# Effects of Magnetic Stimulation on Dental Implant Osseointegration: A Scoping Review
## 4 Discussion
The majority of animal investigations that focused on PEMF showed a higher BIC in animals that received PEMF stimulation compared to the control groups [48; 50; 51; 55] with high variability depending on factors such as the times of exposure, intensity, emitter distance, as well as the animal model employed, which makes any accurate results comparison extremely difficult. The effects of PEMF were also investigated on implants placed in animals affected by systemic pathologies such as osteoporosis and diabetes. Uncontrolled diabetes [71] and also impairments of systemic bone metabolism may be risk factors for osseointegration and its maintenance over time [72]. Interestingly, the majority of the analysed studies [21; 34; 49], demonstrated that PEMF treatment is able to reverse or reduce the negative influence of such systemic pathologies on bone tissue and therefore on the osseointegration process. Clinical studies still appear to be very limited in number and do not show univocal results. Successful osseointegration is a prerequisite for functional dental implants and primary implant stability is a prerequisite for successful osseointegration. Primary implant stability is a mechanical phenomenon related to local bone quality and quantity, the type of implant and the placement technique used. Secondary implant stability depends on the bone formation and remodeling at the implant/tissue interface and in the surrounding bone during the osseointegration process [1]. The majority of clinical investigations regarding PEMF application showed positive effects on implant osseointegration, with an increased implant stability, a higher perimplant radiodensity and a significantly lower bone loss compared to controls [60, 61, 62]. [PERSON] et al. [59] did not report statistically significant differences in radiodensity around implants (considered as an approximation of actual bone contact with implants) receiving PEMF stimulation or not. Regarding SFM stimulation, the still limited available clinical studies showed a statistically significant higher stability of implants exposed to SFM compared to controls in the early phase of osseointegration (first month) [57, 58], whereas no effect has been described at longer time intervals (2-3 months) [58]. The transition from primary to secondary stability is one of the crutial phase during implant osseointegration [73]. The chance to enhance and accelerate implant stability during such a delicate transition phase by means of MFs, makes the abovementioned results particularly interesting and deservable of more in-depth investigations. Concerning the aspects of handling of possible MF devices for clinical use, it must be considered that SFM, differently from PEMF, does not depend on external electrical supplies, thereby avoiding the risk for heat or electric hazards to tissues [74]. Thus, the application of SFM to dentistry might be of benefit. Other review articles from [PERSON] et al. [26] and [PERSON] et al. [17] focused on the application of magnetic fields in implant dentistry, highlighting, similar to that which emerged from the present review, some positive effects exerted by SFM and PEMF on dental implant osseointegration. [PERSON] et al., however, dealt exclusively with PEMF stimulation. Differently from the previous reviews, the present scoping review has been conducted following the PRISMA protocol, leading us to the individuation and the inclusion of a higher number of articles with the aim of providing a wider perspective on the subject, from the preclinical evidence to the clinical one.