2, BMP-7 and attenuate MMP-8 expression during initial alveolar bone remodeling in wistar rats (Rattus norvegicus). Clinical, Cosmetic and Investigational Dentistry. 2020;12:79-85.
[16] Lopez CD, Diaz-Siso JR, Witek L, Bekisz JM, Cronstein BN, Torroni A, et al. Three dimensionally printed bioactive ceramic scaffold osseoconduction across critical-sized mandibular defects. journal of surgical research. 2018;223:115-22. https://doi.org/10.1016/j.jss.2017.10.027.
 [17] Moser N, Lohse N, Goldstein J, Kauffmann P, Sven B, Epple M, et al. Do we need retarded delivery of bone growth factors in facial bone repair? An experimental study in rats. 2017;34:162-79. https://doi.org/10.22203/eCM.v034a11.
 [18] Lee MK, DeConde AS, Lee M, Walthers CM, Sepahdari AR, Elashoff D, et al. Biomimetic scaffolds facilitate healing of critical-sized segmental mandibular defects. American journal of otolaryngology. 2015;36(1):1-6. https://doi.org/10.1016/j.amjoto.2014.06.007.
[19] Alfotawei R, Naudi KB, Lappin D, Barbenel J, Di Silvio L, Hunter K, et al. The use of TriCalcium Phosphate (TCP) and stem cells for the regeneration of osteoperiosteal critical-size mandibular bony defects, an in vitro and preclinical study. Journal of Cranio-Maxillofacial Surgery. 2014;42(6):863-9. https://doi.org/10.1016/j.jcms.2013.12.006.
[20] Dong R, Bai Y, Dai J, Deng M, Zhao C, Tian Z, et al. Engineered scaffolds based on mesenchymal stem cells/preosteoclasts extracellular matrix promote bone regeneration. Journal of tissue engineering. 2020;11:2041731420926918. https://doi.org/10.1177/2041731420926918.
[21] Gugjoo MB, Sharma GT. Equine mesenchymal stem cells: properties, sources, characterization, and potential therapeutic applications. Journal of equine veterinary science. 2019;72:16-27. https://doi.org/10.1016/j.jevs.2018.10.007.
[22] Jingushi S, Urabe K, Okazaki K, Hirata G, Sakai A, Ikenoue T, et al. Intramuscular bone induction by human recombinant bone morphogenetic protein-2 with beta-tricalcium phosphate as a carrier: in vivo bone banking for muscle-pedicle autograft. Journal of orthopaedic science. 2002;7:490-4. https://doi.org/10.1007/s007760200085.
[23] Alam MI, Asahina I, Ohmamiuda K, Enomoto S. Comparative study of biphasic calcium phosphate ceramics impregnated with rhBMP‐2 as bone substitutes. Journal of Biomedical Materials Research: An Official Journal of The Society for Biomaterials and The Japanese Society for Biomaterials. 2001;54(1):129-38.https://doi.org/10.1002/1097-4636(200101).