Does strontium coated titanium implants enhance the osseointegration in animal models under osteoporotic condition? A systematic review and meta-analysis

PURPOSE

The aim of this study was to systematically review the literature to address the effect of strontium modified titanium implants on the osseointegration in the presence of osteoporotic conditions through animal models.

MATERIALS AND METHODS

The databases (PubMed, Scopus, Web of Science, and EBSCO) were searched electronically, and manual searches were performed till December 2022 to identify preclinical studies on the osseointegration of strontium coated titanium implants in animals with induced osteoporotic conditions. The primary outcomes were the bone-implant contact percentage (BIC%), bone area (BA) from the histomorphometric analysis, and the osseointegration parameters from biomechanical tests; the secondary outcomes were the osseointegration parameters from the micro computed tomography.

RESULTS

Nineteen articles were included for the quantitative analysis on basis of the inclusion criteria. The results revealed that Sr-modified implants showed a significant 19.05% increase in BIC, and 15.01% increase in BA. The results of biomechanical tests indicated a significant effect in favor of Sr-coated implants. Furthermore, Results of the secondary outcomes supported the significant advantages of Sr-coated implants over the un-coated implants. The overall, systematic analysis of implants osteointegration parameters proved a significant increase in favor of Sr-coated titanium implants (P < 0.01).

CONCLUSION

The present results provide evidence that strontium-coated titanium implants enhanced the osseointegration in animal models under osteoporotic condition as this surface modification techniques have improved the mechanical and biological properties of the titanium implants.

Plasma sprayed cerium oxide coating inhibits H2O2-induced oxidative stress and supports cell viability

Oxidative stress is a risk factor in the pathogenesis of osteoporosis, and plays a major role in bone regeneration of osteoporotic patients. Cerium oxide (CeO2) ceramics have the unique ability to protect various types of cells from oxidative damage, making them attractive for biomedical applications. In this study, we developed a plasma sprayed CeO2 coating with a hierarchical topography where ceria nanoparticles were superimposed in the micro-rough coating surface. The protective effects of the CeO2 coating on the response of osteoblasts to H2O2-induced oxidative stress have been demonstrated in terms of cell viability, apoptosis and differentiation. The CeO2 coating reversed the reduced superoxide dismutase activity, decreased reactive oxygen species production and suppressed malondialdehyde formation in H2O2-treated osteoblasts. It indicated that the CeO2 coating can preserve the intracellular antioxidant defense system. The cytocompatibility of the CeO2 coating was further assessed in vitro by cell viability assay and scanning electron microscopy analysis. Taken together, the CeO2 coating could provide an opportunity to be utilized as a potential candidate for bone regeneration under oxidative stress.