Effect of pores on cell adhesion to additively manufactured titanium implants: A systematic review.

STATEMENT OF PROBLEM: Titanium dental implants produced by additive manufacturing have pores that, depending on their size and quantity, may improve osteogenic cell adhesion without impairing mechanical properties. A systematic review of in vitro studies on this topic is lacking. PURPOSE: The purpose of this systematic review was to answer the question "What is the influence of pores on osteogenic cell adhesion on titanium surfaces produced by additive manufacturing?". MATERIAL AND METHODS: The study was designed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) 2020 standards and registered in the Open Science Framework (OSF) (osf.io/baw59). A manual search of published articles without language or time restrictions was conducted in November 2022 in the electronic databases PubMed, Scopus, ScienceDirect, Embase, and in the nonpeer-reviewed literature via Google Scholar. RESULTS: A total of 1338 initial results were found, and after removing duplicates and applying eligibility criteria, 13 articles were included in this review that, according to the Joanna Briggs Institute (JBI) tool, presented a low risk of bias. Pores with larger diameters provide greater a surface area that favors cell filopodia adhesion and has interconnection that optimizes the transport of nutrients and oxygen and bone cell activity. CONCLUSIONS: The presence of pores on the surface of titanium produced by additive manufacturing increases the adhesion, migration, proliferation, and viability of osteogenic cells.