The use of bioactive proteins and peptides to promote osseointegration and success of dental implants: a narrative review

Background and Objective: Dental implant failure is an unfortunate reality in clinical practice. Major reasons for implant failure include lack of osseointegration and peri-implantitis. The literature has demonstrated that the use of biological proteins and peptides can increase the success rate of implants through various mechanisms such as osteogenesis, cellular proliferation, vascularization, antimicrobial activity, etc. The aim of this narrative review was to summarize the major proteins and peptides utilized to promote the success of medical and dental implants. Methods: Our methodology for carrying out this narrative review included keyword searching in Google Scholar, PubMed, and MEDLINE from the years 2012–2021 with no language restrictions. Our inclusion criteria consisted of studies that tested the biological effects of proteins and peptides on implant physiology in vitro and in vivo, and we excluded studies that did not fit this criteria. Key Content and Findings: We reviewed 106 studies that tested the effects of various molecules on the interaction between implant surfaces/materials and host cells in vitro and in vivo. The molecules reviewed were divided into four major categories: (I) extracellular matrix components; (II) growth factors; (III) antimicrobial peptides; and (IV) miscellaneous. After analysis of the studies, many of these molecules can improve implant integration through a wide range of overlapping mechanisms. The literature indicates that the optimum combination of molecules would include peptides that have high affinity to the implant surface, promote bone formation, and can prevent bacterial infection. Conclusions: It is highly likely that the use of proteins and peptides is efficient at promoting implant success, but more research in humans and clinical trials is needed in order to determine the optimum molecule(s) in order to apply them in clinical practice.