Search Results (636)

Background/Objectives: Osteonecrosis of the femoral head is a progressive disease that frequently leads to femoral head collapse and secondary osteoarthritis. Although total hip arthroplasty provides reliable outcomes, its use in younger patients is limited due to concerns regarding implant longevity. Joint-preserving procedures such as core decompression have been widely used; however, their efficacy remains controversial. This study aims to evaluate a combined approach using arthroscopy-assisted core decompression and an osteoconductive bone substitute. Methods: This study is designed as a single-center, externally controlled trial conducted at Tohoku University Hospital. Patients with osteonecrosis of the femoral head (Japanese Investigation Committee Stage 1–3B, Type B–C2) will undergo arthroscopy-assisted core decompression combined with octacalcium phosphate/gelatin composite implantation. A total of 25 patients will be prospectively enrolled. Outcomes will be compared with a propensity score-matched historical control cohort. The primary outcome is disease progression within 1 year, defined as radiographic progression or conversion to total hip arthroplasty. Secondary outcomes include radiographic changes, clinical outcomes, and bone remodeling assessed by computed tomography. Expected Results: This study is expected to provide preliminary clinical evidence regarding the feasibility and potential effectiveness of arthroscopy-assisted core decompression combined with octacalcium phosphate/gelatin composite implantation for osteonecrosis of the femoral head. The intervention may promote bone remodeling and contribute to the prevention of femoral head collapse. Conclusions: The findings of this study may contribute to the development of improved minimally invasive joint-preserving treatment strategies for osteonecrosis of the femoral head and provide a basis for future large-scale clinical trials. Full article

Background: Dental ankylosis (DA) in growing patients leads to progressive infraocclusion and alveolar ridge deformities, compromising future implant rehabilitation. Decoronation has been proposed as a biologically driven alternative to extraction for preserving alveolar bone during growth. Objective: We aimed to evaluate the clinical outcomes of decoronation—alveolar ridge preservation, infraocclusion progression, implant site development, and the influence of treatment timing—in growing patients with ankylosed permanent anterior teeth. Methods: This systematic review was conducted in accordance with PRISMA 2020 guidelines. A comprehensive search of MEDLINE (EBSCO), EMBASE, Scopus, and Web of Science was performed (January 2006–May 2026), supplemented by grey literature screening. Eligible studies included clinical investigations reporting outcomes of decoronation in patients ≤18 years. Risk of bias was assessed using the Newcastle–Ottawa Scale (NOS) and Joanna Briggs Institute (JBI) checklist. Certainty of evidence was evaluated using the GRADE framework. Lastly, an inter-rater agreement was quantified using Cohen’s kappa coefficient. Results: Five studies (two retrospective cohorts and three case series) comprising 140 decoronated teeth with follow-up periods ranging from 1 to 30 years were included. A total of 78 records were identified across four databases; five studies met the eligibility criteria after duplicate removal and screening. Inter-rater agreement at the full-text eligibility stage was good (κ = 0.70). The overall risk of bias was low to moderate, and the certainty of evidence was rated as low using the GRADE framework. Vertical alveolar bone preservation or gain was consistently observed, particularly when decoronation was performed during the prepubertal or pubertal growth phases. The largest cohort (n = 103) reported substantial vertical bone gain when intervention occurred at a mean age of 13.0 years in girls and 14.6 years in boys. Infraocclusion stabilisation or improvement was reported across all studies. In contrast, horizontal ridge reduction persisted, with the only quantitative study reporting a mean bucco-palatal loss of 1.67 ± 1.12 mm (p = 0.004). No included study directly assessed implant placement outcomes. Overall, the certainty of evidence was low due to observational study designs, heterogeneity in outcome assessment, and absence of controlled comparators. Conclusions: Decoronation appears to be a promising strategy for preserving vertical alveolar bone and stabilising infraocclusion in growing patients with ankylosed teeth, particularly when performed before or during the pubertal growth phase. Evidence showed considerable bone height preservation, though horizontal ridge reduction persisted across cases. However, the certainty of evidence remains low because available studies are observational, heterogeneous, and lack direct extraction comparators. Therefore, high-quality prospective studies with standardised outcome measures and controlled comparisons are required to establish definitive clinical protocols. Participants underwent decoronation during childhood or adolescence (≤18 years); reported follow-up periods of up to 30 years reflect monitoring that extended into adulthood. Clinical significance: For clinical decision-making, decoronation should be considered once ankylosis with progressive infraocclusion is confirmed during active growth, ideally before the pubertal spurt; the decision should be guided by growth stage rather than chronological age, and clinicians should anticipate likely horizontal ridge reduction by planning for possible augmentation at implant placement and coordinating multidisciplinary follow-up until skeletal maturity. Full article

Background/Objectives: Patient-specific subperiosteal implants are increasingly used to treat severely atrophic ridges due to advances in digital planning and additive manufacturing. This study aimed to evaluate the effects of material type and implant configuration on stress distribution in subperiosteal implant systems and to compare their overall biomechanical performance using a multi-criteria decision framework. Methods: A three-dimensional model of a severely atrophic maxilla was reconstructed to simulate four clinical scenarios combining two configurations (one-piece and two-piece) and two materials (titanium and 60% carbon fiber-reinforced polyetheretherketone). Finite element analysis was conducted to assess stress distribution within the implant body, fixation screws, prosthetic framework, and surrounding bone under vertical and oblique loading conditions. Maximum and minimum principal stresses were evaluated in bone, whereas von Mises stresses were calculated for implant components. The resulting biomechanical indicators were subsequently integrated using an entropy weight–TOPSIS multi-criteria decision analysis. Results: Principal stresses in the surrounding bone showed minimal variation between titanium and 60% carbon fiber-reinforced polyetheretherketone across all configurations. Implant configuration had a more pronounced effect on implant body stress. Under oblique loading, the two-piece configuration demonstrated substantially higher implant stresses than the one-piece design, whereas under vertical loading, lower implant stresses were observed in the two-piece configuration. The multi-criteria analysis ranked the one-piece titanium model highest under oblique loading and the two-piece titanium model highest under vertical loading. Conclusions: Implant configuration and loading direction influenced biomechanical behavior more than material selection in patient-specific subperiosteal implants. Full article

Aiming at the technical bottleneck that traditional porous structures can hardly achieve mechanical load-bearing and acoustic regulation simultaneously, this study designs and fabricates three implicit surface porous structures (Gyroid, Diamond, Lidinoid) based on the bionic principle of trabecular bone. Experimental characterization and numerical analysis of their mechano-acoustic coupling performance are systematically carried out. Selective Laser Melting (SLM) technology is employed to realize the integrated forming of 316L bionic structures. Quasi-static compression experiments and finite element simulations are conducted to reveal the progressive deformation mechanism and energy absorption characteristics of different topological configurations. The results indicate that the Diamond structure exhibits the optimal comprehensive performance in terms of load-bearing capacity, specific energy absorption and isotropy. On this basis, the sound absorption and sound insulation performances of the structures are evaluated via an acoustic impedance tube test. The results show that the Diamond structure possesses a remarkably higher sound absorption coefficient and sound insulation value in the high-frequency range than other configurations, demonstrating excellent acoustic energy dissipation and sound wave isolation capability. The research indicates that the synergistic optimization of mechanical and acoustic performances can be achieved by regulating the Triply Periodic Minimal Surface (TPMS) topological configuration. Benefiting from its efficient stress transfer paths and intricate sound wave propagation channels, the Diamond structure realizes the coupling of high load-bearing capacity, superior energy absorption and favorable acoustic performance. This work provides a theoretical basis and technical support for the design of bionic porous structures in multifunctional scenarios such as bone implants and protective noise reduction. Full article

Background: Modern warfare has introduced novel mechanisms of injury, particularly drone-induced blast trauma, resulting in complex craniomaxillofacial injuries. These injuries differ substantially from typical ballistic wounds and require adapted surgical strategies. This study was conducted to evaluate the clinical characteristics, management approaches, and long-term outcomes of midfacial blast injuries. Methods: A retrospective analytical study was conducted on 41 patients with drone-induced midfacial blast injuries treated at a tertiary referral center in Armenia following the 2020 Nagorno-Karabakh War. All patients underwent surgical management after initial stabilization and were followed for 5 years. Clinical outcomes, complications, and reconstructive needs were assessed. Results: All patients presented with comminuted midfacial fractures, which were frequently associated with polytrauma (87.8%). Burns were observed in 82.9% of cases. Surgical management included radical debridement and early definitive osteosynthesis using titanium fixation systems. No cases of postoperative osteomyelitis, bone sequestration, or implant failure were observed during the 5-year follow-up period. Patients with extensive soft tissue defects, particularly nasal and lip amputations, required multiple reconstructive procedures. Long-term follow-up revealed progressive soft tissue thinning over titanium meshes, especially in the zygomatico-orbital region, necessitating secondary interventions such as lipofilling. Conclusions: Drone-induced midfacial blast injuries represent a distinct and severe form of trauma. Early definitive reconstruction following adequate debridement was associated with favorable outcomes. However, soft tissue reconstruction remains challenging and often requires staged procedures. Long-term follow-up is essential to manage delayed complications and optimize aesthetic outcomes. Full article

GLP-1 receptor agonists (GLP-1RAs) are widely used in the treatment of type 2 diabetes and obesity and are increasingly relevant in periodontal and implant practice. This review covers mechanisms, preclinical and early human evidence, and practical periodontal considerations; the structured database search is conducted in accordance with the Scale for the Assessment of Narrative Review Articles (SANRA) and the International Committee of Medical Journal Editors (ICMJE) principles. Two pathways explain GLP-1RAs’ relevance: indirect effects from better glycemic control, weight loss, and reduced inflammation; and direct tissue effects involving GLP-1R signaling and the GLP-1/dipeptidyl peptidase-4 (DPP-4) axis. Preclinical studies show reduced inflammation, osteoclast activity, and alveolar bone loss, along with improved periodontal stem cell function under hyperglycemia or inflammation via Nuclear Factor-kappaB (NF-kappaB), Wingless-related integration site (Wnt)/beta-catenin, and Mitogen-Activated Protein Kinase (MAPK) pathways. Animal studies on implants and local delivery, including exendin-4 platforms, suggest osteometabolic benefits. Human data are limited and mostly observational, and confounders include metabolic status, smoking, medication, and nutrition. Oral side effects such as xerostomia and dehydration are also noted. At present, GLP-1RA therapy should be regarded as a contextual modifier of periodontal risk and healing capacity rather than as a stand-alone periodontal therapy. Full article

Hydrogel scaffolds have emerged as instructive microenvironments for craniofacial tissue regeneration, moving beyond passive cell carriers toward platforms that regulate cell fate, vascularization, immune remodeling, and tissue-specific architecture. This review synthesizes hydrogel-associated strategies across dental pulp, periodontal ligament, gingival, bone marrow, jawbone, endothelial, oral mucosal, induced pluripotent stem cell (iPSC), extracellular vesicle (EV), exosome, secretome, and acellular systems. The evidence indicates that craniofacial hydrogel performance is governed by reciprocal interactions among biological source, scaffold composition, matrix mechanics, spatial architecture, mineral or ionic signaling, growth factor delivery, vesicle-mediated communication, and inflammatory niche modulation. Mineralized and ion-releasing hydrogels most consistently supported osteogenesis and bone repair, whereas extracellular matrix (ECM)-mimetic, peptide, collagen, fibrin, gelatin methacryloyl (GelMA), alginate, hyaluronic acid (HA), and chitosan-based systems enabled pulp–dentin, periodontal, peri-implant, oral mucosal, and soft-tissue reconstruction. Responsive, antimicrobial, antioxidant, conductive, and immunomodulatory hydrogels further expanded the field by targeting diseased microenvironments rather than regeneration alone. Despite strong preclinical evidence, translation remains limited by heterogeneity in scaffold formulations, biological sources, analytical endpoints, defect models, and long-term functional validation. Future progress will require standardized characterization, tissue-specific design criteria, clinically relevant large-animal models, scalable cell-free technologies, and integrated assessment of regeneration, immunity, vascularization, innervation, mechanics, and safety. Full article

Background: Excessive heat during implant osteotomy adversely affects bone healing and osseointegration. It is essential to carefully study the effects of drill systems, motors, and irrigation methods on intraosseous temperature. We aim to analyze the predictors of intraosseous temperature variation during osteotomy in bovine bone blocks using the Helix GM (Titanium) and Zi Compact (Zirconium) drill systems in conjunction with three different surgical motors and irrigation conditions using a linear regression model. Materials and Methods: An in vitro experimental study was conducted at the Periodontology and Oral Implantology Laboratory of the Universidad Nacional Federico Villarreal. A total of 120 bovine rib bone blocks (1.5 cm) were prepared using a standardized osteotomy protocol involving lance drills and ∅ 2 mm and ∅ 3 mm helical drills from the Zi and Helix GM compact kits (Neodent, Curitiba, Brazil). Irrigation was performed with chlorhexidine 0.12% + CPC 0.05% at ambient temperature (21 °C). Osteotomies were executed with two surgical motors (Coxo and Driller) at 1200 rpm and 35 Ncm torque. The intraosseous temperature was recorded in real time via a calibrated Fluke TiS55+ (Fluke, Everett, WA, USA) infrared thermographic camera and validated using a probe thermometer. Statistical analyses used Stata 17, applying descriptive measures, t-tests, and linear regression at 95% confidence for reliability. Results: Osteotomies without irrigation consistently resulted in slightly higher intraosseous temperatures. The Helix GM system, with the ∅ 3 mm drill and Driller motor, produced a final temperature of 29.3 °C ± 2.0. The Zi system with the lance drill and drill motor produced a maximum temperature of 32.7 °C ± 2.3. Irrigation was successful, and the elevated temperatures after irrigation were close to the surgical room temperature of 21–23 °C. Linear regression analysis showed that the drill motor produced a statistically significant decrease in temperature (−2.29 °C; 95% CI: −4.36 to −0.21; p = 0.031) while the lance drill with no additional irrigation produced a statistically significant increase in temperature (0.24 °C; 95% CI: 0.06 to 0.42; p = 0.009). Conclusions: The absence of irrigation during osteotomy significantly increased the intraosseous temperature, potentially compromising bone integrity. The use of irrigation, especially with the Driller motor, demonstrates a protective thermal effect. Full article

Minimally invasive spine surgery (MISS) has progressively transformed the management of spinal disorders by reducing soft-tissue disruption, perioperative morbidity, and recovery time while maintaining clinical outcomes comparable to conventional open techniques. Beyond its technical evolution, MISS has increasingly assumed a central role in the treatment of bone-related spinal conditions, including vertebral fractures, degenerative instability, metastatic disease, and osteoporosis-associated pathology. This narrative review provides a comprehensive overview of the evolution of MISS with a specific focus on its interaction with vertebral bone biology, implant stability, and fusion processes. A structured literature search of the PubMed/MEDLINE database was conducted, including English-language studies published between 1980 and June 2025 addressing MISS techniques, enabling technologies, and bone-related clinical outcomes. Current evidence suggests that MISS may preserve paraspinal vascularization and soft tissue integrity, potentially supporting bone healing and fusion, although high-quality comparative data remain limited. The effectiveness of MISS in osteoporotic and metastatic vertebral disease is closely linked to bone quality, implant anchorage, and biomechanical considerations, particularly in the context of pedicle screw fixation and interbody support. Emerging technologies—including navigation, robotics, and artificial intelligence—may enhance accuracy in implant placement and reduce bone-related complications, but robust evidence of long-term benefit is still lacking. Despite its advantages, MISS presents important limitations, including a steep learning curve, increased costs, and uncertain superiority in terms of fusion rates and long-term biomechanical stability. Future research should prioritize high-quality comparative studies focusing on bone healing, implant integration, and patient-specific factors such as bone density. MISS should therefore be interpreted not only as a surgical paradigm shift but as an evolving strategy for optimizing outcomes in bone-related spinal disorders. Full article

Background: Large segmental bone defects remain a major challenge in reconstructive surgery, particularly in the presence of impaired vascularization. Despite advances in scaffold design and biomaterials, insufficient vascular supply continues to represent the primary limitation in bone tissue engineering, often leading to impaired osteogenesis and graft failure. Objective: This review aims to analyze the role of vascularized flaps as “living bioreactors” in bone tissue engineering, focusing on their capacity to enhance scaffold vascularization, support osteogenesis, and facilitate clinical translation. Methods: A narrative review was conducted through a structured search of PubMed, Scopus, and Web of Science using combinations of the following keywords: “bone tissue engineering”, “vascularized flaps”, “arteriovenous loop”, and “in vivo bioreactor”. Relevant preclinical and clinical studies were selected based on their contribution to vascularization strategies in scaffold-based bone regeneration, with the aim of illustrating the evolution and integration of these approaches. Results: Vascularized flaps provide an established vascular network and a biologically active microenvironment that promote scaffold integration and tissue regeneration. Periosteal flaps demonstrate strong osteogenic potential, whereas muscle and omental flaps primarily act as vascular carriers and adaptable regenerative environments. AV loop-based strategies enable intrinsic axial vascularization, ensuring rapid and homogeneous perfusion of large constructs. Hybrid approaches, including regenerative matching axial vascularization (RMAV), integrate vascularized tissues with advanced biomaterials and show promising translational outcomes. Conclusions: Vascularization-driven strategies represent a paradigm shift in bone tissue engineering, moving from passive scaffold implantation to actively engineered, vascularized constructs. The integration of microsurgical techniques with advanced biomaterials offers significant potential for the development of personalized and clinically applicable bone regeneration strategies. Full article

The integration of robotic systems in knee arthroplasty has accelerated, with early results indicating improved precision and outcomes. The ROSA^® Knee System facilitates the robotic-assisted positioning of cutting guides while enabling real-time assessment of ligament balance, with the surgeon retaining control of all bone resections. This study aimed to evaluate the precision of implant positioning, achievement of the planned hip–knee–ankle (HKA) axis, and consistency across different operating surgeons. A prospective observational study was conducted on patients undergoing robotic-assisted total knee arthroplasty (RATKA) using the ROSA Knee System. Radiographic assessments included pre- and post-operative AP/lateral knee and long-limb radiographs, supplemented with post-operative CT to assess femoral component rotation. Intra-operative alignment data recorded by the ROSA console were compared to post-operative imaging. Complication rates were also evaluated. Among 94 knees analyzed, the mean difference between intra-operative and post-operative HKA measurements was 1.66 ± 2.09°, which was statistically significant. Minor but significant differences were observed in LDFA (0.32 ± 1.84°, p = 0.034), MPTA (0.84 ± 1.17°, p < 0.001), and femoral component rotation (1.63 ± 2.40°, p < 0.001). No significant variation was noted in LDFA or MPTA between surgeons, though differences were present in rotational alignment and HKA. The intra-operative HKA showed moderate correlation with both measured post-op HKA and arithmetic HKA (aHKA), with slightly stronger correlation with the latter. The ROSA Knee System enables reproducible and accurate implant positioning with reliable restoration of the planned HKA axis. Once a surgeon is proficient, results are consistent without increased complication risks. Full article

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

Background/Objectives: Contemporary implant dentistry is increasingly oriented toward minimally invasive regenerative strategies designed to reduce surgical morbidity while preserving or improving clinical outcomes. Conventional bone augmentation procedures remain effective and biologically well established, but they may be associated with greater patient burden, increased risk of complications, and higher technical demands in selected clinical scenarios. This narrative review critically examines minimally invasive bone regeneration approaches in implant dentistry, with particular focus on the Bone Core Technique, the Sub-Periosteal Peri-implant Augmented Layer (SPAL) technique, and Immediate Dentoalveolar Restoration (IDR), emphasizing their biological rationale, clinical indications, surgical workflows, limitations, and reported outcomes. Methods: A structured, non-systematic literature search was conducted in PubMed/MEDLINE, Scopus, and Web of Science to identify publications relevant to minimally invasive bone regeneration in implant dentistry. Priority was given to clinical studies, prospective cohorts, case series, technical descriptions, and biologically oriented conceptual papers addressing vascular preservation, flap limitation, donor-site morbidity, and peri-implant hard- and soft-tissue integration. Results: Available evidence suggests that minimally invasive regenerative protocols may offer favorable clinical and patient-centered outcomes only in carefully selected indications and when performed by experienced operators. The strength of support is uneven across techniques: the Bone Core Technique currently has the strongest dedicated prospective follow-up for localized peri-implant defects, SPAL is supported by limited retrospective and emerging histologic evidence, and IDR remains largely based on case reports, technique-driven descriptions, and broader immediate implant literature. Conclusions: Minimally invasive bone regeneration reflects a shift toward biologically guided and patient-centered treatment concepts in implant dentistry, but it should not be interpreted as a universal substitute for conventional augmentation. Its successful application depends on careful case selection, sound knowledge of wound healing and defect morphology, and advanced surgical and prosthetic expertise. Further research should prioritize standardized outcome measures, longer follow-up, and comparative prospective studies. Full article

Objectives: Cone-beam computed tomography (CBCT) is central to three-dimensional assessment in oral surgery and implant dentistry; however, CBCT-derived gray values expressed as HU-like units are not equivalent to true CT-derived Hounsfield Units (HU). This brief methodological secondary analysis evaluated the reliability and practical limitations of such values in assessing radiographic changes after peri-implantitis surgery. Methods: The analysis used the imaging protocol and group-level radiological data from a previously published prospective clinical cohort, conducted under the same protocol and ethical approval of the Institutional Ethics Committee of the Medical University of Lublin (KE-0254/248/11/2023; 23 November 2023). The source cohort included 57 patients treated after implant removal for severe peri-implantitis with small-particle dentin (n = 22), Bio-Oss (n = 15), or spontaneous healing without grafting (n = 20). CBCT scans were analyzed in OnDemand3D (version 1.0.11.1007) using manually selected square regions of interest (ROI; 30 × 30 pixels). No external phantom calibration, cross-device normalization, or formal intra-/inter-observer reproducibility assessment was available in the secondary dataset. Results: The previously reported mean study-site values were 779.62 ± 325.92 gray-value units for small-particle dentin, 910.51 ± 155.03 gray-value units for Bio-Oss, and 206.04 ± 174.21 gray-value units for controls. These findings are presented as protocol-dependent attenuation patterns, not as direct material rankings, bone-density thresholds, or proof of regeneration. Variability remained substantial, with study-site coefficients of variation of 41.8%, 17.0%, and 84.6%, respectively, and high adjacent-site variability. Interpretation was constrained by manual ROI placement, lack of calibration, absence of observer-agreement metrics, unequal follow-up timing, and CBCT sensitivity to scatter, beam hardening, field of view, reconstruction settings, and metal-related artifacts. Conclusions: CBCT-derived gray values may be useful as relative indicators of local radiographic attenuation change within a standardized protocol, but they should not be interpreted as absolute measures of bone density. Future regenerative oral surgery studies should combine standardized acquisition, explicit ROI methodology, repeated measurements, observer-agreement analysis, and complementary clinical, radiographic, or histological outcomes. Full article

Background: The integrity of the alveolar ridge is compromised by tooth loss or trauma, initiating chronic resorption that alters bone morphology. Vertical bone augmentation (VBA) is a complex procedure required to rehabilitate severe atrophy. Currently, there is debate regarding the effectiveness of autologous bone versus xenografts and their combination to optimize bone regeneration and ensure dimensional stability. Objectives: To synthesize evidence on the efficacy of VBA by comparing autologous bone, xenografts, and their combination. Specifically, to evaluate vertical bone gain, volumetric stability and resorption, implant survival, complications, and whether combined grafts offer clinical advantages. Methods: A systematic review was conducted following PRISMA 2020 guidelines. MEDLINE, Scopus, SciELO, and Web of Science were searched up to January 2026. Risk of bias was assessed, using RoB 2 for randomized studies and ROBINS-I for non-randomized studies. Results: From 1517 initial records, 9 studies were included and 3 showed high risk of bias. Iliac crest grafts achieved the greatest vertical bone gain but also exhibited higher resorption compared to calvarial grafts. Xenografts (Bio-Oss) demonstrated superior volumetric stability, maintaining 10–13% more residual volume than autologous blocks. The most frequent complication was soft tissue dehiscence. Conclusions: VBA is an effective procedure. The combination of autologous bone and xenograft may represent a balanced approach, providing both biological potential and volumetric stability. Graft origin significantly influences outcomes and morbidity. However, current evidence is limited by methodological heterogeneity and small sample sizes, highlighting the need for well-designed clinical trials with standardized protocols and long-term follow-up. Full article