Osteogenic and Biocompatibility Potential of Polylactic Acid-Based Materials: A Systematic Review of Human Primary Cells Studies

Relatively higher-quality human studies compared with other topics in this database, e.g. multiple RCTs or systematic reviews. This does not mean it is standard or approved care.

• Level A · Stronger Clinical Evidence
• Level B · Emerging clinical evidence with positive signals
• Level C · Early human research exploring benefits
• Level D · Scientific groundwork from lab and animal studies
• Emerging · Emerging topic under active research

Abstract (original English)

Background Guided Bone Regeneration (GBR) relies on barrier membranes, for which polylactic acid (PLA) and its copolymer poly(lactic-co-glycolic acid) (PLGA) are promising biodegradable polymers. However, their inherent hydrophobicity limits biological performance, and the evidence regarding how specific modifications affect key human cell types, particularly osteoblasts and fibroblasts, remains scattered. Methods A systematic review was conducted to synthesize the in vitro evidence on the response of primary human osteoblasts and fibroblasts to polylactic acid-based materials. Following a pre-registered protocol (10.17605/OSF.IO/CE8KB), a comprehensive search was performed across four major databases, and the risk of bias in the included studies was assessed using an adapted OHAT tool. Results Twenty-six studies were included, which showed that polylactic acid-based materials have limited bioactivity, and their modification significantly improves cellular responses. The incorporation of bioceramics and growth factors, or alterations in surface topography, notably enhanced osteogenic differentiation and mineralization in osteoblasts. For gingival fibroblasts, topographical modifications like micro-grooves guided cell alignment and modulated proliferation. Conclusions Native polylactic acid-based materials display limited bioactivity. However, functionalization through biocerami

Evidence level

Relatively higher-quality human studies compared with other topics in this database, e.g. multiple RCTs or systematic reviews. This does not mean it is standard or approved care.

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