How Is Bone Regeneration Influenced by Polymer Membranes? Insight into the Histological and Radiological Point of View in the Literature.

Abstract

The aim of this study was to analyze published works that investigate the in vivo bone regeneration capacity of polymeric membranes loaded with active substances and growth factors. This scoping review's purpose was to highlight the histological and radiological interpretation of the locally produced effects of the polymer membranes studied so far. For the selection of the articles, a search was made in the PubMed and ScienceDirect databases, according to the PRISMA algorithm, for research/clinical trial type studies. The search strategy was represented by the formula "((biodegradable scaffolds AND critical bone defect) OR (polymers AND mechanical properties) OR (3Dmaterials AND cytotoxicity) AND bone tissue regeneration)" for the PubMed database and "((biodegradable scaffolds AND polymers) OR (polymers AND critical bone defects) OR (biodegradable scaffolds AND mechanical properties) AND bone tissue regeneration)" for the ScienceDirect database. Ethical approval was not required. Eligibility criteria included eight clinical studies published between 2018 and 2023. Our analysis showed that polymer membranes that met most histopathological criteria also produced the most remarkable results observed radiologically. The top effective scaffolds were those containing active macromolecules released conditionally and staged. The PLGA and polycaprolactone scaffolds were found in this category; they granted a marked increase in bone density and improvement of osteoinduction. But, regardless of the membrane composition, all membranes implanted in created bone defects induced an inflammatory response in the first phase.