Enhancing Bone Regeneration: A Systematic Review of Osteoinductive Agents Combined with Alloplastic Biomaterials

Bone grafts and biomaterials are commonly used to enhance bone volume.To achieve this objective, they are often combined with additional systems that confer osteogenic, osteoinductive, and osteoconductive properties.The aim of this study was to analyze the characteristics of osteoinductive agents used in combination with alloplastic biomaterials, as well as the survival rates of the implants placed.A systematic review was conducted in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines.A comprehensive literature search was performed using MeSH terms and Boolean operators (AND/OR) in English, Portuguese, and Spanish, covering publications up to December 2024.The databases consulted included Medline, Embase, Scopus, and Web of Science.Additionally, gray literature was explored through Google Scholar and Open Access Theses and Dissertations (OATD).Eight studies met the inclusion criteria.Among the grafted sites, maxillary sinus augmentation was the most frequently reported, followed by post-extraction sockets in premolar and molar regions, and the maxillary incisor area.The average healing period prior to implant placement ranged from 4 to 6 months.A total of 428 implants were placed, with follow-up periods ranging from 9 months to 10 years.In the longest follow-up study, a survival rate of 94.8 % was reported for 160 implants.In conclusion, the combination of synthetic biomaterials with osteoinductive agents appears essential to promote new bone formation both on the internal surfaces of the biomaterial and in the surrounding tissue.