Mesenchymal stem cells in maxillary sinus augmentation: A systematic review with meta-analysis

Area of Science:

• Biomaterials Science
• Regenerative Medicine
• Oral and Maxillofacial Surgery

Background:

• Maxillary sinus augmentation (MSA) is a surgical procedure to increase bone volume in the posterior maxilla.
• Mesenchymal stem cells (MSCs) are multipotent stromal cells with regenerative potential.
• Various scaffold materials are used in conjunction with MSCs for bone regeneration.

Purpose of the Study:

• To evaluate the efficacy of mesenchymal stem cells (MSCs) in maxillary sinus augmentation (MSA).
• To analyze the influence of different scaffold materials on MSC-based MSA outcomes.
• To synthesize existing evidence through a systematic literature review and meta-analysis.

Main Methods:

• Comprehensive literature search of MEDLINE, EMBASE, and SCOPUS databases (2004-2014).
• Inclusion of clinical, radiographic, histologic, and histomorphometric studies in humans and animals.
• Meta-analysis performed on 9 experimental studies (7 animal, 2 human) using regenerated bone volume data.

Main Results:

• Thirty-nine eligible studies were identified, showing variability in design and outcomes.
• Meta-analysis revealed a positive effect of stem cells on bone regeneration, with a weighted mean difference of 9.5%.
• Meta-regression analysis indicated that publication year, support type, and follow-up length explained the observed heterogeneity.

Conclusions:

• Cell-based approaches, particularly using MSCs, demonstrate significant potential for enhancing bone regeneration in MSA.
• The heterogeneity in results can be mitigated by considering study design factors.
• Further high-quality clinical trials are required to validate the efficacy of MSCs in MSA and guide clinical practice.