Effect of Growth Hormone Supplementation on Osseointegration: A Systematic Review and Meta-analyses.

OBJECTIVES: The aim of this study was to assess whether growth hormone (GH) replacement therapy can enhance implant osseointegration. MATERIALS AND METHODS: A systematic literature search was conducted from 1982 to March 2016. A structured search using the keywords "growth hormone," "implants," and "osseointegration" was performed to identify preclinical and clinical in vivo controlled studies and was followed by a 2-phase search strategy. Initially, 31 potentially relevant articles were identified. After removal of duplicates and screening by title and abstract, 10 potential studies were included. Studies were assessed for bias and data were synthesized using a random-effects meta-analysis model. RESULTS: All studies were preclinical animal trials, and the follow-up period ranged from 2 to 16 weeks. Seventy percent of the included studies reported an increase in bone-to-implant contact in animals receiving GH compared with controls. Meta-analysis showed a significant mean difference for bone to implant between GH groups versus controls (no GH supplementation) of 10.60% (95% confidence interval: 3.79%-17.41%) favoring GH administration. CONCLUSION: GH treatment seems to promote osseointegration around implants in preclinical studies; however, these findings must be assessed in highly controlled human clinical trials as a number of confounding factors may have influenced the outcomes of the included studies.