Nanomaterials in alveolar bone regeneration: a systematic review and meta-analysis of preclinical and clinical evidence

Purpose: Alveolar bone loss presents a significant barrier in implant dentistry, necessitating effective regenerative solutions. Nanomaterials offer distinct advantages in this context because of their osteoconductive, anti-inflammatory, and bioactive properties. This systematic review and meta-analysis evaluated the preclinical and clinical efficacy of various nanomaterials in alveolar bone regeneration. Materials and Methods: According to the PRISMA guidelines, 30 eligible studies published between 2019 and 2024 were analyzed, including in vitro, in vivo, and clinical investigations. The key outcomes assessed were bone volume gain, implant stability (ISQ), healing time, and cytokine modulation. Statistical analyses included ANOVA, Pearson correlation, multivariate regression, and Kaplan–Meier survival curves. Results: PLGA-BMP-2 composites showed the highest bone volume gain (43.5%) and ISQ (75.2), with the shortest healing duration. Overall, nanomaterials significantly enhanced bone regeneration (36.2% vs. 17.9%) and implant stability. Inflammatory cytokines, such as TNF-α and IL-1β, decreased by more than 40%. Regression models identified the presence of BMP-2 and follow-up time as major predictors (Adjusted R²=0.71). Implant survival was significantly higher in the nanomaterial-treated groups. Conclusions: Nanomaterials, especially PLGA-BMP-2 scaffolds, show substantial promise in improving the outcomes of alveolar bone regeneration. Nevertheless, further high-quality clinical trials with an extended follow-up are needed to confirm these findings.