# Effects of Magnetic Stimulation on Dental Implant Osseointegration: A Scoping Review
## 1 Introduction  
Implant treatment is a predictable option for the rehabilitation of one or more missing teeth with high long-term dental implant survival rates [1, 2]. The osseointegration of dental implants is a fundamental prerequisite for a successful dental implant rehabilitation. The process of osseointegration involves several steps: the formation of a blood coat following implant insertion, the development of mesenchymal tissue, the formation of intramembrane (woven) bone, and, then, of lamellar bone [3, 4, 5]. A dental implant is considered osseointegrated when a \"direct functional and structural connection between living bone and the surface of an implant under load\" is reached [6]. Surgical technique, bone quality and quantity, smoking habits, dental implant material/surface and postoperative infections and inflammation are key factors influencing the osseointegration process [7, 8, 9, 10, 11]. Differentstrategies have been proposed to promote and accelerate the osseointegration process, thus extending the clinical indications of dental implants. Among the most relevant, the introduction in the early 90's of topographic and chemical modifications of dental implant surfaces significantly enhanced their clinical performance with respect to the older unmodified, machined surfaces [12; 13; 14; 15; 16]. Following this key step, the application of Electromagnetic and Magnetic Fields (EMFs and MFs) was proposed to further improve tissue healing and regeneration [17; 18]. In fact, MFs are known to promote osteogenesis and many preclinical and clinical studies have demonstrated the effects of magnetism on bone healing [19; 20; 21; 22; 23; 24; 25], and the results from orthopedic applications have strongly encouraged the study of their use in dentistry to promote the osseointegration of dental implants [17; 26]. EMF/MF exposure in daily life represents a constant feature of modern society, covering many applications from power distribution lines or home appliances to ICT technologies for wireless communications. As early as 1996 the World Health Organization (WHO) established the International EMF Project to assess the environmental and health effects of exposure to static and time varying electric and magnetic fields, cooperating with the International Commission on Non-Ionizing Radiation Protection (ICNIRP) to formulate updated guidelines for limiting exposure to EMFs [27]. Currently, based on the 1979 draft for electromagnetic compatibility standards for medical devices, the Food and Drug Administration (FDA) approve the medical use of magnetic devices, under the constant control of the Center for Devices and Radiological Health (CDRH). MF sources relevant for medical applications can be either permanent magnets (also known as lodestones) or the stationary flow of unpaired electrons in metal conductors (electric currents), or even the stationary flow of ions present in fluids, e.g., intracellular fluid. When magnets are fixed in space, the generated field does not change with time, and we refer to this case as Static Magnetic Field (SFM) from permanent magnets. Conversely, the more general case of possibly time-varying fields is referred to as EMF, to indicate the coupled nature of electric and magnetic aspects. Finally, when the EMF is generated by sources with a pulsed nature (typically, a sequence of square pulses), we adopt the term Pulsed Electro-Magnetic Field (PEMF), indicating when possible the appropriate details of the field waveform. So far, only a limited number of studies analyzed the effects of MFs on dental implant osseointegration, mostly involving in vitro and animal models, whereas clinical evidence is still inconsistent. The aim of the present scoping review is to provide a broad perspective on the current knowledge regarding the effects of magnetic stimulations on dental implant osseointegration, to identify evidence and gaps in the literature and to provide indications for future research.