Non-Cochrane · intervention · PM41561408
Can Mesenchymal Stem Cells Improve Bone Regeneration in Maxillary Sinus Augmentation? A Systematic Review and Meta-Analysis.
Coronel-Zubiate Franz Tito, Marroquín-Soto Consuelo, Luján-Valencia Sara Antonieta, et al. · Stem cells international · 2026 · PubMed · doi:10.1155/sci/6656563
Findings
12 findings
| Population | ||||
|---|---|---|---|---|
| Adults with posterior maxillary atrophy requiring maxillary sinus augmentation before dental implant placement | Mesenchymal stem cell (MSC)-based bone regeneration (MSC with biomaterial or cellular allograft) | Bone regeneration without stem cells (e.g., biomaterial or autograft alone, blood clot, particulate allograft) | Bone regeneration success (presence or absence of new bone formation, dichotomous) Leave-one-out sensitivity analysis omitting Wildburger et al. | RR 1.22 [0.73, 2.04] GRADE not reported 2 studies |
| Adults with posterior maxillary atrophy requiring maxillary sinus augmentation before dental implant placement | Mesenchymal stem cell (MSC)-based bone regeneration (MSC with biomaterial or cellular allograft) | Bone regeneration without stem cells (e.g., biomaterial or autograft alone, blood clot, particulate allograft) | Implant success rate Leave-one-out sensitivity analysis omitting Wildburger et al. | log RR -0.03 [-0.10, 0.04] GRADE not reported 4 studies |
| Adults with posterior maxillary atrophy undergoing maxillary sinus augmentation before dental implant placement | Mesenchymal stem cell (MSC)-based bone regeneration | Conventional grafting without stem cells (DBBM, autograft, allograft or blood clot) | Bone regeneration (continuous) Maxillary sinus lift | SMD -0.83 [-1.37, -0.30] High 2 studies |
| Adults with posterior maxillary atrophy requiring maxillary sinus augmentation before dental implant placement | Mesenchymal stem cell (MSC)-based bone regeneration (MSC with biomaterial or cellular allograft) | Bone regeneration without stem cells (e.g., biomaterial or autograft alone, blood clot, particulate allograft) | Implant success rate Leave-one-out sensitivity analysis omitting Bajestan et al. | log RR -0.01 [-0.06, 0.03] GRADE not reported 4 studies |
| Adults with posterior maxillary atrophy requiring maxillary sinus augmentation before dental implant placement | Mesenchymal stem cell (MSC)-based bone regeneration (MSC with biomaterial or cellular allograft) | Bone regeneration without stem cells (e.g., biomaterial or autograft alone, blood clot, particulate allograft) | Implant success rate Leave-one-out sensitivity analysis omitting Gupta et al. | log RR -0.03 [-0.09, 0.04] GRADE not reported 4 studies |
| Adults with posterior maxillary atrophy requiring maxillary sinus augmentation before dental implant placement | Mesenchymal stem cell (MSC)-based bone regeneration (MSC with biomaterial or cellular allograft) | Bone regeneration without stem cells (e.g., biomaterial or autograft alone, blood clot, particulate allograft) | Implant success rate Follow-up 3 to 12 months | RR 0.98 [0.94, 1.03] Moderate Downgraded: inconsistency 5 studies · 222 implants participants |
| Adults with posterior maxillary atrophy requiring maxillary sinus augmentation before dental implant placement | Mesenchymal stem cell (MSC)-based bone regeneration (MSC with biomaterial or cellular allograft) | Bone regeneration without stem cells (e.g., biomaterial or autograft alone, blood clot, particulate allograft) | Implant success rate Leave-one-out sensitivity analysis omitting Payer et al. | log RR -0.03 [-0.10, 0.04] GRADE not reported 4 studies |
| Adults with posterior maxillary atrophy requiring maxillary sinus augmentation before dental implant placement | Mesenchymal stem cell (MSC)-based bone regeneration (MSC with biomaterial or cellular allograft) | Bone regeneration without stem cells (e.g., biomaterial or autograft alone, blood clot, particulate allograft) | Bone regeneration success (presence or absence of new bone formation, dichotomous) Leave-one-out sensitivity analysis omitting Rickert et al. | RR 1.16 [0.70, 1.93] GRADE not reported 2 studies |
| Adults with posterior maxillary atrophy requiring maxillary sinus augmentation before dental implant placement | Mesenchymal stem cell (MSC)-based bone regeneration (MSC with biomaterial or cellular allograft) | Bone regeneration without stem cells (e.g., biomaterial or autograft alone, blood clot, particulate allograft) | Bone regeneration (bone neoformation, continuous) | SMD -0.84 [-1.36, -0.32] High 2 studies · 60 participants |
| Adults with posterior maxillary atrophy requiring maxillary sinus augmentation before dental implant placement | Mesenchymal stem cell (MSC)-based bone regeneration (MSC with biomaterial or cellular allograft) | Bone regeneration without stem cells (e.g., biomaterial or autograft alone, blood clot, particulate allograft) | Bone regeneration success (presence or absence of new bone formation, dichotomous) Leave-one-out sensitivity analysis omitting Payer et al. | RR 1.03 [0.63, 1.69] GRADE not reported 2 studies |
| Adults with posterior maxillary atrophy requiring maxillary sinus augmentation before dental implant placement | Mesenchymal stem cell (MSC)-based bone regeneration (MSC with biomaterial or cellular allograft) | Bone regeneration without stem cells (e.g., biomaterial or autograft alone, blood clot, particulate allograft) | Implant success rate Leave-one-out sensitivity analysis omitting Rickert et al. | log RR -0.00 [-0.05, 0.04] GRADE not reported 4 studies |
| Adults with posterior maxillary atrophy requiring maxillary sinus augmentation before dental implant placement | Mesenchymal stem cell (MSC)-based bone regeneration (MSC with biomaterial or cellular allograft) | Bone regeneration without stem cells (e.g., biomaterial or autograft alone, blood clot, particulate allograft) | Bone regeneration success (presence or absence of new bone formation, dichotomous) | RR 1.11 [0.73, 1.67] High 3 studies |
Included primary studies 6
Open in Studies| Study | Year | Also included by | Outcomes it informs here | Trial data |
|---|---|---|---|---|
| Bajestan 2017 Stem cell therapy for reconstruction of alveolar cleft and trauma defects in adults: A randomized controlled, clinical trial. PMID:28656723 | 2017 | 2 other reviews | Implant success rate; Bone regeneration (bone neoformation, continuous) | not extracted yet |
| Gupta 2021 A comparative evaluation of bone regeneration using mesenchymal stem cells versus blood coagulum in sinus augmentation procedures. PMID:35153430 | 2021 | 2 other reviews | Implant success rate; Bone regeneration (bone neoformation, continuous) | not extracted yet |
| Payer 2014 Effects of directly autotransplanted tibial bone marrow aspirates on bone regeneration and osseointegration of dental implants. PMID:23701676 | 2014 | 2 other reviews | Implant success rate; Bone regeneration success (presence or absence of new bone formation, dichotomous) | not extracted yet |
| Whitt 2020 Efficacy of stem cell allograft in maxillary sinus bone regeneration: a randomized controlled clinical and blinded histomorphometric study. PMID:32596764 | 2020 | 2 other reviews | not stated | not extracted yet |
| Rickert 2014 Maxillary sinus floor elevation surgery with BioOss® mixed with a bone marrow concentrate or autogenous bone: test of principle on implant… PMID:24183511 | 2014 | 1 other review | Implant success rate; Bone regeneration success (presence or absence of new bone formation, dichotomous) | not extracted yet |
| Wildburger 2014 Impact of autogenous concentrated bone marrow aspirate on bone regeneration after sinus floor augmentation with a bovine bone… PMID:23875876 | 2014 | 1 other review | Implant success rate; Bone regeneration success (presence or absence of new bone formation, dichotomous) | not extracted yet |
Overlap with other reviews
Reviews that include the same primary studies are not independent evidence. Shared counts match studies by PMID, DOI or NCT, and otherwise by author and year (a probable match). Only the non-Cochrane dental reviews have study lists, so overlap with Cochrane reviews is not counted yet.
Review question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | Adults presenting with posterior maxillary atrophy requiring maxillary sinus augmentation before dental implant placement | Adults undergoing maxillary sinus lift (74 patients, 222 implants; 6 RCTs) |
| Intervention | Treatment with mesenchymal stem cells for bone regeneration | MSC-based grafts: bone marrow aspirate concentrate, peripheral blood MSCs, MSC allograft (n=6) |
| Comparison | Bone regeneration procedures without stem cells (e.g., platelet concentrates, autologous grafts, biomaterials) | DBBM, autograft, allograft or blood clot without MSCs (n=6) |
| Outcomes | Bone neoformation rate or percentage, bone quality, healing time; implant success rate (exploratory) | Implant success rate (n=5); bone regeneration, continuous (n=2); bone regeneration present, dichotomous (n=3) |
| Study designs | Randomized or nonrandomized clinical trials | RCTs (n=6); four split-mouth |
| Timing | Not specified | Follow-up 4 to 12 months |
AMSTAR 2 items
Two independent extractors rated each item. Their ratings are shown side by side because they have not been reconciled yet. The overall rating follows Shea et al. 2017: one critical flaw gives Low, more than one gives Critically Low.
| Item | Extractor A | Extractor B | Agree |
|---|---|---|---|
| 1Research question includes PICO components | Yes | Yes | yes |
| 2Protocol established before the reviewcritical | Partial Yes | Partial Yes | yes |
| 3Choice of study designs explained | Yes | Yes | yes |
| 4Comprehensive literature searchcritical | Partial Yes | Partial Yes | yes |
| 5Study selection in duplicate | Yes | Yes | yes |
| 6Data extraction in duplicate | Yes | Yes | yes |
| 7List of excluded studies with reasonscritical | Yes | Yes | yes |
| 8Included studies described in detail | Partial Yes | Partial Yes | yes |
| 9Risk of bias assessed satisfactorilycritical | RCT: Yes · NRSI: N/A | NRSI: N/A · RCT: Yes | no |
| 10Funding of included studies reported | No | No | yes |
| 11Appropriate meta-analysis methodscritical | RCT: No · NRSI: N/A | NRSI: N/A · RCT: Partial Yes | no |
| 12Impact of risk of bias on the pooled results | Yes | Yes | yes |
| 13Risk of bias accounted for in interpretationcritical | Yes | Yes | yes |
| 14Heterogeneity explained | Yes | Yes | yes |
| 15Publication bias investigatedcritical | No | No | yes |
| 16Conflicts of interest reported | Yes | Yes | yes |
| Overall | Critically Low | Low | no |