Bone substitutes and photobiomodulation in bone regeneration: A systematic review in animal experimental studies

Abstract

In general, bone fractures are able of healing by itself. However, in critical situations such as large bone defects, poor blood supply or even infections, the biological capacity of repair can be impaired, resulting in a delay of the consolidation process or even in non‐union fractures. Thus, technologies able of improving the process of bone regeneration are of high demand. In this context, ceramic biomaterials‐based bone substitutes and photobiomodulation (PBM) have been emerging as promising alternatives. Thus, the present study performed a systematic review targeting to analyze studies in the literature which investigated the effects of the association of ceramic based bone substitutes and PBM in the process of bone healing using animal models of bone defects. The search was conducted from March and April of 2019 in PubMed, Web of Science and Scopus databases. After the eligibility analyses, 16 studies were included in this review. The results showed that the most common material used was hydroxyapatite (HA) followed by Biosilicate associated with infrared PBM. Furthermore, 75% of the studies demonstrated positive effects to stimulate bone regeneration from association of ceramic biomaterials and PBM. All studies used low‐level laser therapy (LLLT) device and the most studies used LLLT infrared. The evidence synthesis was moderate for all experimental studies for the variable histological analysis demonstrating the efficacy of techniques on the process of bone repair stimulation. In conclusion, this review demonstrates that the association of ceramic biomaterials and PBM presented positive effects for bone repair in experimental models of bone defects.

Effects of a Biocomplex Formed by Two Scaffold Biomaterials, Hydroxyapatite/Tricalcium Phosphate Ceramic and Fibrin Biopolymer, with Photobiomodulation, on Bone Repair

“…When applied, their activities are accelerated, resulting in increased mitochondrial respiration and ATP synthesis. In addition, it optimizes protein synthesis, migration, and cell proliferation, and reduces the inflammatory response, decreasing edema and providing an efficient healing and bone regeneration process [ 34 , 35 , 36 , 37 ]. Finally, PBM therapy is a relatively low-cost, non-invasive treatment method.…”

Imatinib-Functionalized Galactose Hydrogels Loaded with Nanohydroxyapatite as a Drug Delivery System for Osteosarcoma: In Vitro Studies

“…The drug in this group is imatinib, which inhibits the BCR-Abl kinase, and is most commonly used in blood cancers. Unfortunately, chemotherapy administered by the oral or intravenous route in this tumor is quite limited due to the poor blood supply to the bones . This causes a significant reduction in drug delivery to the target site and achievement of the therapeutic concentration, leading to various effects associated with chemotherapy, including in terms of the functions of internal organs (liver, kidneys, heart), as well as infectious complications caused by impaired blood cell production by the bone marrow …”

Analysis of the effects of concentrated growth factor and low-level laser therapy on the bone healing

“…PRF or CGF used alone can accelerate the healing of bone defects [ 17 , 18 ], which is the same as our experimental results. Reviews have concluded that the association of PBM and bone substitutes presented positive effects for bone healing in animal studies [ 5 , 19 , 20 ]. Bone substitutes traditionally include biosilicate, mineral tri-oxide aggregate (MTA), ceramic materials, deproteinized bovine bone graft.…”