Scaffold-Mediated Immunoengineering Strategy for periodontal tissue Regeneration: A Systematic Review and Meta-Analysis

This Systematic Review and Meta-Analysis design based on the population, intervention, comparison, and outcome (PICO) of the study design. Did the adjunctive use of a scaffold-mediated immunoengineering strategy have a significant impact on tissue regeneration in patients with periodontitis-induced alveolar bone loss compared to traditional periodontal therapy? In this question, the population (P) was the animal models or patients with periodontal defects, including periodontitis and alveolar bone loss, the intervention (I) was the scaffold combined with immunoengineering approaches, the comparison (C) were scaffold alone without immunoengineering, standard periodontal therapy, or placebo/no treatment, and the outcomes (O) were divided into primary outcomes (gain in clinical attachment level (CAL), increase in bone height/volume, probing depth (PD) reduction, and histological evidence of periodontal tissue regeneration), and secondary outcomes (changes in inflammatory markers, biocompatibility, and time to healing). The criteria applied to the selection of relevant studies included: (1) original article published on 1 January 2015 until 31 January 2025; (2) studies investigating the use of scaffolds combined with an immunoengineering strategy for periodontal tissue regeneration; (3) studies reporting on at least one of the pre-defined primary or secondary outcomes; (4) studies involving in vivo animal models or human clinical trials; (5) studies published in English. Studies investigating scaffolds alone without any immunoengineering component, studies not reporting on any relevant outcomes, review articles, editorials, conference/poster presentations, medical hypothesis, and letters to editor were excluded. Studies focusing solely on in vitro cell cultures were excluded for the meta-analysis portion but may be included in the qualitative review if relevant.