Abstract
Statement of problem
Strontium has been validated for potent bone-seeking and antiosteoporotic properties
and elicits a potentially beneficial impact on implant osseointegration in patients
with osteoporosis. However, the efficacy of strontium supplementation on improving
new bone formation and implant osseointegration in the presence of osteoporotic bone
is still unclear.
Purpose
The purpose of this systematic review was to comprehensively assess the efficacy of
strontium supplementation, encompassing oral intake and local delivery of strontium,
on implant osseointegration in patients with osteoporosis.
Material and methods
Searches on electronic databases (MEDLINE or PubMed, Web of Science, EBSCO, Embase,
and Clinicaltrials.gov) and manual searches were conducted to identify relevant preclinical animal trials
up to June 2020. The primary outcomes were the percentage of bone-implant contact
and bone area; the secondary outcomes were quantitative parameters of biomechanical
tests and microcomputed tomography (μCT).
Results
Fourteen preclinical trials (1 rabbit, 1 sheep, and 12 rat), with a total of 404 ovariectomized
animals and 798 implants, were eligible for analysis. The results revealed a significant
17.1% increase in bone-implant contact and 13.5% increase in bone area, favoring strontium
supplementation despite considerable heterogeneity. Subgroup analyses of both bone-implant
contact and bone area exhibited similar outcomes with low to moderate heterogeneity.
Results of biomechanical and μCT tests showed that strontium-enriched implantation
tended to optimize the mechanical strength and microarchitecture of newly formed bone
despite moderate to generally high heterogeneity.
Conclusions
Based on the available preclinical evidence, strontium supplementation, including
local and systemic delivery, showed promising results for enhancing implant osseointegration
in the presence of osteoporosis during 4 to 12 weeks of healing. Future well-designed
standardized studies are necessary to validate the efficacy and safety of strontium
supplementation and to establish a standard methodology for incorporating Sr into
implant surfaces in a clinical setting.
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Article info
Publication history
Published online: February 12, 2021
Footnotes
Supported by National Natural Science Foundation of China (31670970 and 82001048), Zhejiang Provincial Key Research and Development Project (2019C03081), and Zhejiang Provincial Natural Science Foundation of China (LQ20H140004).
W.L. and Y.Z. contributed equally to the present study.
Identification
Copyright
© 2021 by the Editorial Council for the Journal of Prosthetic Dentistry.
