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Advanced Biomaterials and Oral Implantology—3rd Edition

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

Deadline for manuscript submissions: closed (30 April 2026) | Viewed by 13681

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Editors

Dr. Dominik Kraus

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Guest Editor

Department of Prosthodontics, Preclinical Education and Dental Materials Science, University of Bonn, Bonn, Germany
Interests: oral rehabilitation; biomaterials; periodontitis; implant dentistry
Special Issues, Collections and Topics in MDPI journals

Prof. Dr. Norbert Enkling

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Guest Editor

1. Department of Prosthodontics, Preclinical Education and Dental Materials Science, University of Bonn, Bonn, Germany
2. Department of Reconstructive Dentistry and Gerodontology, Division of Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
Interests: oral rehabilitation; implant dentistry; oral function; oral surgery
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

The development of oral biomaterials has come a long way since Brånemark introduced titanium dental implants and since the concept of biocompatibility first emerged. As for today, a repertoire of customized biomaterials meet the demands of millions of patients worldwide for both prosthetics and regenerative tissue engineering. Dental implantology and alloplastic bone reconstruction rely on varied substrate materials, along with different designs at the macro- level and sophisticated and fine-tuned surface modifications or biochemical functionalizations, to meet the requirements of their specific fields of application. In many cases, there are no alternatives to biomaterial-based oral implants that can produce the same level of long-term functionality.

However, oral implants perform in a complex environment that—besides mechanical stability and esthetics—involves biological interaction with hard and soft tissues, the immune system and the oral microbiome. While progress has been made in the fields of material sciences, surface biofunctionalization, manufacturing processes, and medical understanding of the involved processes in recent years, many oral implants still exhibit impaired (bone and periodontal) healing or fail in the long run, either due to mechanic failure, deficient tissue integration, or peri-implant diseases.

This Special Issue, entitled “Advanced Biomaterials and Oral Implantology—3rd Edition”, will introduce studies that reflect progress in nanobiomaterials, polymers, drug release and surface functionalization, as well as cover hot topics within the clinical workflow such as immediate implant placement, immediate restoration and the digital workflow.

The main topics of this Special Issue include, but are not limited to, the following:

Advances in substrate materials, e.g., metal, bioceramics, polymers, and composites;
Macro-/micro-implant surface modifications;
Surface functionalization (e.g., drug release, hormones, immobilized antibacterial agents, antimicrobial peptides);
Degradable and non-degradable alloplastic bone substitute biomaterials (biomaterial scaffolds, oral tissue engineering and bone regeneration);
Loaded bioscaffolds (and implant regenerative medicine/in bone reconstruction/regeneration);
Individualized/customized implant fabrication/reconstruction (CAD/CAM) including 3D printing;
Clinical workflow: immediate implant placement, immediate loading/restoration, digital workflow, and bone management.

Dr. Dominik Kraus
Prof. Dr. Norbert Enkling
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-anonymized peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Functional Biomaterials is an international peer-reviewed open access monthly journal published by MDPI.

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

oral implants
implant surface modifications
surface functionalization
biomaterials
clinical workflow
bone regeneration
soft tissue integration

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Related Special Issues

Advanced Biomaterials and Oral Implantology in Journal of Functional Biomaterials (12 articles)
Advanced Biomaterials and Oral Implantology—2nd Edition in Journal of Functional Biomaterials (6 articles)

Published Papers (9 papers)

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Research

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17 pages, 8126 KB

Open AccessArticle

Implants in Adolescents: Clinical Outcomes After Growth-Pattern-Adapted Implant Placement

by Felix Tetsch, Milan Stoilov, Dominik Kraus, Michael Marder, Jan Tetsch and Norbert Enkling

J. Funct. Biomater. 2026, 17(7), 332; https://doi.org/10.3390/jfb17070332 - 9 Jul 2026

Viewed by 559

Abstract

(1) Background: Dental implants in adolescents remain controversial. This retrospective study aimed to evaluate the esthetic outcome of implants placed during adolescence using a growth-pattern-adapted concept, with implant survival, peri-implant health, and patient satisfaction as secondary outcomes. (2) Materials and methods: Primary implant survival was retrospectively evaluated based on treatment records in 305 patients (612 implants) affected by tooth loss or congenital tooth agenesis. A subgroup of 68 anterior maxillary implants (50 patients, mean age at implantation: 16.2 ± 2.3 years; range: 12–20) were clinically re-examined after a mean follow-up of 92.4 ± 61.2 months (range: 36–288). (3) Results: Primary implant survival was 93.8% overall (tooth loss: 97.7%; tooth agenesis: 92.3%). The clinical follow-up cohort showed no cases of peri-implantitis and patient satisfaction was high. Anterior maxillary implants demonstrated favorable esthetic outcomes (Pink Esthetic Score [PES]: 12.0 ± 1.1), with females exhibiting significantly higher scores than males. Vertical discrepancies between the implant crown and the contralateral tooth were observed in 41.2% of implants (infraocclusion: 32.4%; supraocclusion: 8.8%). They were significantly associated with tooth loss, non-mesofacial growth patterns and younger age at implantation, without significant influence on PES. (4) Conclusions: The growth-pattern-adapted implant placement met the predefined esthetic threshold and resulted in high primary implant survival, stable peri-implant health, and high satisfaction, supporting its feasibility for anterior maxillary implant placement during adolescence. Full article

(This article belongs to the Special Issue Advanced Biomaterials and Oral Implantology—3rd Edition)

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23 pages, 6589 KB

Open AccessArticle

Comparative In Vitro Evaluation and Osteogenic Mechanisms of Representative Bone Graft Substitutes: Bioactive Glass, Beta-Tricalcium Phosphate, and Deproteinized Bovine Bone

by Jianhang Yuan, Zimeng Li, Ziwei Dai, Yingyue Chai, Zixuan You, Shang Xie, Yifan Kang, Xiaofeng Shan and Zhigang Cai

J. Funct. Biomater. 2026, 17(7), 312; https://doi.org/10.3390/jfb17070312 - 26 Jun 2026

Viewed by 691

Abstract

Objectives: Autologous bone grafting remains the gold standard for maxillofacial reconstruction but is limited by tissue scarcity and donor-site morbidity. Consequently, substitutes like bioactive glass (BG), beta-tricalcium phosphate (β-TCP), and deproteinized bovine bone (DBB) are widely used. However, comprehensive mechanistic comparisons among them remain scarce. Materials and Methods: We systematically evaluated these substitutes under standardized in vitro conditions to compare their physicochemical transformations, degradation profiles, biological performances, and underlying osteogenic molecular pathways. Results: In simulated body fluid, BG underwent rapid hydroxyapatite mineralization, whereas the highly porous DBB and dense β-TCP remained structurally inert. Degradation assays revealed BG exhibited the fastest mass loss and ion release, β-TCP showed intermediate degradation, and DBB maintained high in vitro structural stability. Biologically, all materials showed favorable cytocompatibility and comparable angiogenic potential. However, BG demonstrated significant antibacterial activity (E. coli, S. aureus) and a strong potential to enhance osteogenic differentiation, significantly upregulating the protein-level expression of RUNX2 and OCN, alongside the transcriptional upregulation of Bmp2, Runx2, and Ocn. Transcriptomic profiling and pharmacological validation suggest that the enhanced osteogenic performance of BG might be associated with specific regulatory pathways, supporting the hypothesis that the suppression of NF-κB-mediated inflammation and the activation of the ECM-Integrin-FAK mechanotransduction axis play potential roles. Conclusions: BG offers high bioactivity and notable potential to enhance osteogenic differentiation in vitro but degrades rapidly. DBB ensures structural durability without intrinsic osteoinductivity, and β-TCP provides a balanced, intermediate profile. These in vitro mechanistic insights provide a theoretical foundation for future in vivo evaluations and designing next-generation bone scaffolds. Full article

(This article belongs to the Special Issue Advanced Biomaterials and Oral Implantology—3rd Edition)

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13 pages, 1569 KB

Open AccessArticle

Evaluation of the Effects of Implants with Different Geometries on the Inferior Alveolar Nerve Under Occlusal Stresses

by Dilan Karahan and İhsan Çağlar Çinar

J. Funct. Biomater. 2026, 17(6), 283; https://doi.org/10.3390/jfb17060283 - 6 Jun 2026

Viewed by 644

Abstract

Dental implant placement in the posterior mandible can be challenging due to the presence of the inferior alveolar nerve (IAN). Biomechanical factors related to implant design and loading may also influence nerve compression. This study aimed to investigate the influence of implant geometry, diameter, length, and implant–canal distance on IAN pressure. Dental implants with two geometries (tapered and cylindrical), two lengths (8 and 12 mm), and two diameters (3.3 and 4.1 mm) were virtually positioned at three implant–canal distances (0.5, 1.0, and 1.5 mm). A total of 24 finite element models were generated. Functional occlusal loading was simulated using a 300 N vertical force and a 100 N oblique force applied at a 45° angle. The resulting IAN pressure values were determined. The implant diameter affected IAN pressure, with 3.3 mm implants yielding higher values than 4.1 mm implants. Longer implants exhibited lower pressure values than shorter implants. Cylindrical implants generated higher pressure than tapered implants. Increasing the implant–canal distance from 0.5 to 1.5 mm reduced nerve pressure. Vertical loading yielded higher pressure values than oblique loading. The implant–canal distance was the primary factor influencing IAN pressure. Implant diameter and geometry had secondary effects, whereas implant length had a limited influence. These findings highlight the importance of implant planning and design selection to reduce load transfer to the IAN. Full article

(This article belongs to the Special Issue Advanced Biomaterials and Oral Implantology—3rd Edition)

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27 pages, 10821 KB

Open AccessArticle

Evaluation of the Effectiveness of the Socket Preservation Technique Using Allogeneic and Xenogeneic Materials: A Randomized Controlled Trial

by Piotr Wróbel, Magdalena Jędzierowska, Adam Piecuch, Michał Bąk, Jakub Adamczyk, Piotr Pławecki, Piotr Mojżesz, Kacper Wachol, Sylwia Wójcik, Martin Starosta, Armand Cholewka and Tadeusz Morawiec

J. Funct. Biomater. 2026, 17(6), 262; https://doi.org/10.3390/jfb17060262 - 29 May 2026

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Abstract

Background: The socket preservation technique involves filling the bone defect that occurs after a tooth is extracted with bone substitute material. This procedure helps to minimize bone resorption of the alveolar ridge following extraction. Various bone substitute biomaterials can be used for augmentation, including autogenous, allogeneic, and xenogeneic options. This study aimed to assess changes in alveolar ridge dimensions and variations in radiographic bone density in sockets grafted with two distinct biomaterials. Furthermore, bone biopsies collected from the grafted sites were subjected to histological analysis. Methods: Forty generally healthy patients were enrolled in the study and split into four equal groups. The first and third groups underwent first or second maxillary premolar extraction and received treatment with an allogeneic material (BIOBank®, Biobank, Paris, France), while the second and fourth groups underwent first or second mandibular molar extraction and were treated with a xenogeneic material (Geistlich Bio-Oss®, Geistlich Pharma AG, Wolhusen, Switzerland). Following tooth extraction, the appropriate biomaterial was inserted into the socket. It was covered with a collagen membrane (Geistlich Bio-Gide®, Geistlich Pharma AG, Wolhusen, Switzerland) and stabilized with sutures, which were removed seven to ten days after the procedure. Micro-CBCT scans were conducted to evaluate the dimensions of the alveolar ridge and the radiographic density of the grafted socket at 7–10 days and 6 months after the procedure. A bone trepanobiopsy was performed concurrently with implant placement six months after socket preservation. The obtained biopsy was analyzed histologically using hematoxylin and eosin (H&E) and Masson’s trichrome staining. Results: There was no statistically significant difference in alveolar ridge height or width preservation between allogeneic and xenogeneic biomaterials. After six months of healing, sockets grafted with both materials exhibited greater radiographic bone density, with significantly greater density observed in the xenograft group. Conclusions: The findings of this study suggest that the two biomaterials are comparable in their effectiveness at maintaining the dimensions of the alveolar ridge. However, the quality of the newly formed bone may differ depending on the type of biomaterial used. Full article

(This article belongs to the Special Issue Advanced Biomaterials and Oral Implantology—3rd Edition)

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12 pages, 2673 KB

Open AccessArticle

Additive vs. Subtractive Manufacturing of Zirconia: Influence on Surface Properties, Cell Viability, and Streptococcus mutans Adhesion

by Ülkü Tuğba Kalyoncuoğlu, Nurten Baysal, Gulcin Akca, Simel Ayyıldız and Burak Yilmaz

J. Funct. Biomater. 2026, 17(4), 162; https://doi.org/10.3390/jfb17040162 - 1 Apr 2026

Viewed by 842

Abstract

The surface characteristics of zirconia may influence both soft tissue response and bacterial colonization. This study evaluated the surface roughness and water contact angle of zirconia fabricated by additive manufacturing (material jetting, NPJ) and subtractive manufacturing (milling), and investigated human gingival fibroblast (HGF-1) viability and Streptococcus mutans (S. mutans) (ATCC 25175) adherence on these surfaces, as well as the possible correlation between roughness and bacterial adhesion. Sixty-four zirconia specimens (1 × 1 × 0.1 cm) were fabricated (n = 32 per group), sintered, and standardized by abrasive polishing. Surface roughness and contact angle were measured. Cell viability was assessed using an MTT assay at 24, 48, and 72 h. Bacterial adhesion was quantified after 24 and 48 h of incubation. Data were analyzed using two-way ANOVA, independent t-tests, and Pearson correlation (α = 0.05). No significant differences in HGF-1 viability were observed at 24 and 48 h; however, at 72 h, subtractively manufactured zirconia demonstrated higher cell viability than additively manufactured specimens (p < 0.001). S. mutans adhesion was significantly greater on additively manufactured zirconia at 24 h (p = 0.002), with no significant difference at 48 h. Manufacturing technique influenced surface properties and early bacterial adhesion. Both materials exhibited acceptable biocompatibility within the tested conditions. Full article

(This article belongs to the Special Issue Advanced Biomaterials and Oral Implantology—3rd Edition)

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11 pages, 1728 KB

Open AccessArticle

Tetracalcium Phosphate Graft for Implant Stabilization: Resonance Frequency and Histomorphometric Analysis in a Sheep Tibia Model

by Dogac Mevlut Saltan, Nazlı Ayşeşek, Volkan Arısan and Selim Ersanlı

J. Funct. Biomater. 2026, 17(2), 69; https://doi.org/10.3390/jfb17020069 - 29 Jan 2026

Viewed by 664

Abstract

Background: This study aimed to evaluate the effects of tetracalcium phosphate (TTCP) graft material on the stability and osseointegration of dental implants placed in anatomically compromised bone. Materials and Methods: Six healthy sheep were used following ethical approval. Osteotomies were created in the tibial region and divided into three groups: Group A (control, n = 12) with standard osteotomy; Group B (n = 12) with enlarged and deepened osteotomy; and Group C (n = 36), where osteotomy sites were filled with TTCP prior to implant placement. Implant stability was measured using the resonance frequency analysis (RFA), and osseointegration was evaluated histologically by bone-to-implant contact percentage (BIC%). Animals were sacrificed at the 3rd and 6th weeks for histological analysis. Results: Initial RFA values exceeded 42.5 in all groups. Group C demonstrated the highest RFA at Week 6 (79) and significantly higher RFA values at Week 3 compared to other groups, while Group B consistently showed the lowest stability. At Week 3, Group A exhibited the highest BIC% (28.04 ± 5.05%). By Week 6, BIC% increased in all groups, with no significant intergroup differences. Robust ANOVA revealed significant effects of time and group on both RFA and BIC%. Conclusions: TTCP significantly enhanced implant stability and osseointegration in compromised bone, providing improved secondary stability and suggesting its potential clinical benefit in challenging anatomical conditions. Full article

(This article belongs to the Special Issue Advanced Biomaterials and Oral Implantology—3rd Edition)

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15 pages, 5359 KB

Open AccessArticle

Biomechanical Evaluation of a Novel Non-Engaging Abutment and Screw in Internal Implant Systems: Comparative Fatigue and Load Testing

by Su-Min Cho, Soo-Hwan Byun, So-Yee Ahn, Hyun-Sook Han, Sung-Woon On, Sang-Yoon Park, Sang-Min Yi, In-Young Park, Byoung-Eun Yang and Lee-Kyoung Kim

J. Funct. Biomater. 2025, 16(3), 107; https://doi.org/10.3390/jfb16030107 - 19 Mar 2025

Cited by 4 | Viewed by 4698

Abstract

Dental implants rely on precise prosthetic design and biomechanical stability to ensure long-term success. This study evaluates the mechanical performance of non-engaging abutments in multi-unit combined screw- and cement-retained prostheses (CSCRP) using two internal implant systems: the BlueDiamond (BD) and AnyOne (AO) systems. Unlike conventional implant systems that utilize the same type of screw for both engaging and non-engaging abutments, the BD system employs a distinct screw design for non-engaging abutments. A total of 80 implants were tested, with 40 in each group. Mechanical testing included static compressive load and fatigue tests following ISO 14801 standards. The BD system demonstrated significantly higher compressive strength (326.32 kgf vs. 231.82 kgf, p < 0.001) and 23.4% greater fatigue strength compared to the AO system. Precision fit analysis confirmed no significant deformation, microcracks, or fractures after 5 million loading cycles. These findings suggest that the BD system’s unique screw design for non-engaging abutments contributes to improved mechanical performance and durability. Further clinical studies are needed to assess the long-term implications of this design on prosthetic stability and implant longevity. Full article

(This article belongs to the Special Issue Advanced Biomaterials and Oral Implantology—3rd Edition)

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19 pages, 6726 KB

Open AccessArticle

Intraoperative Profiling of the Supracrestal Implant Complex Minimizes Peri-Implant Crestal Bone Remodeling: The Guided Bone Profiling Concept

by Milan Stoilov, Joerg Winterhoff, Lea Stoilov, Anastasia Timoschenko, Helmut Stark, Florian Heuser, Michael Marder, Dominik Kraus and Norbert Enkling

J. Funct. Biomater. 2025, 16(3), 93; https://doi.org/10.3390/jfb16030093 - 8 Mar 2025

Cited by 1 | Viewed by 2983

Abstract

(1) Background: Early-stage bone resorption following implant placement can significantly impact the long-term success of implants. This study evaluates whether a fully digitally planned implant position based on the E-point concept, along with guided profiling of the supracrestal complex, contributes to improved stability of peri-implant bone levels. (2) Methods: 29 implants were placed in 27 patients utilizing both immediate (Group 1; n = 19) and delayed placement (Group 2; n = 10) protocols. Implant position and emergence profile were preoperatively determined and consistently executed through guided surgery and CAD/CAM-fabricated restorations. Due to the subcrestal positioning of the implant, a corresponding bone profiler with a guide pin was used to shape the emergence profile and prevent the provisional restoration from impinging on the proximal bone. Provisional restorations were immediately placed to support the emergence profile. Bone level changes were documented radiographically over a two-year period. The first Bone-to-Implant Contact Level (∆ fBIC), change in highest approximal Bone Level (∆ haBL), and formation of an emergence profile width (WEP) were measured. (3) Results: All implants and restorations survived after two years, no significant change in first Bone-to-Implant Contact Level (∆ fBIC = 0 ± 0.02 mm), no change in highest approximal Bone Level (∆ haBL) of −0.23 mm ± 0.71 mm, and formation of an emergence profile width (WEP) averaging 0.18 ± 0.19 mm. (4) Conclusions: Despite the initial stress on the bone caused by bone profiling, guided implant placement and bone shaping, supported by an immediate provisional, have a positive effect on peri-implant bone stability. Full article

(This article belongs to the Special Issue Advanced Biomaterials and Oral Implantology—3rd Edition)

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Review

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25 pages, 660 KB

Open AccessReview

Magnesium-Based Membrane for Alveolar Ridge Regeneration—A Scoping Review

by Dragana Gabrić, Yuval Reiser, Ivica Pelivan, Igor Smojver and Luka Marković

J. Funct. Biomater. 2026, 17(6), 293; https://doi.org/10.3390/jfb17060293 - 12 Jun 2026

Viewed by 791

Abstract

Magnesium-based membranes are promising biomaterials for guided bone regeneration due to their unique properties of mechanical strength, biocompatibility, and controlled biodegradation. This scoping review aimed to map and synthesize the available evidence regarding the use of magnesium-based membranes and fixation screws in alveolar ridge regeneration and guided bone regeneration procedures. Relevant studies were identified through a literature search conducted from November 2025 to May 2026, using several databases following the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews guidelines. Thirty-nine studies met the inclusion criteria, including in vitro studies, preclinical animal studies, clinical case reports and case series, and narrative or systematic reviews. In vitro studies demonstrated cytocompatibility and fibroblast adhesion, while moderate magnesium ion concentrations increased markers of osteogenic differentiation. Preclinical animal studies reported controlled degradation, biocompatible tissue responses, maintenance of barrier function during early healing, and findings suggesting potential osteogenic stimulation. Clinical evidence, limited to case reports and small case series, described the use of magnesium membranes in horizontal and vertical ridge augmentation, sinus lift procedures, immediate dentoalveolar regeneration, periodontal defects, and cystic lesions, with generally uneventful healing outcomes and preserved bone volume. Reported complications were mainly minor and included transient soft tissue reactions, membrane exposure, and localized gas cavity formation. However, the available evidence remains limited to low-level studies without controlled clinical trials. Current findings are insufficient to establish clinical efficacy or superiority over conventional membranes, highlighting the need for larger prospective controlled studies. The review’s findings could help researchers advance the understanding of bone regeneration and help develop new strategies to improve and further investigate bone regeneration. Full article

(This article belongs to the Special Issue Advanced Biomaterials and Oral Implantology—3rd Edition)

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