Couto Bárbara Alexandra do Amaral, Fernandes Juliana Campos Hasse, Saavedra-Silva Mariana, Roca Hernan, Castilho Rogério Moraes, Fernandes Gustavo Vicentis de Oliveira
Faculty of Dental Medicine, Universidade Católica Portuguesa, 3505-606 Viseu, Portugal.
Private Practice, Ann Arbor, MI 48109, USA.
J Clin Med. 2023 Feb 6;12(4):1294. doi: 10.3390/jcm12041294.
: This study reviewed the literature on local or systemic administration of antisclerostin, presenting results associated with osseointegration of dental/orthopedic implants and stimulation of bone remodeling. : An extensive electronic search was conducted through MED-LINE/PubMed, PubMed Central, Web of Science databases and specific peer-reviewed journals to identify case reports, case series, randomized controlled trials, clinical trials and animal studies comparing either the systemic or local administration of antisclerostin and its effect in osseointegration and bone remodeling. Articles in English and with no restriction on period were included. : Twenty articles were selected for a full-text, and one was excluded. Finally, 19 articles were included in the study (16 animal studies and 3 randomized control trials). These studies were divided into two groups, which evaluated (i) osseointegration and (ii) bone remodeling potential. Initially 4560 humans and 1191 animals were identified. At least 1017 were excluded from the studies (981 humans and 36 animals), totaling 4724 subjects who completed (3579 humans and 1145 animals). (a) Osseointegration: 7 studies described this phenomenon; 4 reported bone-implant contact, which increased in all included studies. Similar results were found for bone mineral density, bone area/volume and bone thickness. (b) Bone remodeling: 13 studies were used for description. The studies reported an increase in BMD with sclerostin antibody treatment. A similar effect was found for bone mineral density/area/volume, trabecular bone and bone formation. Three biomarkers of bone formation were identified: bone-specific alkaline phosphatase (BSAP), osteocalcin and procollagen type 1 N-terminal Pro-peptide (P1NP); and markers for bone resorption were: serum C-telopeptide (sCTX), C-terminal telopeptides of type I collagen (CTX-1), β-isomer of C-terminal telopeptides of type I collagen (β-CTX) and tartrate-resistant acid phosphatase 5b (TRACP-5b). There were limitations: low number of human studies identified; high divergence in the model used (animal or human); the variance in the type of Scl-Ab and doses of administration; and the lack of reference quantitative values in the parameters analyzed by authors' studies (many articles only reported qualitative information). : Within the limitations of this review and carefully observing all data, due to the number of articles included and the heterogeneity existing, more studies must be carried out to better evaluate the action of the antisclerostin on the osseointegration of dental implants. Otherwise, these findings can accelerate and stimulate bone remodeling and neoformation.
本研究回顾了关于抗硬化蛋白局部或全身给药的文献，呈现了与牙种植体/骨科植入物骨整合及骨重塑刺激相关的结果。通过MEDLINE/PubMed、PubMed Central、Web of Science数据库及特定同行评审期刊进行了广泛的电子检索，以识别比较抗硬化蛋白全身或局部给药及其在骨整合和骨重塑中作用的病例报告、病例系列、随机对照试验、临床试验和动物研究。纳入英文且无时间限制的文章。筛选出20篇文章进行全文阅读，排除1篇。最终，19篇文章纳入本研究（16篇动物研究和3篇随机对照试验）。这些研究分为两组，分别评估（i）骨整合和（ii）骨重塑潜力。最初识别出4560名人类和1191只动物。研究中至少排除1017例（981名人类和36只动物），共有4724名受试者完成研究（3579名人类和1145只动物）。（a）骨整合：7项研究描述了这一现象；4项报告了骨与植入物的接触，在所有纳入研究中均增加。骨矿物质密度、骨面积/体积和骨厚度也有类似结果。（b）骨重塑：13项研究用于描述。研究报告硬化蛋白抗体治疗后骨密度增加。骨矿物质密度/面积/体积、小梁骨和骨形成也有类似效果。确定了三种骨形成生物标志物：骨特异性碱性磷酸酶（BSAP）、骨钙素和I型前胶原N端前肽（P1NP）；骨吸收标志物为：血清I型胶原C末端肽（sCTX）、I型胶原C末端肽（CTX-1）、I型胶原C末端肽β异构体（β-CTX）和抗酒石酸酸性磷酸酶5b（TRACP-5b）。存在局限性：识别出的人类研究数量少；所用模型（动物或人类）差异大；硬化蛋白抗体类型和给药剂量存在差异；作者研究分析的参数缺乏参考定量值（许多文章仅报告定性信息）。在本综述的局限性内并仔细观察所有数据，由于纳入文章数量及存在的异质性，必须开展更多研究以更好地评估抗硬化蛋白对牙种植体骨整合的作用。否则，这些发现可加速并刺激骨重塑和新骨形成。
