Main factors of bone loss and the processes of osseointegration for dental implant: a systematic review

Abstract

Introduction: In the cellular, molecular and structural scenario for dental implants, primary or mechanical stability in implant dentistry is considered a prerequisite for successful osseointegration. The alveolar bone architecture of the implant drilling site dictates the success of anchored endosteal implants. Objective: It was to carry out a systematic review to highlight the main variables that can compromise bone formation and osseointegration for dental implants. Methods: The systematic review rules of the PRISMA Platform were followed. The search was carried out from October to December 2022 in the Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases, using articles from 2010 to 2022. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: A total of 220 articles were found, and 65 articles were evaluated in full and 22 were included and developed in this systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 45 studies with a high risk of bias and 92 studies that did not meet GRADE. The success of the prosthetic restoration supported by osseointegrated implants and the health of the surrounding tissues, such as the reduction of bone loss, are closely related to the precision and adaptation of the components, the stability of the implant/abutment interface, as well as the resistance of this interface when it is subjected to loads during masticatory function. It is necessary to provide a complete understanding of the biological events that occur during osseointegration. Factors that can compromise bone healing are cholesterol, hyperlipidemia, and low vitamin D intake. Furthermore, the prominent influence of osteocytes and immune cells is influenced as being the main regulators during osseointegration and maintenance of the dental implant.