Evaluation of Bone Regeneration Based on Fibronectin Effect Around Dental Implant: A Systematic Review

Abstract

Context: Fibronectin, a key glycoprotein, promotes the attachment and movement of progenitor cells, initiating the process of bone formation. Methods: This systematic review focused on the question: Does fibronectin alter bone regeneration? Two investigators independently conducted searches in electronic databases (PubMed, Web of Science, Cochrane, EMBASE, and Scopus) up to March 2025. Search terms included “Dental Implant”, “Fibronectin”, and “Bone Regeneration” or “Osseointegration”. Studies were selected based on the PICOS framework (population: Dental implants; intervention: Fibronectin; comparison: Calcium phosphate, beta-tricalcium phosphate (β-TCP), uncoated or no coating, osseointegration; outcome: Bone regeneration, osseointegration; study design: Animal studies). The following information was extracted from the articles by two researchers independently: Publication year, study design, details of the participants, type of implant, site of surgery, intervention, and outcome. Risk of bias (RoB) in individual studies was assessed using the SYRCLE’s RoB tool for animal studies. Results: The search yielded 1,832 potentially-related titles. After removing duplicate articles, 1,612 articles remained. A total of 773 were excluded due to irrelevant titles, leaving 839 articles. Subsequently, 802 articles were excluded based on their abstracts. The full texts of 37 studies were obtained, and 28 studies were excluded. Among the excluded studies, 21 were review articles. Nine articles were included in this systematic review, and their data were extracted. All studies were animal studies. A total of 27 dogs, 63 rats, 6 minipigs, and 24 rabbits were enrolled in the selected nine studies. All nine studies had a high RoB. Conclusions: Fibronectin consistently demonstrates efficacy in promoting bone regeneration and osseointegration around dental implants across a range of experimental models. Its primary mechanisms include enhancing cell adhesion, recruiting osteoblasts, and promoting osteogenic differentiation through integrin-mediated signaling. Further research is needed to optimize the use of fibronectin in clinical settings, especially regarding its synergistic effects with other regenerative materials.