Search Results (77)

Orthognathic surgery restores functional balance and facial esthetics in patients with dentofacial deformities. The use of adjunctive facial implants—made from materials such as porous polyethylene, titanium, or polyetheretherketone (PEEK)—has increased to enhance contour and projection, although standardized guidelines for their selection and integration remain scarce. Following PRISMA-ScR guidelines, a systematic search of PubMed, Scopus, Embase, and LILACS identified studies reporting facial implants placed concomitantly with orthognathic surgery. Eligible studies included case reports, case series, observational studies, clinical trials, and reviews involving human patients, without language or date restrictions. Seventeen studies published between 1998 and 2025 met the inclusion criteria, comprising retrospective and prospective designs, case series, and one technical note. Implants were used in the malar, infraorbital, paranasal, chin, mandibular body, and angle regions. Materials included PEEK, porous polyethylene, silicone, hydroxyapatite, polymethylmethacrylate, and titanium. PEEK was mainly used for patient-specific implants, while porous polyethylene was commonly used as stock implants. Follow-up time, outcome reporting, and study design varied widely, reflecting substantial methodological heterogeneity and predominantly observational evidence. As a result, outcomes were primarily reported qualitatively, limiting comparative assessment and long-term inference. Overall, the available literature suggests that alloplastic facial implants may serve as useful adjuncts to orthognathic surgery for contour enhancement, with outcomes influenced by implant design, surgical expertise, fixation, and soft tissue conditions. However, the current evidence base remains limited, underscoring the need for standardized outcome measures, comparative studies, and longer follow-up to better inform clinical decision-making and future research. Full article

Methods: Currently available randomized controlled clinical trials (RCTs) reporting on the adjunctive clinical effects of biomaterials, grafting materials, and grafting techniques on immediate implant placement (IIP) were systematically assessed. Data were qualitatively analyzed and, when appropriate, meta-analysis was performed. Risk of bias and quality of evidence were evaluated using the Cochrane RoB 2 tool and the GRADE framework, respectively. Results: A total of 12 RCTs (484 implants, 6–36 months of follow-up) were included and consistently reported high implant survival rates (96–100%). Data on the use of xenografts, alloplastic and mixed grafts, connective tissue grafts and socket shield technique seem, to different extents, to demonstrate favorable results in terms of peri-implant hard and soft tissue dynamics and esthetic outcomes. Quantitative synthesis conducted on four RCTs demonstrated significantly higher short-term patient-reported postoperative pain, assessed on a 0–100 Visual Analog Scale (VAS) (weighted mean difference 19.45 mm; 95% CI 0.55–38.36; p = 0.04). Most RCTs were rated at moderate to high risk of bias, and certainty of evidence was low to moderate. Conclusions: Regardless of the use of adjunctive materials/approaches, IIP guarantees high implant survival rates. Although different adjunctive strategies to IIP may favor hard and soft tissue stability, they appear to increase short-term patient-reported morbidity. Currently available evidence lacks standardized and patient-centered outcome reporting. Full article

Background: To compare the histological and histomorphometrical outcomes after sinus floor elevation using an anorganic bovine bone biomaterial or a biphasic calcium phosphate biomaterial. Material and Methods: Patients who needed maxillary sinus elevation were included in this study. A total of 68 implant sites were evaluated from a total of 42 patients. Twenty patients were treated with anorganic bovine bone, while 22 were treated with biphasic calcium phosphate biomaterial. Morphological and morphometrical studies were performed on the bone samples collected during implant placement. Results: Both biomaterials induced similar relative areas of mineralized tissue overall, particularly if only the area of grafted bone was considered. In turn, a higher proportion of non-mineralized tissue was observed in cases of biphasic calcium phosphate biomaterial with less area of remnant biomaterial particles. None of the implants failed at one year of follow-up. Conclusions: Although both biomaterials induce a similar amount of bone formation, the histopathological characteristics of the grafts are different, with a greater proportion of scar connective tissue with the biphasic calcium phosphate biomaterial. Full article

Regeneration of jawbone defects poses major challenges. The combination of dental pulp stem cells (DPSCs) or DPSC-derived extracellular vesicles (EVs) with bone substitute materials shows promising potential for bone tissue engineering in vitro. This study evaluated the in vivo bone regeneration potential of DPSCs and EVs with bone graft substitutes in a novel intrabony defect model. DPSCs were isolated from 35 male Sprague–Dawley rat incisors, and EVs were collected from the cell culture medium. DPSCs were seeded onto alloplastic and xenogeneic bone graft materials and implanted into bone defects. Control groups received bone substitutes without DPSCs or EVs. Micro-computed tomography (µCT) was performed at 12 and 24 weeks post-implantation to assess bone volume (BV), bone density (BD), trabecular thickness (Tr.Th), bone growth rate (BGR), and bone-to-mineral ratio (BMR). Both graft types increased BV and BD, with no significant differences between them. Tr.Th increased across all treatments after 24 weeks, indicating ongoing bone remodeling. Notably, xenogeneic grafts combined with DPSCs and EVs significantly improved BGR (p = 0.034) and BMR (p = 0.021) compared to alloplastic grafts with DPSCs. Xenogeneic bone grafts combined with DPSCs and EVs appear to be a promising approach for bone regeneration of alveolar bone defects. Full article

Background: Tooth extraction is often accompanied by bone tissue loss. This systematic review aims to compare osteoplastic materials for socket preservation. Methods: This systematic review was carried out with the PRISMA statement. To identify relevant studies, a thorough literature search was executed in several databases, such as Medline, PubMed, Scopus, and the Cochrane Central Register of Controlled Trials. The inclusion criteria were restricted to randomized controlled trials, and their methodological quality was evaluated with the Cochrane Risk of Bias tool (ROB 2). Results: Based on the predefined inclusion and exclusion criteria, nine randomized clinical trials published before 2024 were selected for analysis, all of them investigating the application of osteoplastic materials. Six studies performed xenogenic bone augmentation; one of them compared alloplastic and xenogenic materials; two studies described synthetic osteoplastic materials; and one described autogenic bone material. Conclusion: Socket augmentation with osteoplastic materials demonstrates effectiveness in preserving alveolar ridge dimensions and creating favorable conditions for further implant placement, though differences in clinical performance highlight the need for careful material selection. Full article

Background: In atrophic posterior maxillary regions, sub-antral surgery is often used for rehabilitation with implants. In order to stimulate bone regeneration, autogenous, xenogenic, alloplastic and platelet-rich fibrin (PRF) grafts are commonly used. Aim: To assess the effectiveness of PRF alone or combination with synthetic bone substitutes on bone formation, implant stability, and survival in sub-antral surgery. Materials and Methods: A literature review was carried out from September 2024 to April 2025, according to PRISMA guidelines using the PubMed, Cochrane Library, Wiley, ScienceDirect, and Web of Science databases. From a total of 601 articles identified, 11 met the inclusion criteria and were selected for analysis. Results: PRF in combination with synthetic materials has shown potential benefits, especially in increasing biomechanical stability and bone formation. Although, most studies have not reported statistically significant differences when comparing the use of synthetic material alone against its combination with PRF. Discussion: The use of synthetic grafts in combination with PRF has become increasingly common in sub-antral implant procedures. PRF promotes angiogenesis, osteoprogenitor cell differentiation and bone regeneration, favouring the healing and remodelling process of the tissues, as well as greater stability and longevity of the implant. Conclusions: The combination of PRF with synthetic bone grafting shows promising results; however, further studies are needed to confirm the efficacy of PRF in maxillary sinus grafts in conjunction with the use of biomaterials. Full article

The reconstruction of a severely resorbed alveolar bone is a significant challenge in dental implantology and maxillofacial surgery. Traditional bone grafting materials, including autogenous, allogeneic, xenogeneic, and alloplastic materials, have limitations such as donor site morbidity, limited availability, and prolonged maturation periods. To address these challenges, recombinant human bone morphogenetic protein-2 (rhBMP-2) has emerged as a potent osteoinductive factor that facilitates bone regeneration without the need for additional donor site surgery. This study introduces a box technique which combines rhBMP-2 (CowellBMP^®, Cowellmedi, Busan, Republic of Korea) with a 3D-preformed titanium mesh (3D-PFTM), utilizing a mixture of allografts and xenografts for horizontal and vertical alveolar ridge augmentation. The technique leverages the structural stability provided by the OssBuilder^® (Osstem, Seoul, Republic of Korea), a preformed titanium mesh, that allows for simultaneous implant placement and vertical ridge augmentation. This technique not only reduces the treatment time compared to traditional methods but also minimizes post-operative discomfort by eliminating the need for autogenous bone harvesting. Clinical outcomes from this technique demonstrate successful bone regeneration within a shorter period than previously reported techniques, with excellent bone quality and implant stability being observed just four months after vertical augmentation. In conclusion, the so called BOXAM (BMP-2, Oss-builder, Xenograft, Allograft, Maintenance) technique presents a promising therapeutic strategy for alveolar bone reconstruction, particularly in cases of severe bone resorption. Further studies are needed to evaluate the long-term outcomes and potential limitations of this approach, especially in scenarios where the inferior alveolar nerve proximity poses challenges for fixture placement. Full article

Facial reconstruction presents complex challenges due to the intricate nature of craniofacial anatomy and the necessity for individualized treatment. Conventional reconstructive methods—such as autologous bone grafts and prefabricated alloplastic implants—pose limitations, including donor site morbidity, implant rejection, and suboptimal aesthetic results. The emergence of 3D printing technology has introduced patient-specific implants (PSIs) that enhance anatomical fit, functional restoration, and biocompatibility. This review outlines the evolution of 3D-printed implants, key materials, computer-assisted design (CAD), and their applications across trauma, oncology, congenital conditions, and aesthetics. It also addresses current challenges and explores future directions, such as bioprinting, smart implants, and drug-eluting coatings. Full article

Objective: A peri-implant gap or a “jumping gap” between an implant surface and the buccal bone can often complicate the successful integration of dental implants, impairing osseointegration and long-term implant stability. Although various techniques and materials are available for managing this gap, there is no consensus on the most effective approach. The current literature lacks standardized, evidence-based guidelines for selecting the optimal technique or material for managing peri-implant gaps, especially following immediate implant placement. This systematic review aims to evaluate the efficacy of various techniques and materials to manage the peri-implant gap to improve the implant stability, bone preservation, and esthetic outcomes using the PROSPERO registration number CRD42024508852. Methods: A comprehensive search of the MEDLINE, Embase, and Cochrane databases was conducted, and various studies were selected, including 11 randomized clinical trials that investigated different grafting materials and techniques for managing the gap between the implant and the buccal plate. The selected studies were assessed for the risk of bias, and the data were extracted based on primary outcomes such as implant stability, bone density, and esthetic parameters. Results: The findings indicate that xenografts and alloplastic grafts were superior in preserving bone volume compared to platelet-rich fibrin. Techniques like the socket shield and immediate provisional prothesis methods showed promise in maintaining soft tissue and bone integrity. However, heterogeneity across the studies limits definitive conclusions. Conclusions: Further high-quality research is needed to establish standardized guidelines for peri-implant gap management. The selection of techniques and materials should be tailored to individual patient needs. Full article

Gorlin-Goltz syndrome (GGS) is also known as Nevoid basal cell carcinoma syndrome (NBCCS). In the most common manifestation, GGS is diagnosed based on multiple cysts in the jaw bones, namely OKCs (odontogenic keratocysts). Other features might include major and minor clinical and radiological criteria to confirm this syndrome. Quite commonly, BCCs (basal cell carcinomas), bifid ribs, palmar and plantar pits, and ectopic calcification of the falx cerebri can be found in the majority of patients. Currently, the mutation of the PTCH1 gene seems to be responsible for GGS occurrence, while the male-to-female ratio is 1:1. The following radiological study based on OPGs and CBCT confirmed multiple cystic lesions in jaw bones, confirmed to be OKCs in the histopathological evaluation with an occurrence of numerous skin BCC lesions. In cases of most oral OKC cystic lesions, either surgical removal, curettage, or enucleation with or without any bone grafting can be used with a good amount of success. Rarely, some stable bone osteosynthesis procedures have to be carried out to avoid pathological bone fractures after cyst removal. A special consideration should include the temporomandibular joint. TMJ surgery and the replacement of the joint with an alloplastic material can be performed to improve biting, chewing, proper mouth opening, and maintain good patient occlusion. The authors want to present how effective and simple a standard dental panoramic radiograph combined with CBCT is and how it is suitable for GGS detection. They also want to underline how a standard TMJ prosthesis can be used as an alternative to a custom-made prosthesis. Full article

Background: Sinus-lift (SL) is a pre-prosthetic procedure with the objective of increasing bone height to achieve implant insertion primary stability in implant-supported prostheses. The biomechanical properties of SL augmentation materials are influenced by their origin, manufacture, bioactive substances addition, receiver, and surgical procedure. This systematic review provides insights into state-of-the-art SL biomaterials, focusing on autologous bone grafting as the gold standard. Methods: The study followed the PRISMA flow diagram, searching WoS (Web of Science), Embase, Cochrane, and PubMed databases using the search terms «sinus lift» OR «sinus augmentation» OR «bone graft» OR «bovine» OR «porcine» OR «autologous» OR «allogenic» OR «xenogeneic» OR «alloplastic» OR «hydroxyapatite» OR «β-tricalcium phosphate (β-TCP)» OR «equine» OR «PRF». Results: The highest bone gain was provided by Bioglass at 42%. Articles written between 2014 and 2024 in English or French, containing human studies and with full text available, were included. Participants were required to be in good general health, without acute, chronic, or congenital diseases, or substance abuse (drugs, alcohol, or nicotine). SL surgery was performed using the lateral approach, with no Schneiderian membrane perforation or postoperative complications. The network meta-analysis was conducted using the R statistical computing environment. To assess the inconsistency between direct and indirect evidence, we used a net heat plot. To evaluate heterogeneity across studies, we used the chi-squared-based Q-test and I² statistic. A significance level of 0.05 was applied throughout all analyses. Results: Allogeneic bovine bone and hydrox yapatite demonstrated the lowest resorption rates. Significant differences were found for residual graft and connective tissue between allogenous bovine bone (ABB) + AlB vs. β-TCP + PRF (p = 0.028); ABB + AlB vs. β-TCP (p = 0.034); ABB + AlB vs. BCP (p = 0.037). Meta-analysis showed that the overall heterogeneity was 51.8% (6.9–75%; p = 0.019), with significant heterogeneity within designs (p = 0.007) and no significant heterogeneity between designs (p = 0.39). AB had a better bone regeneration ratio compared to many of the other interventions, but only two passed the threshold of significance: A1B and B-TCP + AB. Conclusions: A grafting material’s superiority is determined by its new bone formation ratio, connective tissue integration, residual graft content, and bone resorptionratio. Although autologous bone grafting has exhibited superior bone regeneration compared to other biomaterials, it was not favored due to its unpredictable connective tissue concentration and bone resorption ratio. Additionally, autologous bone exhibited the fastest metabolic turnover among all grafting materials. Full article

Background/Objectives: Regenerative periodontal therapy is a treatment method that focuses on restoring the periodontium affected by chronic inflammatory disease or injury. It involves using different biomaterials and techniques to completely restore the periodontal structures. The main objective was to identify and critically evaluate relevant studies comparing the clinical efficacy of allograft and alloplastic materials in regenerative periodontal therapy. Methods: For evaluation, a systematic review based on PRISMA guidelines was conducted. Data were extracted using only specific types of study designs, which included randomized controlled trials, cohort studies, and case-control studies. Target patients with periodontal disease or periodontal lesions undergoing periodontal therapy using allograft or alloplastic materials were selected. Periodontal parameters such as clinical attachment level, probing pocket depth, radiographic bone fill, or patient-reported outcomes were analyzed. Results: The results showed that allograft and alloplastic materials offered reduced pocket depth, a gain in clinical attachment, and bone repairment. The variation observed indicated that allografts showed a slightly more significant clinical attachment gain and a superior bone fill than alloplastic ones, suggesting that allografts enhance osteogenesis and provide a greater capacity for repair in periodontal defects. Conclusions: The results of the present study suggest that allograft and alloplastic materials offered reduced pocket depth, a gain in clinical attachment, and bone repairment, with both methods having similar clinical efficacy. Full article

Background: Children make up a large percentage of those affected by burns worldwide, with most of them suffering from severe injuries that necessitate skilled medical attention. Despite medical progress, there is still no ideal dressing for the treatment of burn wounds in children. The aim of the study was to assess the impact of epidermal substitutes in the treatment of burn wounds in children. Materials and Methods: This retrospective study evaluates the use of three dressings in the treatment of pediatric burns at a major Polish burn center. A patient database was used to identify children who received treatment with silver dressings, paraffin dressings or epidermal substitutes from 2009 to 2023. A demographic analysis was performed to collect the following information: causes of burns, procedural details and patient outcomes. Results: There were 439 patients aged between 1 month and 18 years. For severe burns, the number of interventions was lowest among children with epidermal substitute application (p = 0.039). Paraffin gauze resulted in the greatest number of skin grafts, whereas alloplastic replacement produced the least amount of transplantation (p < 0.005) regardless of the severity of the burn. Conclusions: Epidermal substitutes offer a good dressing option for burn wounds to improve their treatment and reduce the need for skin graft coverage. In the future, extended comparative or randomized trials are needed to confirm our results. Full article

Periodontal regeneration is a multifaceted therapeutic approach to restore the tooth-supporting structures lost due to periodontal diseases. This manuscript explores the intricate interactions between regenerative therapies and the oral microbiome, emphasizing the critical role of microbial balance in achieving long-term success. While guided tissue regeneration (GTR), bone grafting, and soft tissue grafting offer promising outcomes in terms of tissue regeneration, these procedures can inadvertently alter the oral microbial ecosystem, potentially leading to dysbiosis or pathogenic recolonization. Different grafting materials, including autografts, allografts, xenografts, and alloplasts, influence microbial shifts, with variations in the healing timeline and microbial stabilization. Biologics and antimicrobials, such as enamel matrix derivatives (EMD) and sub-antimicrobial dose doxycycline (SDD), play a key role in promoting microbial homeostasis by supporting tissue repair and reducing pathogenic bacteria. Emerging strategies, such as enzyme-based therapies and antifouling materials, aim to disrupt biofilm formation and enhance the effectiveness of periodontal treatments. Understanding these microbial dynamics is essential for optimizing regenerative therapies and improving patient outcomes. The future of periodontal therapy lies in the development of advanced materials and strategies that not only restore lost tissues but also stabilize the oral microbiome, ultimately leading to long-term periodontal health. Full article

Objective: Bone augmentation has become a significant practice in various areas of bone regeneration dentistry. This systematic review analyzes the research focused on evaluating bone substitute materials for the presence of contaminants. Methods: In June 2024, an extensive electronic search was conducted using renowned databases such as PubMed, Web of Science, and Scopus. Specific keywords employed in the search included ((bone AND (substitute) AND (remnants OR (purity)) OR ((graft AND tooth) AND (remnants OR purity)) OR ((graft AND dentin) AND (remnants OR purity)). The search adhered to the PRISMA protocol and the PICO framework. The review concentrated on the origin of bone substitute materials, the processing methods used for these materials, techniques for assessing purity, and types of contamination identified. A total of 594 articles were identified of which 22 met the criteria and were incorporated into the review. Results: Investigations into allogeneic and xenogeneic bone substitute materials have revealed that, despite manufacturers’ assurances of purity, some materials still contain contaminants. Sample analyses demonstrated the presence of donor cellular remains, cellular debris, intertrabecular fat, connective tissue, and collagen. Similarly, synthetically produced bone substitute materials (alloplastic materials) contained various impurities, such as polyvinyl alcohol (PVA), CaO phases, calcium-deficient HAp phases, oily substances containing carbon and silicone, cellulose derivatives, alpha-tricalcium phosphate (α-TCP), and heavy metals. Conclusions: Bone-derived and bone-like graft materials can contain various organic and inorganic impurities. Full article