Magnesium-Doped Coatings as a Suitable Approach to Improve Osseointegration of Titanium-Based Implants: A Systematic Review and Meta-Analyses of Animal Studies.

Abstract

This review evaluates the effect of magnesium (Mg)-doped coatings on the osseointegration of titanium (Ti)-based implants. The recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses and the PRISMA 2020 Statement were followed, with registration in PROSPERO (CRD42024572571). The PICOS strategy was based on population: dental implants; intervention: Mg coatings; control: surfaces without Mg; outcomes: bone-implant contact (BIC), bone area (BA), implant stability coefficient (ISQ), and removal torque (RTQ); and study Design: in vivo studies. The SYRCLE tool was used to assess the risk of bias of animal studies. Meta-analyses were performed, using a random-effect model and 95% confidence interval. Twenty-three records were included, and 21 were enrolled in the meta-analyses. The most commonly used Mg doping method was microarc oxidation. The Mg-doped coatings, significantly favored pooled BIC values in animals [-6.09 (-8.35, -3.82), I²: 50%, p < 0.00001], especially up to 3, 4, 6, and 8 weeks compared to surfaces without Mg. Interestingly, Mg-doped coatings favored BA up to 6 weeks [-8.20 (-14.31, -2.09), I²: 0%, p = 0.008], and RTQ up to 3 [-8.44 (-12.33, -4.56), I²: 63%, p < 0.0001]. Conversely, it did not influence ISQ [-0.24 (-2.05, 1.58), I²: 88%, p = 0.80]. Mg-doped coatings significantly enhanced osseointegration in dental implants by improving BIC, BA, and RTQ, while showing no impact on ISQ. Supported by studies across various animal species, these results confirm that such coatings represent an effective and safe approach for promoting bone integration.