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Simple Summary: This study aimed to establish reference data on tooth root length and post-extraction alveolar volume for mature maxillary and mandibular incisors and canines in dogs. We determined the mean length and volume of these teeth in dogs in the weight ranges of 1–5 kg, 5–10 kg, 10–20 kg, and over 20 kg. The obtained values given showed a correlation between tooth length and alveolar volume in a specific weight range. The data obtained in the study can serve as reference values for tooth crown length and alveolar volume, allowing operators to plan a specific volume of bone substitute material for filling post-extraction alveoli. Filling post-extraction alveoli with hydroxyapatite-based materials is becoming an increasingly common procedure in veterinary dentistry. In dogs, tooth roots vary in structure depending on the weight of the dog, but data on tooth length and volume have not yet been described. This study aimed to establish reference data on tooth root length and post-extraction alveolar volume for mature maxillary and mandibular incisors and canines in dogs. We determined the mean length and volume of these teeth in dogs in the weight ranges of 1–5 kg, 5–10 kg, 10–20 kg, and over 20 kg. The obtained values given showed a correlation between tooth length and alveolar volume in a specific weight range. A review of the commercially available hydroxyapatite-based bone substitute materials was then conducted. A table is presented which shows how to calculate the volume of bone substitute material required to fill a post-extraction alveolus with a given material. Statistics were used to assess significant differences between the mass of the bone substitute product used (μL) for specific weight ranges and to demonstrate the correlation between tooth length and alveolar volume for a specific weight range. The data obtained in this study can serve as reference values for tooth crown length and alveolar volume, allowing operators to plan a specific volume of bone substitute material for filling post-extraction alveoli. This research is interesting because it shows that the weight of an animal is an important aspect in planning the amount of bone substitute material for tooth extraction. In clinical work, it is much easier to weigh an animal than it is to make calculations based on the length of the tooth root. [ABSTRACT FROM AUTHOR]

This study investigated the effect of platelet-rich fibrin (PRF) on bone healing around implants placed in elevated sinus cavities. Forty New Zealand albino rabbits were divided into eight groups, based on the time of sacrifice (14 or 40 days) and the material used: blood clot (control), hydroxyapatite (HA) from bovine bone, HA combined with PRF, and PRF alone. Each group consisted of five animals (n = 5). A histological analysis measured bone-to-implant contact (BIC) and bone area fraction occupancy (BAFO). The results showed significant increases in the BIC and BAFO values at 40 days compared to 14 days in most groups. At day 14, the HA+PRF group had higher BIC than the clot and the PRF alone groups. At 40 days, HA+PRF maintained the highest BIC across all groups (p < 0.05), though it did not show an advantage for BAFO. These findings indicate that combining HA with PRF promotes better osseointegration around implants placed immediately in maxillary sinus augmentation. Given the limited research on PRF's biological impact, these results underscore the importance of evaluating PRF's role in peri-implant healing and its potential benefits for clinical use in sinus augmentation. [ABSTRACT FROM AUTHOR]

In connection with the increase in the number and severity of various types of bone tissue injuries received as a result of wounds during military operations in Ukraine, an important issue in orthopedics and traumatology is making informed decisions about the possibility of restoring the integrity and functions of bone tissue when using different types of composition, porosity and strength of apatite-biopolymer composites. The scientific direction of research is the development of principles and methods for making scientifically based decisions in the design and additive manufacturing of bone substitutes based on apatite-biopolymer composites with functional properties depending on the nature of the localization of the cavity bone defect and its size. A set of methods for analyzing images of bone tissue, taking into account its spatial structure, which are obtained by sensors of different physical nature, with the use of neural network models, development of methods of their design, optimization and training is proposed. The new knowledge obtained as a result of the project will become the necessary basis for making optimal decisions in practice for the introduction of the latest methods of treatment and prosthetics in trauma surgery, oncology, cranio-maxillofacial surgery, dentistry, taking into account the risks of biocompatibility of apatite-biopolymer composites. Software development of an intelligent decision support system will be used to design bone substitutes with controlled composition, structure, porosity and mechanical strength for the further selection of additive technology for its production from apatite-polymer composites, which will contribute to increasing the efficiency of treatment and prosthetics in orthopedics and traumatology. [ABSTRACT FROM AUTHOR]

Featured Application: This study provides an innovative approach to prevent the migration of carbonate apatite (CAp) granules during implantation. The proposed method combines the setting properties of calcium sulfate hemihydrate (CSH) with CAp granules, enabling their use as a stable, porous scaffold for bone regeneration. Granular bone substitutes are commonly used in dental treatments owing to their adaptability to irregular bone defects. However, granule migration during and after implantation poses a significant challenge, impairing bone regeneration. This study addresses this issue by setting carbonate apatite (CAp) granules using crystal interlocking owing to the bassanite (calcium sulfate hemihydrate (CSH))-to-gypsum (calcium sulfate dihydrate (CSD)) transformation on the granule surface. CAp granules were mixed with CSH slurry (water/CSH ratio of 0.4) at varying CSH/CAp ratios of 0.33, 0.43, 0.54, 0.67, and 0.82. At all of these mixing ratios, needle-shaped CSD crystals formed on the CAp granule surface, and the CSD crystals interlocked with each other; consequently, CAp granules were set. As the CSH/CAp ratio increased from 0.33 to 0.82, the CSD crystal length increased from 6.58 to 6.79 μm, while the setting time decreased from 30.3 to 15.5 min. Although the porosity of the set CAp granules decreased with an increase in the CSH/CAp ratio, the set granules maintained intergranular spaces of 77.3 μm at a CSH/CAp ratio of 0.82 conducive to cellular infiltration. After immersion in saline for six days, the set CAp granules at a CSH/CAp ratio of 0.82 maintained their original shape, demonstrating enhanced stability compared to lower CSH/CAp ratios where partial or complete collapse occurred. The porosity and specific surface area increased to 59.9% and 3.66 m2/g, respectively, and the intergranular spaces increased to 176.4 μm. Therefore, mixing the CAp granules with CSH at a ratio of 0.82 may prevent granule migration during and after implantation. Moreover, the CSD component of the granules is likely to resorb more rapidly than the CAp component in vivo, promoting porosity in the set granules and facilitating efficient bone replacement. [ABSTRACT FROM AUTHOR]

A postoperative maxillary cyst (POMC) is a delayed complication of the original Caldwell-Luc operation, which was once widely performed to treat chronic rhinosinusitis. Two patients who had previously undergone Caldwell-Luc operations desired dental implant treatment. In both cases, preoperative cone-beam computerized tomography (CBCT) revealed a POMC occupying the entire maxillary sinus on the side where the implants were to be placed. The residual bone height was 3–4 mm. Furthermore, the sinuses were divided into compartments by septum-like structures. An intraoral approach was applied for POMC enucleation and implant placement. The implants were placed with sinus floor penetration due to the small residual bone height. No bone substitute material was grafted in the sinus. Postoperative healing was uneventful. All implants were successfully osseointegrated and performed well (4 and 5 years for each patient). No sinonasal complications were reported. Follow-up CBCTs showed that the exposed implant parts were covered by newly formed bone. The intraoral approach is a feasible option for implant placement in a pneumatized maxillary sinus with POMC. [ABSTRACT FROM AUTHOR]

In the world of dental implants, the essential determinant of success lies in the phenomenon of osseointegration, wherein titanium implants exhibit the ability for robust integration with the surrounding bone and tissue. Beyond the inherent qualities of titanium which make it an attractive candidate as an implant material, attention has shifted towards its' tailored surface modifications. These methods help the implant manufacturers to modify the implant surface for successful osseointegration and higher chances of enduring implantation. This review explores different surface modification methods and their impact on the dental implant success. [ABSTRACT FROM AUTHOR]

Additive manufacturing with Arburg Plastic Freeforming (APF), an extrusion-based additive manufacturing process, was used to produce biomimetic bone scaffolds for assistance of osteosynthesis made of poly-caprolactone (PCL) with channel structures for the ingrowth of blood vessels. The specific creation of defined channel structures is very important to support the ingrowth of blood vessels, which significantly supports the regeneration of natural tissue. The tibia model used was divided into the corticalis and the spongiosa to be able to compare the realization of the different requirements of the two natural structures with the printed structures separately. Microtome cuts of the manufactured bone scaffolds with channels were prepared for characterization with light microscopy. Compression tests were carried out on a tensile testing machine. It was found that the channels in the tibial cortex led to a slightly higher stiffness compared to those without channels due to the frame outlines. Overall, however, the stiffness of the Polycaprolactone (PCL) scaffolds was significantly lower than that of natural bone. In the spongiosa scaffolds, the stiffness with channels was lower than that without channels, but still within the physiological range, as was the model without channels. The porosity was within the required range for both scaffold types. [ABSTRACT FROM AUTHOR]

Modern dentistry is turning towards natural sources to overcome the immunological, toxicological, aesthetic, and durability drawbacks of synthetic materials. Among the first biomaterials used as endosseous dental implants, mollusk shells also display unique features, such as high mechanical strength, superior toughness, hierarchical architecture, and layered, microporous structure. This review focusses on hydroxyapatite—a bioactive, osteoconductive, calcium-based material crucial for bone healing and regeneration. Mollusk-derived hydroxyapatite is widely available, cost-effective, sustainable, and a low-impact biomaterial. Thermal treatment coupled with wet chemical precipitation and hydrothermal synthesis are the most common methods used for its recovery since they provide efficiency, scalability, and the ability to produce highly crystalline and pure resulting materials. Several factors, such as temperature, pH, and sintering parameters, modulate the size, purity, and crystallinity of the final product. Experimental and clinical data support that mollusk shell-derived hydroxyapatite and its carbonated derivatives, especially their nanocrystaline forms, display notable bioactivity, osteoconductivity, and osteoinductivity without causing adverse immune reactions. These biomaterials are therefore highly relevant for specific dental applications, such as bone graft substitutes or dental implant coatings. However, continued research and clinical validation is needed to optimize the synthesis of mollusk shell-derived hydroxyapatite and determine its applicability to regenerative dentistry and beyond. [ABSTRACT FROM AUTHOR]

Purpose: To use histomorphometric analysis to evaluate bone reconstruction in rabbit calvaria with autogenous bone, anorganic bovine bone, undecalcified human tooth bone (UdTB), and decalcified human tooth bone (dTB) grafts. Materials and Methods: Extracted human teeth were crushed, and tooth bone with and without decalcification was prepared. Bony defects were made in 10 rabbit calvaria and allocated to one of the following four groups: group 1, in which UdTB was grafted; group 2, in which dTB was grafted; group 3, in which anorganic bovine bone was grafted; group 4, in which autogenous bone was grafted. The rabbits were sacrificed at 2 or 8 weeks postoperatively, and histomorphometric comparison was performed. Results: Histologically, new bone formation was observed at the defect margin and around all graft materials. The dTB group revealed significantly greater new bone areas at 2 and 8 weeks compared to the UdTB group and the anorganic bovine bone group (P < .05). The dTB group revealed no significant difference in the new bone area at 2 weeks but revealed significantly less new bone area at 8 weeks compared to the autogenous bone group (P < .05). The dTB group also revealed significantly less graft material area compared to the anorganic bovine bone group at 8 weeks (P < .05). The autogenous bone group revealed significantly less graft material area and significantly greater bone marrow area compared to other groups at 8 weeks (P < .05). Conclusions: Grafting with dTB resulted in better bone regeneration than UdTB and anorganic bovine bone grafting at 8 weeks and addresses the potential disadvantages of autogenous bone grafting. [ABSTRACT FROM AUTHOR]

Purpose: To examine the stresses caused by different All-on-4 surgical techniques—conventional, a combination of monocortical and bicortical, bicortical, and nasal floor elevation—on the implant and the surrounding bone using 3D finite element analysis (FEA). Materials and Methods: A 3D bone model of the atrophic maxilla was created based on CT imaging of the fully edentulous adult patient. All implants used in the models were 4 mm in diameter, and the length was 13 mm in the anterior and 15 mm in the posterior. Implants were applied to four different atrophic maxillary models with the All-on-4 technique: anterior and posterior monocortical implants in the first model, anterior monocortical and posterior bicortical in the second model, anterior and posterior bicortical in the third model, and anterior and posterior bicortical with nasal floor elevation in the fourth model. Eight linear analyses were performed by applying force from both vertical and 45-degree oblique directions to the four models prepared in our study. Results: When the cortical and cancellous bone around the anterior implants was examined, it was observed that the oblique and vertical loading conditions and the stresses around the implant were similar in all models. When the posterior implants were examined, model 1 (ie, anterior and posterior monocortical implants) showed the greatest oblique compression, vertical compression, and vertical tension forces. According to the Von Mises stress (VMS) analysis results for anterior and posterior implants, higher values were observed in model 1 compared to models 3 and 4 under oblique and vertical forces. It was observed that bicortical placement of the implants reduced the stresses on the bone and implant-abutment system but had no significant effect on the stress on the bar. Conclusions: According to the results of our study, in the All-on-4 technique, bicortical placement of the implants reduced the stresses on the bone and implant when the anatomical limitations allowed. In addition, nasal floor elevation can be applied in the atrophic maxilla in appropriate indications. [ABSTRACT FROM AUTHOR]

Xenogeneic-derived biomaterials are among the most routinely employed bone substitutes for immediate grafting of extraction sites as a modality of alveolar ridge preservation (ARP). The deproteinized bovine bone material is widely used and documented around the world. The present pilot clinical trial evaluated and compared the clinical and morphologic alterations of extraction sites after ARP using two commercially available yet differently processed bovine bone grafts. A total of 20 adjacent extraction sites in 10 patients were included. All sites received the exact same ARP therapy except for the type of bovine bone graft, which was randomly assigned between two adjacent extraction sockets in 10 patients (Group A received Bio-Oss particles and Group B received Cerabone particles). At all sites, healing was monitored at the time of surgery and at 1, 2, 3, and 4 months postoperative. All of the augmented extraction sites achieved successful implant therapy regardless of the bone graft material used for ARP. Six weeks after implant placement, second-stage/uncovering procedures were performed without complications. Intergroup comparisons of the crestal gingival healing process (CGHP), mean transversal crestal ridge resorption (MTRR), and mean implant primary stability (MIPS) were in favor of Group A sites (treatment with Bio-Oss particles). [ABSTRACT FROM AUTHOR]

Purpose: To compare bone substitutes composed of glycated collagen with synthetic micro-sized (1 to 10 µm) hydroxyapatite (OB) vs non-cross-linked collagen matrix with large-particle (250 to 1,000 µm) bovine-derived hydroxyapatite (BOC). Materials and Methods: The P1 to P4 premolars were bilaterally extracted from the mandibles of 19 Beagle dogs. After 21 days, osteotomies were created in each dog that received OB or BOC and were covered with a collagen membrane or were left untreated. The animals were randomly divided into three groups based on sacrifice time (4, 12, or 24 weeks). The right and left hemimandibles were trimmed to facilitate imaging and histology, and all tissues were placed in 10% neutral-buffered formalin. Microcomputed tomography (MicroCT 40 Scanner, Scanco) was used to analyze bone sections. Bone volume, residual material volume, and bone mineral density were determined for each treatment site (OB and BOC) based on a volume of interest that encompassed the original defect. Additionally, blinded histopathologic assessment (based on the ISO 10993-6 scoring system) and histomorphometry were performed on sections ground to < 100 µm thick and stained with Stevenel's blue. Results: No clinical side effects were noted. No statistical differences were observed for OB vs BOC regarding the mineral volume percentage. Compared to OB, BOC had significantly higher mean mineralization densities at 12 weeks (P < .01), but this difference did not extend to 24 weeks. For residual grafting material, bone maturation, alveolar ridge restoration, and inflammatory response, OB showed a residual amount of bone graft and no statistical differences compared to BOC. Conclusion: Both OB and BOC represent valid treatment options for critically sized bone defects. Both bone fillers outperformed the sham-operated, ungrafted (empty) control, demonstrating statistically improved bone growth and ridge restoration. [ABSTRACT FROM AUTHOR]

Purpose: Several forms of autogenous tooth graft have been presented. However, it is still unclear which form provides better bone formation and is the best to use clinically. This network meta-analysis aimed to thoroughly evaluate the available literature on the ability of different forms of the autogenous tooth graft to promote bone regeneration, in order to explore if any specific type or method of processing would result in better overall outcomes. Methods: MEDLINE/PubMed, Cochrane library, and Scopus databases were searched, to find randomized clinical trials, published up to November 29, 2023, which compared two forms of autogenous tooth graft or any form of this material with other bone grafts or with empty sockets and reported the percentage of bone formation in the grafted sites. Results: Of 1129 articles found, nine were included. The outcomes of this meta-analysis indicated that demineralized dentin, demineralized root with BMP-2 and undemineralized tooth all showed significantly higher bone formation, compared to xenograft; Mean difference (MD) = 23.25, 95% Confidence interval (CI) = 7.42 to 39.08, MD = 17.09, 95% CI = 4.03 to 30.15, and MD = 12.40, 95% CI = 5.64 to 19.16, respectively. Following the GRADE system, the level of evidence was judged to be low/very low. Conclusion: Choosing the undemineralized tooth could be a better option than other forms of this material, considering the complexity, time, and cost of the other forms of autogenous tooth graft. Nevertheless, future investigations with more direct comparisons are highly needed, considering the small number of included studies and the low level of evidence obtained from this meta-analysis. [ABSTRACT FROM AUTHOR]

Abstract Background With over 2 million grafts performed annually, bone ranks second only to blood in the frequency of transplants. This high demand is primarily driven by the persistent challenges posed by bone defects, particularly following trauma or surgical interventions such as tumour excision. The demand for effective and efficient treatments has increased exponentially in the twenty-first century. Limitations associated with autologous bone grafts drive exploration into replacements, including allografts, synthetic substitutes, and 3D-printed scaffolds. This research aimed to unravel disparities in the knowledge and evaluation of current and future bone defect treatments between surgeons and biomaterial scientists. Methods A prospective cross-sectional survey, pre-registered with the OSF ( https://osf.io/y837m/?view_only=fab29e24df4f4adf897353ac70aa3361 ) and conducted online from October 2022 to March 2023, collected data on surgeons’ views (n = 337) and scientists (n = 99) on bone defect treatments. Results Scientists were significantly more optimistic than surgeons regarding the future replacement of autologous bone grafts with synthetic or tissue-engineered substitutes (p

Objective To research new methods and materials for cranioplasty in children with various types of skull defects. Methods and Results A total of 40 childrens with different locations, sizes and reasons of skull defects underwent surgery using 3 classes of homogeneous yet heterogeneous biomimetic hydroxyapatite collagen bone materials developed by Tsinghua University. These include porous mineralized collagen scaffolds (pMC), compact mineralized collagen scaffolds (cMC), and biphasic mineralized collagen composite scaffolds (bMC). Cranioplasty was successful in all cases, with no serious postoperative complications and good recovery outcomes. After 3 months to one year of follow-up, there was no displacement of the implants, the shape of the head was normal, the incisions healed well. Reexamination CT showed that the biomimetic hydroxyapatite collagen bone material implants were not shifted, and imaging fusion was partially achieved. The pMC CT HU-value was 300-400 HU, and the cMC CT HU - value was 700-900 HU, and the CT HU - value was close to normal bone tissue over time. Conclusions The use of different types of biomimetic hydroxyapatite collagen composites allows for personalized cranial reconstruction based on individual needs, and has been proven to possess good bio- compatibility and osteoinductive capacity. This approach is thus promising for research and clinical applications, with significant value.

Objective: White spot lesions are initial sign of enamel caries that compromise esthetic appearance following orthodontic treatment. Thus, the systematic review was conducted to evaluate the remineralization potential of orthodontic adhesives on early-enamel lesions surrounding orthodontic bracket. Methods: Search strategy was performed through three databases (PubMed, Web of Science, and Scopus). A total number of 1712 studies were identified for being potentially relevant, 62 among them were further assessed. Finally, 24 studies were included in this systematic review after adopting the eligibility criteria. The methodologies used to assess enamel remineralization were micro-computed tomography, cross-sectional microhardness, and polarized light microscopy for evaluating remineralization extent; surface microhardness, color change, and laser-induced fluorescence for evaluating superficial surface mineralization; Fourier Transform InfraRed, and Energy Dispersive Spectroscopy technique for chemical characterization. Results: Bioactive glass (BAG), nano-hydroxyapatite (n-HAP), nano-amorphous calcium phosphate (n-ACP), nano-calcium fluoride (n-CaF2), fluorinated amorphous calcium phosphate nanoparticles (AFCP), and ammonium-based methacrylate monomer were incorporated into orthodontic adhesives. Seven out of the 24 included studies utilized commercially available orthodontic adhesives. While the remaining studies utilized experimental bioactive adhesives; 13 studies evaluated adhesives containing (BAG), two studies evaluated adhesives containing (n-ACP), one study evaluated adhesives containing (AFCP), and one study evaluated adhesives containing (n-HAP). Orthodontic adhesives containing the previously mentioned additives showed significant remineralization power compared to control group. Majority of studies that evaluated bioactive-based orthodontic adhesives revealed significant remineralization effect in comparison with their corresponding control groups. Out of 24 studies, 8 have assessed ion-release. However, few numbers of included studies evaluated the ion-release peak values. The output of most studies reported a significant increase of ion-release over time. Only one study reported a mark decrease of calcium and phosphate ions after 72 h. Following the high risk of bias in the majority of studies, and lack of standard evaluation protocol, meta-analysis was not conducted. Conclusion: The outcome of the included studies supports the effectiveness of incorporation of remineralizing agents into orthodontic adhesives. [ABSTRACT FROM AUTHOR]

Research of new materials for bone substitutes is of the utmost importance. Bioglass (BG) is an excellent material for this necessity due to its biocompatibility with surrounding tissues once implanted. Unfortunately, these implants tend to develop cracks. Therefore, an alternative is to use a hydroxyapatite (HA) coating (BHAC) to prevent crack formation and its consequent damage restoration for better properties. The BHAC formed was analyzed using different nitric acid (HNO3) concentrations. In addition, attenuated total reflectance Fourier transform spectroscopy (ATR‐FTIR), energy dispersive spectrometry (EDS), scanning electron microscopy (SEM), and X‐ray diffraction (XRD) were performed on the HA coating after immersion in simulated body fluid (SBF). The BHAC was submerged in a simulated gastric fluid (SGF) and simulated intestinal fluid (SIF) to evaluate changes in the groups of the biomaterial surface, specifically the Si–OH and P–O groups. Moreover, the variations in the Ca/P molar ratio of BHAC suggested significant changes in the BG cover when subjected to a physiological environment since HA converts into tricalcium phosphate (TCP) and dicalcium phosphate dihydrate (DCPD). Also, the presence of Si ions is modified when BHAC is immersed in SIF. [ABSTRACT FROM AUTHOR]

In this study, functionally graded composite (FGC) was prepared using a high-energy ball mill by fabricating five layers of alumina (Al 2 O 3), titania (TiO 2), hydroxyapatite (HA), and iron oxide (Fe 3 O 4), which were sintered at 1100 °C to create an FGC sample. Scanning electron microscopy (SEM), inductively coupled plasma-atomic emission spectroscopy (ICP-AES), and weight loss measurements were used to assess bioactivity and biodegradation after immersing samples in simulated body fluid (SBF). Also, the antimicrobial activity and biocompatibility of these layers were evaluated. Furthermore, their electrical, dielectric, and mechanical properties were examined. The results revealed that all sintered layers were bioactive, and adding HA and Fe 3 O 4 enhanced this desired property. Also, S. aureus bacterial growth was inhibited by TiO 2 and Fe 3 O 4. Fortunately, the sintered layers showed no cytotoxic effect, validating the ICP findings that demonstrated acceptable biodegradation. Adding HA and Fe 3 O 4 enhanced fracture toughness in another hopeful outcome, which is crucial for biomaterial efficacy and long-term therapeutic success. Moreover, the compressive strength of all the layers and the FGC sample was 191.7, 182.2, 171.18, 159.8, 142.5, and 171.1 MPa. Layers 3, 4, and 5 notably had a compressive strength similar to cortical bone. This means that implanting these layers into human bone will protect the bone around them from stress-shielding action. Finally, the successive increase in HA/Fe 3 O 4 contents increased the electrical conductivity. Accordingly, the prepared FGC sample and its layers are attractive bone substitute materials. [ABSTRACT FROM AUTHOR]

ABSTRACT Objective Materials and Methods Results Conclusions To determine the effect of polydeoxyribonucleotide (PDRN) on endosinus bone regeneration in a rabbit sinus model at sequential healing time points.Eighteen New Zealand white rabbits were used. Bilateral sinus floor elevation (SFE) was performed. Two groups were randomly assigned to each sinus: (1) test group, in which SFE was performed using collagenated bone substitute material soaked with PDRN (concentration 2.0 mg/mL, dose 0.5 mL), and (2) control group, in which SFE was performed using collagenated bone substitute material only. The experimental animals were sacrificed at 2, 4, and 8 weeks (n = 6 at each healing time point). Microcomputed tomography (micro‐CT), histologic, and histomorphometric analyses were performed.The micro‐CT analysis revealed statistically significant increases in the mineralized tissue volume between 4 and 8 weeks (p < 0.05). Histologically, no specific intergroup difference was found in the pattern of new bone formation. Histomorphometrically, the area of newly formed bone (NB) was larger in the test group than in the control group at all healing time points (1.4 vs. 1.2 mm2 at 2 weeks, 3.4 vs. 1.9 mm2 at 4 weeks, and 5.7 vs. 4.5 mm2 at 8 weeks; median value), but the difference was statistically significant only at 4 weeks (p < 0.05). NB in set regions of interest (ROI_C, ROI_W, and ROI_M) tended to be greater in the test group than in the control group without statistical significance (p > 0.05).PDRN appeared to enhance new bone formation at all healing time points, but the improvement was statistically significant only at 4 weeks. [ABSTRACT FROM AUTHOR]

The porous particles prepared from composited calcium–ortho-phosphate (biphasic), Thai silk fibroin, gelatin, and alginate, with an organic to inorganic component ratio of 15.5:84.5, were tested for their abilities to control the release of the commercialized antibiotic solutions, clindamycin phosphate (CDP) and amikacin sulfate (AMK). The in vitro biodegradability tests complying to the ISO 10993-13:2010 standard showed that the particles degraded <20 wt% within 56 days. The drugs were loaded through a simple adsorption, with the maximum loading of injection-graded drug solution of 43.41 wt% for CDP, and 39.08 wt% for AMK. The release profiles from dissolution tests of the drug-loaded particles varied based on the adsorption methods used. The drug-loaded particles (without a drying step) released the drug immediately, while the drying process after the drug loading resulted in the sustained-release capability of the particles. The model-fitting of drug release profiles showed the release driven by diffusion with the first-ordered kinetic after the initial burst release. The released CDF and AMK from particles could sustain the inhibition of Gram-positive bacteria and Gram-negative bacteria, respectively, for at least 72 h. These results indicated the potential of these composited particles as controlled-release carriers for CDP and AMK. [ABSTRACT FROM AUTHOR]

ABSTRACT Background Case Presentation Conclusions Chondroblastoma is a rare bone tumor that originates from the epiphysis, constitutes around 1% of all primary bone tumors and is recognized for its tendency to exhibit local invasiveness, as well as the possibility of metastasis and recurrence in nearby areas. Currently, the main surgical treatment for chondroblastoma is open surgery, involving excision of the lesion. There are relatively few reports on arthroscopic surgery for the treatment of chondroblastoma. However, open surgical curettage is associated with operation‐related trauma and potential for damage to the osteoepiphysis resulting in growth disturbances.This case study presents the application of an arthroscopic technique in a 14‐year‐old male patient with chondroblastoma affecting the proximal tibia and tibial eminence. The procedure involved thorough removal of the lesion using direct visualization with the management of the cavity utilizing a substitute for autologous bone graft. After 1 year of follow‐up, the patient remains free from symptoms, exhibits normal knee functionality, and radiographic analysis reveals a good autologous bone graft fusion without any signs of recurrence.Based on the existing cases of arthroscopic treatment for chondroblastoma and the report of this case, arthroscopic treatment for chondroblastoma can be considered as a specific treatment option for certain patients. In some cases, this technique could be an effective alternative to open surgery. [ABSTRACT FROM AUTHOR]

Background : With over 2 million grafts performed annually, bone ranks second only to blood in the frequency of transplants. This high demand is primarily driven by the persistent challenges posed by bone defects, particularly following trauma or surgical interventions such as tumour excision. The demand for effective and efficient treatments has increased exponentially in the twenty-first century. Limitations associated with autologous bone grafts drive exploration into replacements, including allografts, synthetic substitutes, and 3D-printed scaffolds. This research aimed to unravel disparities in the knowledge and evaluation of current and future bone defect treatments between surgeons and biomaterial scientists. Methods: A prospective cross-sectional survey, pre-registered with the OSF (https://osf.io/y837m/?view%5fonly=fab29e24df4f4adf897353ac70aa3361) and conducted online from October 2022 to March 2023, collected data on surgeons' views (n = 337) and scientists (n = 99) on bone defect treatments. Results: Scientists were significantly more optimistic than surgeons regarding the future replacement of autologous bone grafts with synthetic or tissue-engineered substitutes (p < 0.001). Accordingly, scientists foresee a paradigm shift from autologous bone grafts to biomaterial and tissue-engineered solutions, reflecting their confidence in the ongoing advancements within this field. Furthermore, regulatory trepidations for 3D-printed bone scaffolds were acknowledged, with scientists emphasizing the need for a more significant focus on clinical relevance in preclinical studies and regulatory clarity. In a ranked categorical assessment, witnessing the technology in action was deemed most influential in adopting new bone regeneration methods by both scientists and surgeons. Conclusions: To conclude, this study was conducted through a web-based survey, highlighting a substantial translational gap. It underscores the immediate need ("call to action") for meaningful interdisciplinary collaboration between surgeons and scientists, often referred to as the need to "walk the talk". The findings underscore the critical importance of aligning clinical needs, research outcomes, and regulatory frameworks to improve the development and implementation of biomaterial-based bone graft substitutes that demonstrate efficacy and efficiency in bone defect treatment. [ABSTRACT FROM AUTHOR]

Carbon fiber (CF) is one of ideal reinforcements to hydroxyapatite (HA) owing to its unique structure, excellent biocompatibility and high mechanical properties. However, the mechanical property of CF reinforced HA (CF/HA) composites cannot be effectively improved due to the mismatch in surface properties and thermal expansion coefficients between CF and HA. In order to solve the problems, nano-hydroxyapatite (nHA) coating with different thickness was fabricated on the CF surface. The effect of the coating thickness on mechanical property of nHA-coated CF/HA composites was studied by finite element analysis. The CF with proper nHA coating thickness was subsequently used to reinforce HA. The compressive strength of nHA-coated CF/HA composites was approximately 97.3 % and 164.6 % higher than those of the uncoated CF/HA composites and pure HA ceramics, respectively. The interface properties and crack propagation were analyzed by cohesive element in the finite element analysis. The toughening mechanism of the composites included interfacial debonding, crack deflection, crack branching, and crack bridging. The mechanical properties of nHA-coated CF/HA composites were enhanced due to the strong interfacial bonding strength and reducing cracking in HA matrix. The prepared nHA-coated CF/HA composites satisfy the requirement of the mechanical properties of human load-bearing bone. It can be used to prepare cages, plates, screws, pins and other compact bone substitute parts in bone grafting. The study provided a method for construction of nHA-coated CF/HA composites with the designed properties by adjusting the nHA coating on the fiber and can be used to design other fibers reinforced ceramic matrix composites. [Display omitted] [ABSTRACT FROM AUTHOR]

Void fillers are required for osseous gaps generated after orthopedic procedures as medial open-wedge high-tibial osteotomy (MOWHTO) to provide sufficient structural support and a rapid osteosynthesis. We developed a novel three-dimensional (3D) printing-based platform technology using the customized 3D scaffolds covered with polycaprolactone (PCL)/β-tri-calcium phosphates (β-TCP)/bone decellularized extracellular matrix (dECM) for use as bone substitute scaffold, which can be effectively exploited to estimate the calculated correction angle with preoperative simulations. PCL/β-TCP/bone dECM scaffolds demonstrated significantly higher cell contain levels in cell seeding efficiency, excellent proliferation capacity, and promotion of early osteogenic differentiation compared with PCL/β-TCP scaffolds. The scaffolds promoted bone mineralization at the early time points of an in vivo study (8 weeks) and exhibited biodegradable properties (38% for 16 weeks). The correction angle measured after osteotomy using 3D printed scaffolds was estimated with high accuracy with low errors (10.3° ± 0.9°) and was not significantly different even in the presence of lateral cortical hinge fractures. The customized 3D scaffold enriched with PCL/β-TCP/bone dECM yielded excellent cell seeding efficiency, proliferation capacity, early osteogenic differentiation, and bone mineralization outcomes. It is expected to solve the disadvantages related to bone union in MOWHTO and to replace autografts in the future. [ABSTRACT FROM AUTHOR]

Bone anabolic drugs used for the pharmacologic treatment of osteoporosis have the potential to enhance alveolar bone regeneration to improve implant success. There are no US Food and Drug Administration–approved drugs indicated to improve oral bone density around teeth or implants. The authors summarized expert opinions on a novel coordinated treatment approach leveraging the effects of systemic bone anabolic drugs to enhance dental implant therapy in patients with osteoporosis and a dual referral model for physicians and dentists to address the clinical needs of patients with osteoporosis from a comprehensive perspective of oral-systemic health. Interviews of key opinion leaders were conducted with a bone health specialist group consisting of specialists in orthopedic surgery, internal medicine, geriatrics, endocrinology, and clinical densitometry and a surgical dental specialist group consisting of periodontists and oral surgeons. Overall, both groups shared positive feedback on the idea of strategically timing administration of anabolic osteoporosis drugs with dental treatment. Both groups expressed interest in the dual referral model. The feedback of key opinion leaders supported the coordinated bone anabolic therapy concept and identified a need for improved interdisciplinary collaboration, education, and communication to realize the synergies of physician-dentist clinical cooperation. Strategic timing of osteoporosis therapy could improve skeletal bone health and reduce fracture risk while offering adjunctive dental benefits. [ABSTRACT FROM AUTHOR]

One of the most frequent post-extraction complications of posterior maxillary teeth is oroantral communication, which consists of direct communication between the maxillary sinus and the oral cavity. The recommendation is to make an immediate closure within the first 48 hours to avoid possible complications that may include an oroantral fistula or chronic sinus disease. Currently, different techniques have been described for closing communication, including various types of materials. Some of the techniques are exclusively oriented toward closure, while others seek to achieve bone regeneration by using bone substitutes for the subsequent placement of dental implants. The aim of this study is to describe a simple surgical technique for managing oroantral communication using a collagen sponge with hydroxyapatite and ribose and covering it with overlapping double layers of ribose cross-linked collagen membrane without fixation. [ABSTRACT FROM AUTHOR]

Bone-related disorders create critical-sized bone defects that require multifunctional bone graft materials for successful bone repair. Integration of therapeutics with 3D-printed calcium phosphate (CaP) scaffolds offers a personalized treatment option. The inherent properties of CaP enable it to act as a bone substitute, while drug delivering abilities provide a new dimension through localized drug delivery. It enhances both therapeutic efficacy and patient compliance. Controlled delivery of drugs significantly impacts the process of bone regeneration. It can be achieved through various strategies, including polymer coatings, formulation integration, microporous scaffold design, chemical crosslinking, and direct extrusion 3D printing. Understanding drug release mechanisms aids in assessing the in vivo performance of multifunctional scaffolds. 3D printing has revolutionized bone tissue engineering (BTE) by enabling the fabrication of patient- or defect-specific scaffolds to enhance bone regeneration. The superior biocompatibility, customizable bioactivity, and biodegradability have enabled calcium phosphate (CaP) to gain significance as a bone graft material. 3D-printed (3DP) CaP scaffolds allow precise drug delivery due to their porous structure, adaptable structure–property relationship, dynamic chemistry, and controlled dissolution. The effectiveness of conventional scaffold-based drug delivery is hampered by initial burst release and drug loss. This review summarizes different multifunctional drug delivery approaches explored in controlling drug release, including polymer coatings, formulation integration, microporous scaffold design, chemical crosslinking, and direct extrusion printing for BTE applications. The review also outlines perspectives and future challenges in drug delivery research, paving the way for next-generation bone repair methodologies. [ABSTRACT FROM AUTHOR]

To date, severe bone defects remain a significant challenge to the quality of life. All clinically used bone grafts have their limitations. Bone tissue engineering offers the promise of novel bone graft substitutes. Various biomaterial scaffolds are fabricated by mimicking the natural bone structure, mechanical properties, and biological properties. Among them, gelatin methacryloyl (GelMA), as a modified natural biomaterial, possesses a controllable chemical network, high cellular stability and viability, good biocompatibility and degradability, and holds the prospect of a wide range of applications. However, because they are hindered by their mechanical properties, degradation rate, and lack of osteogenic activity, GelMA hydrogels need to be combined with other materials to improve the properties of the composites and endow them with the ability for osteogenesis, vascularization, and neurogenesis. In this paper, we systematically review and summarize the research progress of GelMA composite hydrogel scaffolds in the field of bone defect repair, and discuss ways to improve the properties, which will provide ideas for the design and application of bionic bone substitutes. [ABSTRACT FROM AUTHOR]

Estrogen deficiency is one of several contributing factors to catabolic changes in bone surrounding dental implants, impairing bone repair in defects requiring bone regeneration. Functionalizing bone substitutes is an alternative approach among various strategies to address this challenge. In this study, the aim was to evaluate the effect of functionalizing deproteinized bovine bone (Bio-Oss®, BO) with genistein via sonication on peri-implant bone defects in ovariectomized rats. The animals were randomly distributed according to the treatment into the following four groups (n = 10): BO sonicated with genistein (BOS + GEN), BO sonicated alone (BOS), untreated BO (BO), and blood clot only (CLOT). After twenty-eight days, implant removal torque was determined, and the peri-implant bone parameters were calculated based on computed microtomography. Additionally, the gene expression of bone turnover markers was evaluated. As a main result, the functionalization with genistein increased implant removal torque and the peri-implant bone volume in the BOS + GEN group compared to both BOS and BO groups (both p < 0.05). These findings suggest that the sonification of deproteinized bovine bone functionalized with genistein improves bone repair in peri-implant bone defects in ovariectomized rats. [ABSTRACT FROM AUTHOR]

This study aimed to describe a case of simultaneous guided bone regeneration (GBR) and implant placement in a patient with prior aesthetic implant failure, focusing on achieving optimal aesthetic and functional outcomes, and to perform a literature review of the current evidence. A 38-year-old male presented with an improperly positioned implant at the level of the right upper central (tooth 2.1), leading to aesthetic and functional issues. The initial assessment included a panoramic radiograph revealing marginal bone loss and an enlarged peri-implant space, necessitating implant removal. Following implant removal and provisional restoration, the patient was re-evaluated for subsequent therapeutic treatments. The patient underwent orthodontic treatment to improve mesio-distal spacing, followed by surgical intervention involving GBR and simultaneous implant placement. The GBR procedure utilised bone substitutes and resorbable membranes, with soft tissue augmentation conducted subsequently. The surgical intervention involved local anaesthesia, flap design, defect assessment, and palatally oriented implant placement. GBR was then performed. After six months, implant uncovering and soft tissue augmentation were conducted. The implant was loaded with a screwed restoration following complete hard and soft tissue healing. The patient was monitored every six months for two years, then annually. At the 10-year follow-up, no signs of bone resorption or soft tissue inflammation were observed. This case demonstrated that GBR and simultaneous implant placement, with the application of advanced biomaterials, effectively promoted osseointegration and maintained aesthetic and functional stability over a decade. [ABSTRACT FROM AUTHOR]

Background: Platelet-rich fibrin (PRF) is a concentrate derived from autologous blood, containing platelets, fibrin, and growth factors (GF) obtained through centrifugation. PRF can be mixed with bone replacement material to form sticky bone, which is then introduced into the desired area for stabilizing and graft-covering. Depending on the centrifugation protocol, the effectiveness of the end products can vary. This controlled clinical study examines the impact of our established PRF protocol in alveolar augmentation and dental implant placement on vertical bone loss. Materials and Methods: A total of 362 implants were performed in 170 patients at the Department of Oral and Maxillofacial Surgery at the University Hospital Innsbruck between 2018 and 2021. After accounting for lost implants, we retrospectively evaluated a radiological vertical bone loss exceeding 1 mm in the first year as the primary endpoint. Results: The use of PRF was significantly associated with vertical bone loss > 1 mm (OR = 0.32, 95% CI (0.13–0.81), p = 0.016). There were no significant associations between PRF and the number of implants lost, the type of augmentation, or bone loss. Discussion: A-PRF+ sticky bone grafts, when combined with bone graft materials, show reduced resorption rates, indicating their potential to enhance graft stability in oral implantology. Our data indicate that the Medifuge MF 100 (Silfradent srl, Forlì, Italy) is effective in producing A-PRF+. [ABSTRACT FROM AUTHOR]

The emergence of hybrid scaffolds, blending biomaterials with diverse properties, offers promise in musculoskeletal tissue engineering. However, a need for in vitro platforms investigating biological behavior and the interplay of different load‐bearing and colonizable synthetic bone substitute materials remains. Herein, we present a novel, in‐house producible, and scalable clamp culture system designed for facile in vitro analysis of interactions between biomaterials, hydrogels, and cells. The system, constructed here from an exemplary 3D‐printable polymer and photopolymerizable hydrogel using a widely available benchtop 3D printer, ensures mechanical stability and protection for the embedded hydrogel via its double‐clamp structure, facilitating various analytical methods while preserving culture integrity. Hybrid clamp cultures were additively manufactured from polylactic acid, filled with a bone precursor cell‐laden methacrylate gelatin hydrogel, cultured for 14 days, and analyzed for cell viability, mineralization, and osseous differentiation. Results indicate no adverse effects on osteogenic differentiation or mineralization compared to conventional droplet cultures, with enhanced cell viability and simplified handling and downstream analysis. This system demonstrates the potential for robust experimentation in tissue engineering and is adaptable to various plate formats, and thus highly suitable for the investigation of biomaterial‐cell interactions and the development of implants for musculoskeletal tissue defects. [ABSTRACT FROM AUTHOR]

A complex of interrelated methods and means of analysis, clustering, segmentation and classification of objects on images obtained by sensors of different physical nature (with the help of modern methods of radiography, computer and magnetic resonance imaging) is proposed, which will allow modeling the optimal form of a bone substitute with functional properties by CAD/CAM/CAE design methods, depending on the anatomical data, the nature and localization of the cavity bone defect, its size, load conditions and patterns of bone tissue neoplasm. Methods for making multi-criteria decisions have been developed, which will allow for their implementation for a wide range of optimization tasks of researching the correlation of the shape and size of porosity with indicators of the stress-deformed state of bone substitutes in order to maintain the structural integrity of the biomaterial in the process of regeneration of hard tissue. [ABSTRACT FROM AUTHOR]

ABSTRACT Aim Materials and Methods Results Conclusion This first randomized controlled trial in humans aimed to assess the efficacy and safety of low‐dosage Escherichia coli‐derived recombinant human bone morphogenetic protein 2 (ErhBMP‐2)‐incorporated biomimetic calcium phosphate coating‐functionalized β‐TCP (ErhBMP‐2/BioCaP/β‐TCP) as a novel bone substitute using the tooth‐extraction‐socket‐healing model.Forty patients requiring dental implants after single‐root tooth extraction were enrolled in this study and randomly assigned into three groups: ErhBMP‐2/BioCaP/β‐TCP (N = 15), β‐TCP (N = 15) and natural healing (N = 10). New bone volume density from histomorphometric analyses was evaluated 6 weeks post‐operatively as the primary outcome, and other histomorphometric analyses, alveolar bone and soft‐tissue changes were the secondary outcomes. Safety parameters included adverse events, soft‐tissue healing, oral health impact profile, serum BMP‐2 concentrations and other laboratory tests.The findings revealed a significant increase in new bone volume density in patients treated with ErhBMP‐2/BioCaP/β‐TCP compared to those receiving β‐TCP alone. The required bone augmentation procedures during implant placement surgery in the ErhBMP‐2/BioCaP/β‐TCP group were significantly less than in the natural healing group. There were no significant differences in safety parameters among the three groups.This clinical trial primarily proved the safety and efficacy of ErhBMP‐2/BioCaP/β‐TCP as a promising bone substitute. [ABSTRACT FROM AUTHOR]

Each year, approximately million tons of waste is generated from eggshells disposed of in landfills. This waste is challenging to manage because of the odor and microbiological development. However, eggshells have potential applications as a solid byproduct. They can be modified and used in various industries such as metal, polymer and ceramic composites, in the production of biodiesel, heavy metal absorption from wastewater, and even as a biomaterial to substitute bone tissues. Furthermore, eggshells can be used as a cheap adsorbent for the treatment of contaminated waterways. They are also a great source of calcium and fertilizer for plants, animals and humans. Chicken eggshells can even be used as a catalyst for converting waste frying oil into biofuel. This review highlights the challenges and opportunities of eggshell waste valorization in the food industry. © 2024 Society of Chemical Industry. [ABSTRACT FROM AUTHOR]

Purpose: Although bone morphogenetic protein-2 (BMP-2) possesses potent osteoinductivity, there have been some concerns on the safety of BMP-2 and BMP-2-incorporated bone substitutes used for bone formation. On the other hand, BMP-2-loaded calcium phosphate cement (BMP-2@CPC) has been developed and used for bone regeneration in oral implantology. Therefore, this study aims to investigate this product's biocompatibility and clinical safety after being used in maxillofacial surgery. Materials and methods: A rat model was employed to assess the osteoinduction and biocompatibility of BMP-2@CPC. Further, a retrospective investigation was carried out: 110 patients who received BMP-2@CPC treatment after their maxillofacial surgery were recruited to describe relative adverse events. Results: In vivo, BMP-2@CPC showed a significantly higher mean bone volume density and osteoblasts volume density (15 ± 2% and 3 ± 1%)than those of the CPC group (p < 0.05) after being implanted in the dorsal area of rats. Regarding biocompatibility, the mean fibrous tissue volume density was significantly lower in the BMP-2@CPC group (20 ± 5% compared to 31 ± 6%, p = 0.026). The retrospective clinical study showed that only five mild/moderate adverse events were identified in four patients based on the medical records of 110 patients, including swelling, bony mass, and wound dehiscence. This adverse event occurrence was not affected by gender, age, the dose of filled materials, and operations in the study (p > 0.05). Conclusions: BMP-2-loaded CPC has osteoinductivity and more promising biocompatibility than pure CPC. However, its degradation is slower than CPC. The safety of BMP-2-loaded CPC with 0.5 or 1 mg BMP-2 is promising in oral maxillofacial surgery. Clinical implications: This study confirmed the promising safety of this BMP-2 incorporated CPC used in dental clinical practice, which can promote its reassuring application for dental implant placement in bone insufficient areas. [ABSTRACT FROM AUTHOR]

Background: Lateral lumbar interbody fusion (LLIF) via a retroperitoneum approach has gained popularity due to minimal invasiveness, which avoids resection of the spinous process and laminae. However, as challenges in grafting autogenous bone persist, artificial bone has been tested in Japan to fill the spinal cage. Platelet-rich plasma (PRP) contains growth factors and anti-inflammatory cytokines to promote cellular proliferation and repair damaged tissues. While the effects of PRP on tendon and ligament repair are widely known, any effects on bone healing are scarcely reported. However, PRP-loaded artificial bone carries potential to improve intervertebral bone fusion. Objective: This study assessed whether PRP enhances intervertebral bone fusion in LLIF surgery using β-tricalcium phosphate artificial bone. Methods: The current study was a prospective, randomized, controlled trial. We evaluated 13 consecutive patients undergoing LLIF surgery in our hospital. Patients received artificial bone impregnated with PRP or without PRP within the same fusion cage. The primary outcome was the intervertebral bone fusion rate at 6 and 12 months postoperatively, evaluated using CT imaging. The intervertebral bone fusion rates with and without PRP loading and with and without contact part between the endplate and the artificial bone were compared. Secondary outcomes included clinical evaluations using visual analog scale scores for low back pain, buttock-leg pain, and leg numbness from the Japanese Orthopaedic Association Back Pain Evaluation Questionnaire (JOA-BPEQ) and the Oswestry Disability Index (ODI), plus adverse events information. Results: Of the 13 patients (29 vertebral segments) included, bone fusion was observed in 43.4% of the PRP group and 26.1% of the non-PRP group at 6 months (p = 0.216). At 12 months, fusion rates were 60.9% with PRP and 34.8% without PRP (p = 0.074). The fusion rate was significantly higher in cases with good contact between the vertebral endplate and the artificial bone (p = 0.0004). Clinical scores improved postoperatively. Adverse events were in accordance with expectations from LLIF surgery and no PRP-specific events occurred. Conclusion: PRP did not significantly improve intervertebral bone fusion rates in LLIF surgeries, particularly in cases with poor contact between the vertebral endplate and artificial bone. While PRP may have a limited role in enhancing bone fusion, maintaining good contact between the vertebral endplate and artificial bone is crucial for successful outcomes. Further research is needed to explore optimal uses of PRP in spinal fusion surgeries. [ABSTRACT FROM AUTHOR]

Many studies have shown that it is important to use bone grafts that are easy to mold, bioabsorbable, and stable over time. We focused on Type H blood vessels, which were discovered by Kusumbe et al. in 2014 to be responsible for the interaction between angiogenesis and osteogenesis. The aim of this study was to assess the effect of octacalcium phosphate collagen (OCP/Col), on the healing processes of the extraction socket and the alveolar bone surrounding the extraction socket. Ridge preservation of rat lower first molars was conducted using OCP/Col, and a series of experiments involving micro-CT scanning, observations of new bone, bone morphometry measurements, histological and immunohistochemical analyses, and second harmonic generation imaging were conducted to analyze bone mass, bone quality, angiogenesis, and mechanical properties. The results demonstrate that the calcification level was not very high when using OCP/Col for RP. Moreover, the newly formed bone is rich in vascular components and collagen fibers that are essential for bone tissue remodeling. These characteristics of OCP/Col in RP could contribute significantly to the construction of a rich vascular network around dental implants immediately after implant placement and the subsequent acquisition of osseointegration and reconstruction of the surrounding tissue. [ABSTRACT FROM AUTHOR]

Hydroxyapatite (HA) is a bioceramic material widely used as a bone biomimetic substitute and can be synthesized by biomineralization, according to which HA nanoparticles are formed on a polymer template. Nevertheless, little is known about the effect of ion doping and biomineralization on cell metabolism, oxidative stress, and DNA damage. In the present contribution, we report on synthesizing and characterizing biomineralized chitosan as a polymer template with HA nanoparticles doped with magnesium (MgHA) and iron ions (FeHA). The physical-chemical and morphological characterization confirmed the successful synthesis of low crystalline ions-doped HA nanoparticles on the chitosan template, whereas the biochemical activity of the resulting nanoparticles towards human osteoblasts-like cells (MG63 and HOBIT) was investigated considering their effect on cell metabolism, proliferation, colony formation, redox status, and DNA damage extent. Data obtained suggest that particles enhance cell metabolism but partially limit cell proliferation. The redox status of cells was measured suggesting a slight increase in Reactive Oxygen Species production with chitosan biomineralized with iron-doped HA, whereas no effect with magnesium-doped HA and no effect of all formulations on the oxidation level of Peroxiredoxin. On the other hand, DNA damage was investigated by COMET assay, and expression and foci γH2AX. These latter tests indicated that HA-based nanoparticles promote DNA damage which is enhanced by chitosan thus suggesting that chitosan favors the nanoparticles' internalization by cells and modulates their biological activity. The potential DNA damage should be considered – and potentially exploited for instance in anticancer treatment – when HA-based particles are used to devise biomaterials. [ABSTRACT FROM AUTHOR]

After tooth extraction, bone levels in the alveoli decrease. Using a bone substitute can help minimize this bone loss. The substitute can be sourced from a human or animal donor or synthetically prepared. In this study, we aimed to address the following PICOS question: In patients needing dental alveolar preservation for implant placement, how does alveolar preservation using a bovine hydroxyapatite bone xenograft with collagen compare to a xenograft without collagen in terms of changes in alveolar height and width, bone density, and the characteristics of the bone tissue observed in biopsies taken at 6 months? We evaluated two xenograft-type bone substitutes for preserving post-extraction dental sockets using tomography and microscopy to answer that question. A total of 18 dental alveoli were studied: 11 preserved with a xenograft composed of apatite (InterOss) and 7 with a xenograft composed of apatite–collagen (InterOss Collagen). Tomographic controls were performed at 1 and 6 months, and microscopic studies were performed on 13 samples. The biopsies were examined with scanning electron microscopy (SEM) and energy-dispersive spectroscopy (EDS). A Multivariate Analysis of Variance (MANOVA) was conducted in the statistical analysis, revealing a significant increase in bone density over time (p = 0.04). Specifically, bone density increased from an average of 526.14 HU at 30 days to 721.96 HU at 60 days in collagen-free samples. However, no statistically significant differences in height or width were found between groups. The MANOVA results indicated that the overall model had a low predictive ability for height, width, and density variables (R-squared values were low), likely due to sample size limitations and the complexity of bone tissue dynamics. On the other hand, FTIR analysis revealed the presence of phosphate groups, carbonates, and amides I, II, and III, indicative of inorganic (hydroxyapatite) and organic (type I collagen) materials in the xenografts. TGA and DSC showed high thermal stability, with minimal mass loss below 150 °C. Finally, both xenografts were influential in alveolar bone regeneration after extraction without significant differences. The trend of increasing collagen density suggests an effect that requires further investigation. However, it is recommended that the sample size be increased to enhance the validity of the results. [ABSTRACT FROM AUTHOR]

Simple Summary: Bone defects present significant challenges in orthopedics, with alternatives to autografts commonly required owing to issues such as donor-site morbidity. Allogeneic demineralized bone matrix (DBM) is one viable option; however, handling difficulties and low mechanical strength necessitate effective carriers. Currently, DBM formulations are usually a paste or putty. This study evaluated hydroxyethyl cellulose (HEC) as a novel DBM carrier to improve clinical outcomes in a canine tibial defect model. We aimed to enhance the mechanical strength and osteogenic properties of DBM by incorporating cancellous bone or calcium phosphate. Our results suggest that combining DBM with HEC effectively promotes bone regeneration. Demineralized bone matrix (DBM) is a widely used allograft material for bone repair, but its handling properties and retention at defect sites can be challenging. Hydroxyethyl cellulose (HEC) has shown promise as a biocompatible carrier for bone graft materials. This study aimed to evaluate the efficacy of DBM combined with cancellous bone putty formed using HEC as an allograft material for bone regeneration in a canine tibial defect model. Experiments were conducted using dogs with proximal tibial defects. Four groups were compared: empty (control group), DBM + HEC (DH), DBM + cancellous bone + HEC (DCH), and DBM + cancellous bone + calcium phosphate + HEC (DCCH). Radiographic, micro-computed tomography (CT), and histomorphometric evaluations were performed 4 and 8 weeks postoperatively to assess bone regeneration. The Empty group consistently exhibited the lowest levels of bone regeneration throughout the study period, indicating that DBM and cancellous bone with HEC significantly enhanced bone regeneration. At week 4, the DCCH group showed the fastest bone regeneration on radiography and micro-computed tomography. By week 8, the DCH group showed the highest area ratio of new bone among all experimental areas, followed by the DH and DCCH groups. This study demonstrated that HEC significantly enhances the handling, mechanical properties, and osteogenic potential of DBM and cancellous bone grafts, making it a promising carrier for clinical applications in canine allograft models. When mixed with allograft cancellous bone, which has high porosity and mechanical strength, it becomes a promising material offering a more effective and reliable option for bone repair and regeneration. [ABSTRACT FROM AUTHOR]

Background: Osteomyelitis secondary to mandibular fracture surgery is rare and complete surgical debridement of necrotic infected tissues is an optimal treatment for it. Subsequent reconstruction is required for bone defect caused by operation. Autogenous, allograft and synthetic bone graft substitutes have become widespread in bone defect treatment. Distraction osteogenesis (DO) was also applied in bone defect reconstruction, even it wasn't conventional therapy in jaw. Case presentation: Here we report a case of a 40-year-old aged man who presented with chronic swelling and pain on the right mandibular masseteric region after mandibular angle and Le Fort II fracture surgery. In six weeks after surgery, CBCT images showed that the fracture ends hadn't heal and the fracture gap had widened significantly. The clinical diagnosis of the patient was right mandibular angle osteomyelitis. After controlling the symptoms of pain and infection with local rinses and systemic antibiotic therapy, the patient underwent segmental resection of the infected bone and DO reconstruction for bone defect simultaneously. Encouragingly, well bone healing and normal occlusion restoration was observed finally. Conclusions: DO could be a valuable alternative therapy to bone grafts for bone defect, even in the case of infection. [ABSTRACT FROM AUTHOR]

Cranioplasty is one of the most common neurosurgical procedure performed to repair cranial defect. Many materials and fabrication technique are used to prepare cranial implant in cases where autologous bone is not available. Polymethyl Methacrylate (PMMA) is one of the most common polymer used as bone substitute. PMMA fabricated using 3D printed models have shown better fit, symmetrical shape, and restore esthetic looks of patients. The use of 3D printed implants in medical procedures has several advantages over traditional manufacturing methods. 3D printing allows for greater precision, customization, and quicker implant time. [ABSTRACT FROM AUTHOR]

Hydroxyapatite (HA) is an extensively used biomaterial for dental and orthopaedic applications because of its biocompatibility and biomimetic nature. HA is extensively used as a bone-graft substitute. HA bone graft substitutes of bovine or synthetic origins have been extensively studied. However, caprine-based HA has not been explored. In this study, we aimed to determine the utilization of goat bone-derived HA for commercial applications. HA from caprine bone and teeth was isolated using thermal calcination. The developed HA can be used as a bone graft substitute. Chemical characterization of the isolated HA was carried out using Fourier transform infrared spectroscopy, X-Ray Diffraction, Raman spectroscopy, scanning electron microscopy, and transmission electron microscopy. The biocompatibility and apatite formation of isolated HA were assessed using MG-63 cells, MC3T3-E1, L929 cells, MSCs, adipose derived stem cells, human dermal tissue derived fibroblast cells and osteoblast-like cell line, The studies demonstrate that HA support cell adhesion and osteogenic properties. To improve sheep, lamp, or caprine bone-derived HA, several other composites have been developed with MgO2, ZrO2, ZnO2, and other polymeric substances. 3D printed technology was used to develop a bioink using sheep-derived HA and printed the composite scaffold as a bone graft substitute. Furthermore, the biomedical applications of sheep-derived HA been studied in terms of their antimicrobial activity, bone-forming ability, and wound healing applications. Sheep-, goat-, and caprine-derived HA are still underutilized and require further research to develop commercial possibilities and sustainable raw materials for HA-based bone graft substitutes. [ABSTRACT FROM AUTHOR]

Purpose: Ridge preservation is essential to restore alveolar ridge volume and to enhance esthetic and functional outcomes for dental implants. The addition of hyaluronic acid to allogeneic bone substitute materials might enhance these outcomes. This clinical study evaluated the efficacy of ridge preservation after tooth extraction using granular allografts with and without hyaluronic acid addition. Methods: In this retrospective study, 40 patients with compromised extraction sockets were enrolled. Among them, 19 received particulate allogeneic bone substitutes (Allo), 21 received allogeneic bone substitutes with hyaluronic acid (AlloHya). Vertical and horizontal graft stability, graft shrinkage rate, and bone mineral density were assessed using radiographic measurements on CBCT scans conducted before tooth extraction, directly after ridge preservation and after four months. Patients were followed up 12 months post-implantation. Results: Vertical height loss after 4 months was significantly greater in the Allo group (-0.82 ± 0.95 mm) compared to the AlloHya group (-0.19 ± 0.51 mm; p = 0.011). Graft shrinkage rate was 16.9 ± 11.5% (Allo) and 10.3 ± 7.7% (AlloHya) (p = 0.038). After four months, average bone density was significantly higher in the AlloHya compared to the Allo group (p = 0.004). Nearly all implants (39 out of 40) were classified as "Success" according to the ICOI scheme, with no differences in implant quality between the two study groups. Conclusions: Improved graft stability, reduced resorption, and increased bone density were observed in hyaluronic acid-enriched allografts compared to pure allografts. Adding hyaluronic acid to allogeneic bone grafts significantly enhanced outcomes in ridge preservation. [ABSTRACT FROM AUTHOR]

There is a deficit for bone tissue natural grafts that seek to be covered with synthetic substitutes. Scaffolds generated with 3D printing and electrospinning allow adequate mechanical properties maintaining a structure appropriate for cell growth. Here, a scaffold made up of three-dimensional (3D) printed PLA frameworks added with PCL/PLA/nHA nanofibers was manufactured. The framework showed mechanical properties similar to other reported bone substitutes, while the nanofibers showed diameters between 200 and 850 nm. Scaffolds were suitable for cell adhesion and proliferation when evaluated with fibroblasts, showing cell proliferation into the nanofiber network, a fundamental aspect in tissue engineering. [ABSTRACT FROM AUTHOR]

Biocompatible materials are natural or man-made substances kept in the body to turn a living cell into a working organ. Bone tissue and biocompatibility are emerging as an alternative approach to regenerating bone due to some distinct advantages over autografting and allografting. This research aimed to fabricate a novel porous scaffold Ti-Nb-Zr-Sn alloy that can be utilized as a bone substitute. Ti-Nb-Sn-Zr were selected by different weight ratios and synthesized using the powder metallurgy method. Zir- conium (Zr) is incorporated to get enhanced biological performance. The elements Ti, Nb with Zr, and Sn are utilized due to their excellent biocompatibility with the human body. The Ti-35Nb-7Zr-4Sn alloy has high tensile strength between 1042 and 1603 MPa by increasing Zr and Nb weight ratios. In addition, 35% Nb/7% Zr with 4% Sn composite show improved hardness, which is beneficial for resembling bone tissue and die-casting fittings in automobile applications. Fatigue and wear analysis is conducted to help us understand the behaviour of the Ti-Nb-Zr-Sn alloy. [ABSTRACT FROM AUTHOR]

Study Design. A multicenter randomized controlled noninferiority trial with intrapatient comparisons. Objective. The aim of this study was to determine noninferiority of a slowly resorbable biphasic calcium phosphate with submicron microporosity (BCP<µm, MagnetOs Granules) as an alternative for autograft in instrumented posterolateral fusion (PLF). Summary of Background Data. Successful spinal fusion with a solid bone bridge between the vertebrae is traditionally achieved by grafting with autologous iliac bone. However, the disadvantages of autografts and unsatisfactory fusion rates have prompted the exploration of alternatives, including ceramics. Nevertheless, clinical evidence for the standalone use of these materials is limited. Methods. Adults indicated for instrumented PLF (1 to 6 levels) were enrolled at 5 participating centers. After bilateral instrumentation and fusion-bed preparation, the randomized allocation side (left or right) was disclosed. Per segment 10 cc of BCP<µm granules (1 to 2 mm) were placed in the posterolateral gutter on one side and 10 cc autograft on the contralateral side. Fusion was systematically scored on 1-year follow-up CT scans. The study was powered to detect >15% inferiority with binomial paired comparisons of the fusion performance score per treatment side. Results. Of the 100 patients (57 ± 12.9 y, 62% female), 91 subjects and 128 segments were analyzed. The overall posterolateral fusion rate per segment (left and/or right) was 83%. For the BCP<µm side only the fusion rate was 79% versus 47% for the autograft side (difference of 32 percentage points, 95% CI, 23-41). Analysis of the primary outcome confirmed the noninferiority of BCP <µm with an absolute difference in paired proportions of 39.6% (95% CI, 26.8-51.2; p < 0.001). Conclusion. This clinical trial demonstrates noninferiority and indicates superiority of MagnetOs Granules as a standalone ceramic when compared to autograft for posterolateral spinal fusion. These results challange the belief that autologous bone is the most optimal graft material. [ABSTRACT FROM AUTHOR]

Aims: This study aimed to systematically compare the patients undergoing lateral MSFA therapies utilizing bovine‐originated xenografts versus varied synthetic bone grafting materials. Methods: Pubmed, Scopus, Embase, and Cochrane Library were searched up to April 2023, compensated by a manual search in selected journals. Studies reporting histological outcomes (residual bone graft, newly formed bone, non‐mineralized tissue) and clinical outcomes (implant survival, ISQ value) were included. Several analyses were performed, including meta‐analysis, sensitivity study, and Egger's regression tests. Results: Sixteen clinical/randomized control trials were included in this systematic review, among which 12 were enrolled in a meta‐analysis. The percentage of newly formed bone within the grafted sinuses by hybrid HA/TCP was significantly higher than those by xenografts (WMD 2.85, 95%CI [0.72; 4.99]), but those grafted by pure HA (WMD −1.72, 95%CI [−3.15; −0.29]) or TCP (WMD −7.10, 95%CI [−13.02; −1.17]) were significantly lower than xenograft counterparts. The residual bone graft and non‐mineralized tissue yielded by synthetic HA, TCP, and HA/TCP showed no significant differences with the xenograft group. Conclusion: The chemistry of grafted bone substitutes in lateral MSFA influenced the quantity of newly formed bone. Those grafted with hybrid HA/TCP yielded the highest amount of new bone compared to bovine‐originated HA. However, this influence was not significant on residual bone graft and non‐mineralized tissue. [ABSTRACT FROM AUTHOR]

Lateral tibial plateau fractures with significant articular depression and metaphyseal comminution in the setting of osteoporosis are challenging to manage. The subchondral bone defect and capacious cancellous void after surgical elevation of the articular surface is usually filled with nonstructural graft such as autologous cancellous bone graft, allogenic cancellous bone graft, or bone graft substitutes. Reports have shown a high rate of subsidence with these grafts when patients start to bear weight and ultimately failure of the construct. Structural grafts demonstrated stronger mechanical properties and lower subsidence rates. The purpose of this note is to describe a novel surgical technique using structural tricortical iliac crest allograft for the treatment of osteoporotic depressed lateral tibia plateau fracture. [ABSTRACT FROM AUTHOR]