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Functional Biomaterials for Regenerative Dentistry
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Functional Biomaterials for Regenerative Dentistry

A special issue of Journal of Functional Biomaterials (ISSN 2079-4983). This special issue belongs to the section "Dental Biomaterials".

Deadline for manuscript submissions: 20 July 2025 | Viewed by 17125

Special Issue Editor

Dr. Nicholas G. Fischer

E-Mail Website
Guest Editor
Minnesota Dental Research Center for Biomaterials and Biomechanics, University of Minnesota, Minneapolis, MN, USA
Interests: extracellular matrix signaling; dental biomaterials; surface modification; antimicrobial biomaterials; hemidesmosomes; surface analysis; peptide-based biomaterials
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Regenerative dentistry aims to replace diseased and damaged tissue with functionally integrated regenerated tissue rather than conventional bonded or embedded synthetic materials. The wide array of oral tissues that require regeneration due to common diseases—the periodontal ligament supporting sound biomechanical integration of teeth, the dental pulp maintaining tooth vitality, the alveolar bone supporting function of overlying tissue and retention of teeth, and mineralized tooth structure—presents many daunting challenges. Overcoming these challenges is essential for oral health and the associated benefits to the well-being and lifestyle of patients. 

Biomaterials that promote regeneration serve a growing role in the dentist’s repertoire of tools and techniques. The inherent patient-specific, adaptable, biocompatible, and immunomodulatory nature of regenerative biomaterials positions them as the future of everyday dental practice. The long history of dentistry’s surgical techniques, combined with the wide scope of biomaterials being developed for nearly every diseased human tissue, produces an exciting opportunity for the development of functional regenerative biomaterials in dentistry. The objective of this Special Issue is to publish the latest research on the development of functional biomaterials for regenerative dentistry—broadly defined—to highlight the present and future capacity of dentistry to lead the way in tissue regeneration.

Dr. Nicholas G. Fischer
Guest Editor

Manuscript Submission Information

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Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2700 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • dental implant
  • scaffold
  • hydrogel
  • bone regeneration
  • antimicrobial
  • bioactive material
  • biocompatibility
  • surface
  • immunomodulation
  • extracellular matrix

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Published Papers (10 papers)

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Research

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16 pages, 1044 KiB  
Article
Treatment of Medication-Related Osteonecrosis of the Jaw Without and With the Use of Advanced Platelet-Rich Fibrin: A Retrospective Clinical Study
by Paulina Adamska, Marcin Stasiak, Natalia Kobusińska, Michał Bartmański, Adam Zedler and Michał Studniarek
J. Funct. Biomater. 2025, 16(5), 180; https://doi.org/10.3390/jfb16050180 - 14 May 2025
Viewed by 133
Abstract
Background: Medication-related osteonecrosis of the jaw (MRONJ) is drug-induced bone destruction that is exposed for a minimum of 6 to 8 weeks in patients who have not received head and neck radiotherapy and who have not been diagnosed with facial bone metastases. MRONJ [...] Read more.
Background: Medication-related osteonecrosis of the jaw (MRONJ) is drug-induced bone destruction that is exposed for a minimum of 6 to 8 weeks in patients who have not received head and neck radiotherapy and who have not been diagnosed with facial bone metastases. MRONJ treatment outcomes are unpredictable. Therefore, alternative treatment methods are being explored, such as blood-derived platelet-rich preparations enriched with growth factors, including advanced platelet-rich fibrin (A-PRF). The presence of growth factors may enhance healing and reduce post-procedure complications. There are no studies examining the effect of A-PRF on the healing of patients with MRONJ. The aim of this study was to retrospectively evaluate treatment outcomes of patients with MRONJ surgically treated without and with the use of A-PRF. Materials and methods: This retrospective study included 28 patients who suffered from osteomyelitis due to MRONJ and underwent surgical treatment between 2019 and 2024. The patients were divided into two groups: the first group received surgical treatment without A-PRF, and the second group received surgical treatment with the application of A-PRF. This study analyzed demographic and clinical data, as well as treatment outcomes. Results: The patients were aged from 43 to 82 years. The most common cause of MRONJ was the administration of zoledronic acid for oncological reasons (22 patients, 78.6%), given intravenously. In 20 patients (71.4%), the antiresorptive treatment lasted longer than three years. The obtained healing distribution was binomial (presence or absence of healing). Estimation of the probability of healing using the maximum likelihood method provided a result of approximately 64%. The probability of ten or more healed patients in the A-PRF group was 41%. A-PRF helps with a probability of 59%, and without A-PRF, it was lower. Concomitantly, the differences between the group with A-PRF and without A-PRF were not statistically significant. Conclusions: The patients with MRONJ should have regular check-ups with radiological examinations at least every six months to detect possible recurrence. Treatment for MRONJ is long and difficult. Treatment of non-advanced lesions, without additional risk factors (such as treatment with zoledronate intravenously for oncological purposes for 3 years), showed a better prognosis. Sometimes, in addition to surgery, it is necessary to consider alternative methods. A-PRF may enhance MRONJ healing. However, there is no evidence of a significant effect of A-PRF on the healing of MRONJ. Full article
(This article belongs to the Special Issue Functional Biomaterials for Regenerative Dentistry)
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11 pages, 6631 KiB  
Article
Wear Resistance of Light-Cure Resin Luting Cements for Ceramic Veneers
by Miyuki Oshika, Takafumi Kishimoto, Taku Horie, Abdulaziz Alhotan, Masao Irie, Veronica C. Sule, Wayne W. Barkmeier and Akimasa Tsujimoto
J. Funct. Biomater. 2025, 16(1), 5; https://doi.org/10.3390/jfb16010005 - 26 Dec 2024
Viewed by 1068
Abstract
The purpose of this study was to compare the wear resistance of light-cure resin luting cements for veneers with that of other luting materials investigated in earlier studies. An Alabama wear-testing machine was used to measure the wear resistance of four recent light-cure [...] Read more.
The purpose of this study was to compare the wear resistance of light-cure resin luting cements for veneers with that of other luting materials investigated in earlier studies. An Alabama wear-testing machine was used to measure the wear resistance of four recent light-cure resin luting cements for veneers (G-Cem Veneer; Panavia V5 LC; RelyX Veneer Cement; and Vario-link Esthetic LC). The volume loss ranged from 0.027 ± 0.003 to 0.119 ± 0.030 mm3, the mean facet depth from 56.053 ± 7.074 to 81.531 ± 7.712 µm, and the maximum facet depth from 100.439 ± 26.534 to 215.958 ± 27.320 µm. G-Cem Veneer showed significantly better (p < 0.05) wear resistance than the other materials tested. Representative SEM images were obtained which showed differences in form among the wear facets for the luting cements examined. Correlations were calculated between the three measurements for each material, and the pattern of correlations was also different for each material. Full article
(This article belongs to the Special Issue Functional Biomaterials for Regenerative Dentistry)
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9 pages, 3112 KiB  
Article
Effect of Fluoride Varnishes on Demineralization and Acid Resistance in Subsurface Demineralized Lesion Models
by Rika Iwawaki, Taku Horie, Abdulaziz Alhotan, Yuka Nagatsuka, Keiko Sakuma, Kumiko Yoshihara and Akimasa Tsujimoto
J. Funct. Biomater. 2024, 15(12), 380; https://doi.org/10.3390/jfb15120380 - 17 Dec 2024
Viewed by 1069
Abstract
This study aimed to clarify the effects of high-concentration fluoride varnish application on the inhibition of the progression of initial enamel caries. Remineralization capacity and acid resistance following high-concentration fluoride varnish application were compared with untreated models and models treated with fluoride mouthwash. [...] Read more.
This study aimed to clarify the effects of high-concentration fluoride varnish application on the inhibition of the progression of initial enamel caries. Remineralization capacity and acid resistance following high-concentration fluoride varnish application were compared with untreated models and models treated with fluoride mouthwash. Bovine enamel was used to create a model of initial enamel caries. The high-concentration fluoride varnishes Enamelast and Clinpro White Varnish and the fluoride mouthwash Miranol were used. Specimens were evaluated using Contact Microradiography (CMR) and an Electron Probe Micro-Analyzer (EPMA). While a single application of high-concentration fluoride varnish and short-term fluoride mouthwash use did not appear to cause remineralization in the subsurface demineralized layer, improvements in acid resistance were observed, leading to reduced demineralization under subsequent acidic challenges. Full article
(This article belongs to the Special Issue Functional Biomaterials for Regenerative Dentistry)
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14 pages, 1009 KiB  
Article
Plasma Rich in Growth Factors Compared to Xenogenic Bone Graft in Treatment of Periodontal Intra-Osseous Defects—A Prospective, Comparative Clinical Study
by Sourav Panda, Sital Panda, Abhaya Chandra Das, Natalia Lewkowicz, Barbara Lapinska, Margherita Tumedei, Funda Goker, Niccolò Cenzato and Massimo Del Fabbro
J. Funct. Biomater. 2024, 15(11), 336; https://doi.org/10.3390/jfb15110336 - 9 Nov 2024
Cited by 1 | Viewed by 1563
Abstract
Background: Periodontal intra-bony defects are challenging conditions in dental practice, often requiring regenerative approaches for successful treatment. This clinical study aimed to compare the effectiveness of plasma rich in growth factors (PRGF) versus xenogenic bone graft (BXG) in addressing intra-bony defects. Methods: Forty [...] Read more.
Background: Periodontal intra-bony defects are challenging conditions in dental practice, often requiring regenerative approaches for successful treatment. This clinical study aimed to compare the effectiveness of plasma rich in growth factors (PRGF) versus xenogenic bone graft (BXG) in addressing intra-bony defects. Methods: Forty patients aged between 30 and 50 years presenting with generalized periodontitis were included. The study assessed various parameters, including relative attachment level (RAL); probing pocket depth (PPD); gingival marginal level (GML); intra-bony defect depth (IBDD) at baseline, 3, and 6 months; and level of pain, post-operative bleeding, and swelling, as patient-reported outcomes during the first seven days post operation. Results: The results revealed that both PRGF and BXG treatments led to significant reductions in IBDD over the 6-month study period. PRGF demonstrated significant advantages in GML enhancement and post-operative pain management during the initial post-treatment days. However, BXG showed a significantly greater reduction in IBDD compared to PRGF. Post-operative bleeding and swelling levels were comparable between the two treatments. Conclusions: These findings underscore the efficacy of both PRGF and BXG in periodontal regeneration, with treatment decisions guided by patient-specific factors and clinical goals. Full article
(This article belongs to the Special Issue Functional Biomaterials for Regenerative Dentistry)
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11 pages, 1657 KiB  
Article
Osteoinductive Properties of Autologous Dentin: An Ex Vivo Study on Extracted Teeth
by Giulia Mazzucchi, Alessia Mariano, Giorgio Serafini, Luca Lamazza, Anna Scotto d’Abusco, Alberto De Biase and Marco Lollobrigida
J. Funct. Biomater. 2024, 15(6), 162; https://doi.org/10.3390/jfb15060162 - 12 Jun 2024
Cited by 2 | Viewed by 1884
Abstract
Over the last decades, a variety of biomaterials, ranging from synthetic products to autologous and heterologous grafts, have been recommended to conserve and regenerate bone tissue after tooth extraction. We conducted a biochemical study on ground extracted teeth that aimed to evaluate the [...] Read more.
Over the last decades, a variety of biomaterials, ranging from synthetic products to autologous and heterologous grafts, have been recommended to conserve and regenerate bone tissue after tooth extraction. We conducted a biochemical study on ground extracted teeth that aimed to evaluate the osteoinductive and osteoconductive potential of dentin by assessing the releases of bone morphogenetic protein (BMP-2), osteocalcin (OC) and osteonectin (ON) over time (24 h, 10 days and 28 days). Twenty-six patients, who required the extraction of nonrestorable teeth, were enrolled in the study according to the inclusion criteria, as follows: thirteen young patients 18 to 49 years of age (UNDER 50), and thirteen patients of 50 to 70 years (OVER 50); a total of twenty-six teeth were extracted, ground and analyzed by enzyme-linked immunosorbent assays (ELISA). All ground teeth released BMP-2, OC and ON at each time point; no differences were observed between the UNDER-50 and OVER-50 patients. The results of the study support the use of autologous dentin as osteoinductive material for bone regeneration procedures, irrespective of patients’ ages. Full article
(This article belongs to the Special Issue Functional Biomaterials for Regenerative Dentistry)
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16 pages, 6751 KiB  
Article
In Vitro Effects of Weissella cibaria CMU and CMS1 on Receptor Activator of NF-κB Ligand (RANKL)-Induced Osteoclast Differentiation
by Geun-Yeong Park, Jeong-Ae Park and Mi-Sun Kang
J. Funct. Biomater. 2024, 15(3), 65; https://doi.org/10.3390/jfb15030065 - 8 Mar 2024
Viewed by 2037
Abstract
Excessive osteoclast activity can promote periodontitis-associated bone destruction. The inhibitory mechanisms of Weissella cibaria strains CMU and CMS1 against periodontitis have not yet been fully elucidated. In this study, we aimed to investigate whether heat-killed (HK) W. cibaria CMU and CMS1 or their [...] Read more.
Excessive osteoclast activity can promote periodontitis-associated bone destruction. The inhibitory mechanisms of Weissella cibaria strains CMU and CMS1 against periodontitis have not yet been fully elucidated. In this study, we aimed to investigate whether heat-killed (HK) W. cibaria CMU and CMS1 or their respective cell-free supernatants (CFSs) inhibit osteoclast differentiation and bone resorption in response to receptor activator of nuclear factor kappa-B ligand (RANKL)-treated RAW 264.7 cells. TRAP (tartrate-resistant acid phosphatase) staining and bone resorption assays revealed that both HK bacteria and CFSs significantly suppressed the number of TRAP-positive cells, TRAP activity, and bone pit formation compared to the RANKL-treated control (p < 0.05). HK bacteria dose-dependently inhibited osteoclastogenesis while selectively regulating certain genes in CFSs (p < 0.05). We found that disrupting the direct interaction between HK bacteria and RAW 264.7 cells abolished the inhibitory effect of HK bacteria on the expression of osteoclastogenesis-associated proteins (c-Fos, nuclear factor of activated T cells c1 (NFATc1), and cathepsin K). These results suggest that dead bacteria suppress osteoclast differentiation more effectively than the metabolites and may serve as beneficial agents in preventing periodontitis by inhibiting osteoclast differentiation via direct interaction with cells. Full article
(This article belongs to the Special Issue Functional Biomaterials for Regenerative Dentistry)
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13 pages, 3614 KiB  
Article
Reconstructive Approach in Residual Periodontal Pockets with Biofunctionalized Heterografts—A Retrospective Comparison of 12-Month Data from Three Centers
by Anton Friedmann, Pheline Liedloff, Meizi Eliezer, Arthur Brincat, Thomas Ostermann and Daniel Diehl
J. Funct. Biomater. 2024, 15(2), 39; https://doi.org/10.3390/jfb15020039 - 9 Feb 2024
Cited by 1 | Viewed by 2195
Abstract
The regenerative capacity of well-preserved blood clots may be enhanced by biologics like enamel matrix derivative (EMD). This retrospective analysis compares outcomes reported by three centers using different heterografts. Center 1 (C1) treated intrabony defects combining cross-linked high-molecular-weight hyaluronic acid (xHyA) with a [...] Read more.
The regenerative capacity of well-preserved blood clots may be enhanced by biologics like enamel matrix derivative (EMD). This retrospective analysis compares outcomes reported by three centers using different heterografts. Center 1 (C1) treated intrabony defects combining cross-linked high-molecular-weight hyaluronic acid (xHyA) with a xenograft; center 2 (C2) used EMD with an allograft combination to graft a residual pocket. Center 3 (C3) combined xHyA with the placement of a resorbable polymer membrane for defect cover. Clinical parameters, BoP reduction, and radiographically observed defect fill at 12-month examination are reported. The 12-month evaluation yielded significant improvements in PPD and CAL at each center (p < 0.001, respectively). Analyses of Covariance revealed significant improvements in all parameters, and a significantly greater CAL gain was revealed for C2 vs. C1 (p = 0.006). Radiographic defect fill presented significantly higher scores for C2 and C3 vs. C1 (p = 0.003 and = 0.014; C2 vs. C3 p = 1.00). Gingival recession increased in C1 and C3 (p = 1.00), while C2 reported no GR after 12 months (C2:C1 p = 0.002; C2:C3 p = 0.005). BoP tendency and pocket closure rate shared similar rates. Within the limitations of the study, a data comparison indicated that xHyA showed a similar capacity to enhance the regenerative response, as known for EMD. Radiographic follow-up underlined xHyA’s unique role in new attachment formation. Full article
(This article belongs to the Special Issue Functional Biomaterials for Regenerative Dentistry)
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Review

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24 pages, 1663 KiB  
Review
The Integration of Gold Nanoparticles into Dental Biomaterials as a Novel Approach for Clinical Advancement: A Narrative Review
by Saharat Jongrungsomran, Dakrong Pissuwan, Apichai Yavirach, Chaiy Rungsiyakull and Pimduen Rungsiyakull
J. Funct. Biomater. 2024, 15(10), 291; https://doi.org/10.3390/jfb15100291 - 30 Sep 2024
Cited by 5 | Viewed by 3517
Abstract
Gold nanoparticles (AuNPs) have gained significant attention in the biomedical field owing to their versatile properties. AuNPs can be customized by modifying their size, shape and surface characteristics. In recent years, extensive research has explored the integration of AuNPs into various dental materials, [...] Read more.
Gold nanoparticles (AuNPs) have gained significant attention in the biomedical field owing to their versatile properties. AuNPs can be customized by modifying their size, shape and surface characteristics. In recent years, extensive research has explored the integration of AuNPs into various dental materials, including titanium, polymethylmethacrylate (PMMA) and resin composites. This review aims to summarize the advancements in the application of modified AuNPs in dental materials and to assess their effects on related cellular processes in the dental field. Relevant articles published in English on AuNPs in association with dental materials were identified through a systematic search of the PubMed/MEDLINE, Embase, Scopus and ScienceDirect databases from January 2014 to April 2024. Future prospects for the utilization of AuNPs in the field of dentistry are surveyed. Full article
(This article belongs to the Special Issue Functional Biomaterials for Regenerative Dentistry)
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Other

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14 pages, 567 KiB  
Systematic Review
Advanced Platelet-Rich Fibrin Plus (A-PRF+) as an Additive to Hard Tissue Managing Protocols in Oral Surgery: A Systematic Review
by Marek Chmielewski, Andrea Pilloni and Paulina Adamska
J. Funct. Biomater. 2025, 16(4), 145; https://doi.org/10.3390/jfb16040145 - 19 Apr 2025
Viewed by 439
Abstract
Background: Advanced platelet-rich fibrin + (A-PRF+) represents a third generation of autologous platelet derivatives. Appropriate centrifugation conditions cause the formation of a clot containing platelets, which slowly release growth factors that influence healing. The objective of this article was to undertake a review [...] Read more.
Background: Advanced platelet-rich fibrin + (A-PRF+) represents a third generation of autologous platelet derivatives. Appropriate centrifugation conditions cause the formation of a clot containing platelets, which slowly release growth factors that influence healing. The objective of this article was to undertake a review of the available literature on the effectiveness of A-PRF+ use in hard tissue procedures. Materials and methods: In order to ensure the most accurate and relevant results, only randomized clinical trials regarding bone regeneration techniques/bone healing that compared the effect of the A-PRF+ addition in dentistry were included in this study. Articles taken into consideration for the review were published between the beginning of 2014 and 31 December 2024. The search of manuscripts for the review was conducted using the PubMed, Scopus, Google Scholar, and Cochrane databases. For this study, 10 articles focusing on A-PRF+ were qualified. Results: A-PRF+ was found to increase the post-surgical vertical and horizontal alveolar ridge dimensions. The bone formed in the surgical site presented a higher volume of vital and non-vital bone and a more optimal bone composition, at the same time providing a lower percentage of connective tissue inclusions. When combined with other grafting biomaterials, A-PRF+ enhanced their performance and integration. A-PRF+ did not have any significant effect on the mineral bone density compared with other grafting materials. Compared with PRF and other blood derived plasmas rich in growth factors, the performance of A-PRF+ was generally better, but often with no statistical significance. The treatment of periodontal defects measured by the reduction in pocket depth and clinical attachment level also fared better with the A-PRF+ addition, although there was no differences noted between A-PRF+ and biphasic calcium phosphate and xenograft. Finally, the A-PRF+ addition improved the primary implant stability in the evaluated studies. Conclusions: The A-PRF+ addition to the surgical protocols significantly enhanced the healing of the bone and when combined with biomaterials improved their integration and increased the implant insertion torque, improving the primary and secondary stability. It may be a viable alternative for patients that express their concern towards human- and animal-derived biomaterials. Full article
(This article belongs to the Special Issue Functional Biomaterials for Regenerative Dentistry)
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25 pages, 2439 KiB  
Systematic Review
Application of Advanced Platelet-Rich Fibrin in Oral and Maxillo-Facial Surgery: A Systematic Review
by Marek Chmielewski, Andrea Pilloni and Paulina Adamska
J. Funct. Biomater. 2024, 15(12), 377; https://doi.org/10.3390/jfb15120377 - 14 Dec 2024
Cited by 2 | Viewed by 1823
Abstract
Background: Advanced platelet-rich fibrin (A-PRF) is produced by centrifuging the patient’s blood in vacuum tubes for 14 min at 1500 rpm. The most important component of A-PRF is the platelets, which release growth factors from their ⍺-granules during the clotting process. This process [...] Read more.
Background: Advanced platelet-rich fibrin (A-PRF) is produced by centrifuging the patient’s blood in vacuum tubes for 14 min at 1500 rpm. The most important component of A-PRF is the platelets, which release growth factors from their ⍺-granules during the clotting process. This process is believed to be the main source of growth factors. The aim of this paper was to systematically review the literature and to summarize the role of A-PRF in oral and maxillo-facial surgery. Materials and Methods: A systematic review was carried out, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines (PROSPERO: CRD42024584161). Results: Thirty-eight articles published before 11 November 2024 were included in the systematic review. The largest study group consisted of 102 patients, and the smallest study group consisted of 10 patients. A-PRF was most often analyzed compared to leukocyte-PRF (L-PRF) or blood cloth. A-PRF was correlated with lower postoperative pain. Also, A-PRF was highlighted to have a positive effect on grafting material integration. A-PRF protected areas after free gingival graft very well, promoted more efficient epithelialization of donor sites and enhanced wound healing. Conclusions: Due to its biological properties, A-PRF could be considered a reliable addition to the surgical protocols, both alone and as an additive to bio-materials, with the advantages of healing improvement, pain relief, soft tissue management and bone preservation, as well as graft integration. However, to determine the long-term clinical implications and recommendations for clinical practice, more well-designed randomized clinical trials are needed in each application, especially those with larger patient cohorts, as well as additional blinding of personnel and long follow-up periods. Full article
(This article belongs to the Special Issue Functional Biomaterials for Regenerative Dentistry)
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