Search Results (246)

Intraosseous hemangiomas (IH) are rare intrabony lesions that represent less than 1% of intraosseous tumors. IH are mostly seen in the axial skeleton and skull. Most commonly, the frontal bone, zygomatic, sphenoid, maxilla, ethmoid, and lacrimal bone can manifest IH. Currently, IH is classified as a developmental condition of endothelial origin. According to WHO, the five histological types of IH are cavernous, capillary, epithelioid, histiocytoid, and sclerosing. IH of the zygoma is an extremely rare condition with female predominance. A systematic review recently estimated that there were 78 cases published in the literature until 2023. The lesion is usually asymptomatic and presents with a gradually deteriorating deformity of the malar area, and the patient might be able to recall a history of trauma. Numbness due to involvement of the infraorbital nerve might also be present; however, atypical skin and bone sensations might also occur. Other symptoms include painful swelling, bone asymmetry, skin irritation, sinus pressure, paresthesia, diplopia, enophthalmos, or atypical neuralgia. A bony lesion with a trabecular pattern in a radiating formation (sunburst pattern) or a multilocal lytic lesion pattern created by the multiple cavernous spaces (honeycomb pattern) is commonly observed during radiologic evaluation. We present a rare case of IH of the zygoma in a 65-year-old generally healthy woman. A cyst-like bone tumor was revealed from the CT scan, which made preoperative biopsy of the lesion problematic. A careful radiological diagnostic differentiation of the lesion should always be conducted in such cases to outline a safe surgical plan and possible alternatives if needed. The patient underwent total tumor resection in the operating room, and the defect was reconstructed with the use of a titanium mesh and a synthetic hydroxyapatite bone graft based on a 3D surgical guide printed model. Full article

Sinus augmentation provides a well-established model for investigating the three-dimensional morphometry and macromolecular dynamics of bone regeneration, particularly when using biphasic calcium phosphate (BCP) graft substitutes. This case series included six biopsies from patients who underwent maxillary sinus augmentation using BCP granules composed of 30% hydroxyapatite (HA) and 70% β-tricalcium phosphate (β-TCP). Bone core biopsies were obtained at healing times of 6 months, 9 months, and 12 months. Histological evaluation yielded qualitative and quantitative insights into new bone distribution, while micro-computed tomography (micro-CT) and Raman microspectroscopy (RMS) were employed to assess the three-dimensional architecture and macromolecular composition of the regenerated bone. Micro-CT analysis revealed progressive maturation of the regenerated bone microstructure over time. At 6 months, the apical regenerated area exhibited a significantly higher mineralized volume fraction (58 ± 5%) compared to the basal native bone (44 ± 11%; p = 0.0170), as well as significantly reduced trabecular spacing (Tb.Sp: 187 ± 70 µm vs. 325 ± 96 µm; p = 0.0155) and degree of anisotropy (DA: 0.37 ± 0.05 vs. 0.73 ± 0.03; p < 0.0001). By 12 months, the mineralized volume fraction in the regenerated area (53 ± 5%) was statistically comparable to basal bone (44 ± 3%; p > 0.05), while Tb.Sp (211 ± 20 µm) and DA (0.23 ± 0.09) remained significantly lower (Tb.Sp: 395 ± 41 µm, p = 0.0041; DA: 0.46 ± 0.04, p = 0.0001), indicating continued structural remodelling and organization. Raman microspectroscopy further revealed dynamic macromolecular changes during healing. Characteristic β-TCP peaks (e.g., 1315, 1380, 1483 cm⁻¹) progressively diminished over time and were completely absent in the regenerated tissue at 12 months, contrasting with their partial presence at 6 months. Simultaneously, increased intensity of collagen-specific bands (e.g., Amide I at 1661 cm⁻¹, Amide III at 1250 cm⁻¹) and carbonate peaks (1065 cm⁻¹) reflected active matrix formation and mineralization. Overall, this case series provides qualitative and quantitative evidence that bone regeneration and integration of BCP granules in sinus augmentation continues beyond 6 months, with ongoing maturation observed up to 12 months post-grafting. Full article

This study aimed to compare the performance of three hydroxyapatite–β-tricalcium phosphate (HA–β-TCP) collagen composite grafts in a canine model for extraction socket preservation. Eight mongrel dogs underwent atraumatic bilateral mandibular premolar extraction, and sockets were randomly grafted with HBC28 (20% high-crystalline HA, 80% β-TCP bovine collagen), HBC37 (30% HA, 70% β-TCP, bovine collagen), or HPC64 (60% HA, 40% β-TCP, porcine collagen). Grafts differed in their HA–β-TCP ratio and collagen origin and content. Animals were sacrificed at 4 and 12 weeks, and the healing sites were evaluated using micro-computed tomography (micro-CT) and histological analysis. At 12 weeks, all groups showed good socket maintenance with comparable new bone formation. However, histological analysis revealed that HBC28 had significantly higher residual graft volume, while HPC64 demonstrated more extensive graft resorption. Histomorphometric analysis confirmed these findings, with statistically significant differences in residual graft area and bone volume fraction. No inflammatory response or adverse tissue reactions were observed in any group. These results suggest that all three HA–β-TCP collagen composites are biocompatible and suitable for socket preservation, with varying resorption kinetics influenced by graft composition. Selection of graft material may thus be guided by the desired rate of replacement by new bone. Full article

Alveolar bone loss due to trauma, extraction, or periodontal disease often requires bone grafting prior to implant placement. Although human allograft bone is widely used as an alternative to autograft, it has limited osteoinductive potential and a prolonged healing time. Mesenchymal stem cell–conditioned media (MSC-CM), rich in paracrine factors, has emerged as a promising adjunct to enhance bone regeneration. This study evaluated the regenerative effect of MSC-CM combined with human allograft bone in a rabbit calvarial defect model. Bilateral 8 mm defects were created in eight rabbits. Each animal received a human allograft alone (HB group) on one side and an allograft mixed with MSC-CM (HB+GF group) on the other. Histological and histomorphometric analyses were performed at 2 and 8 weeks postoperatively. Both groups showed new bone formation, but the HB+GF group demonstrated significantly greater bone regeneration at both time points (p < 0.05). New bone extended into the defect center in the HB+GF group. Additionally, greater graft resorption and marrow formation were observed in this group at 8 weeks. These findings suggest that MSC-CM enhances the osteogenic performance of human allograft bone and may serve as a biologically active adjunct for bone regeneration. Full article

Background: The combination of polynucleotides and hyaluronic acid with bovine bone grafts in maxillary sinus lift procedures appears to be a promising strategy to enhance bone regeneration. This study aimed to analyze implant osseointegration, bone repair and sinus mucosa integrity using Bio-Oss^® and Hyaluronic Acid-Polynucleotide Gel (Regenfast^®) in maxillary sinus augmentation in rabbits. Methods: Sinus floor elevation was performed in 12 rabbits, with one implant placed per sinus simultaneously. In the control group, sinuses were grafted with deproteinized bovine bone mineral (Bio-Oss^®) alone; in the test group, Bio-Oss^® was combined with Regenfast^®. Two histological slides were obtained per sinus after 2 weeks (six animals) and 10 weeks (six animals): one from the grafted area alone (non-implant sites), and one from the implant site. Primary outcome variables included the percentage of newly formed bone, the extent of implant osseointegration, and the number of sinus mucosa perforations caused by contact with graft granules. Results: After 10 weeks of healing, the test group showed a significantly higher percentage of new bone formation (37.2 ± 6.7%) compared to the control group (26.8 ± 10.0%; p = 0.031); osseointegration extended to the implant apex in both groups; fewer sinus mucosa perforations were observed in the test group (n = 5) than in the control group (n = 14). Conclusions: The addition of Regenfast^® to Bio-Oss^® granules promoted enhanced bone regeneration within the elevated sinus area and was associated with a lower incidence of sinus membrane perforations compared to the use of Bio-Oss^® alone. Full article

Objective: This study aimed to compare the efficacy of Sticky Tooth (ST) derived from ground teeth and Sticky Bone (SB) based on equine bone and human allograft in maxillary bone defect regeneration through histological examination. Materials and Methods: Forty patients underwent maxillary alveolar ridge regeneration using four different biomaterials: Sticky Tooth processed with the BonMaker device (n = 10), Sticky Tooth prepared with the Smart Dentin Grinder (n = 10) Sticky Bone derived from an equine xenograft (n = 10), and Sticky Bone derived from human allografts (n = 10). CBCT imaging was performed preoperatively, post-regeneration, and during follow-up. Histological and quantitative statistical evaluation was conducted on biopsy samples obtained four months post-regeneration at the time of implant placement. Results: Successful alveolar ridge regeneration was achieved in all 40 patients. Histological analyses confirmed good integration between the biomaterials and bone tissue without signs of inflammation. Conclusion: Histological comparisons demonstrated that both ST and SB are effective biomaterials for bone regeneration. However, ST exhibited a faster bone healing process compared to xenograft and allograft SB. Full article

Background: Maxillofacial bone defects present considerable challenges in oral and reconstructive surgery. While autologous bone grafts are the gold standard, their limitations, such as donor site morbidity and limited availability, have driven the search for alternative biomaterials. SmartBone^®, a xeno-hybrid graft, offers potential advantages due to its bioactivity and remodeling capacity. Methods: This analysis of a series of clinical cases, evaluated the performance of SmartBone^® in 10 patients presenting with various maxillofacial bone defects. The patient follow-up period spanned from 2017 to 2019, with a maximum duration of 30 months. Bone grafting was performed, and integration was monitored using Cone-Beam Computed Tomography at multiple timepoints. Bone density changes (ΔCT values) in selected anatomical sites were analyzed to assess graft transformation and integration. Results: SmartBone^® supported effective bone regeneration and selective remodeling in all cases. One patient required a revision procedure, after which successful integration was observed. Cellular colonization began within weeks, with complete remodeling into mature bone occurring between 6–12 months. Evidence of cortical wall resorption and reformation on the graft’s external surface confirmed this transformation. ΔCT values progressively aligned with native bone densities, indicating structural and functional integration. Conclusions: SmartBone^® demonstrates strong osteointegrative and site-specific remodeling capabilities, offering a reliable and predictable alternative for maxillofacial bone reconstruction. The study presents several limitations, including the small sample size, inter-patient variability, possible imaging artifacts due to metallic elements in Cone-Beam Computed Tomography scans and the lack of histological confirmation. Full article

Background: Bone resorption following tooth loss poses significant challenges for dental implant success. Guided bone regeneration (GBR) techniques, particularly in vertically deficient ridges, often require complex procedures and soft tissue management. This case report introduces a modified occlusive barrier with a window, combined with tricalcium phosphate, to address these challenges. Methods: A 26-year-old female with significant bone loss in the mandibular anterior region underwent GBR using a digitally designed titanium occlusive barrier. The barrier was fabricated using CAD/CAM technology and secured with screws. A blood clot mixed with tricalcium phosphate was used to promote bone regeneration. Postoperative care included regular irrigation, de-epithelialization, and follow-up over six months. Implant placement and histological analysis were performed to evaluate outcomes. Case Presentation: The patient achieved 8.8 mm of vertical and 7.6 mm of horizontal bone regeneration. Histological analysis confirmed the presence of mature, mineralized bone, and keratinized gingiva. The implant was successfully placed, and a fixed prosthesis was restored after four months, with stable results at a three-year follow-up. Conclusion: This technique demonstrates effective bone and soft tissue regeneration in a single procedure, eliminating the need for autologous bone grafts and secondary surgeries. The use of a digitally designed occlusive barrier offers precision, reduces morbidity, and simplifies the surgical process, suggesting a promising advancement in GBR. Further studies are needed to validate these findings. Full article

Background: The rehabilitation of complex bone defects in the anterior maxilla presents significant challenges in restoring both function and esthetics. A multidisciplinary approach integrating guided bone regeneration (GBR) and connective tissue grafting (CTG) has proven effective in addressing such cases. Methods: This report describes the case of a 60-year-old female patient who presented with severe alveolar ridge resorption and peri-implant bone loss, necessitating an advanced regenerative strategy. The treatment protocol involved the use of autologous and xenogeneic bone grafts in combination with hyaluronic acid and polynucleotides to enhance osteogenesis and tissue integration. A six-month healing period was observed before histological and clinical evaluations were conducted. Results: The results demonstrated a significant increase in lamellar bone formation and vascularization in sites treated with biomodulators compared to conventional GBR techniques. Subsequently, CTG was employed to optimize peri-implant soft tissue volume and stability, leading to improved keratinized tissue thickness and enhanced esthetic outcomes. This case underscores the importance of a comprehensive surgical and prosthetic plan that integrates bone regeneration with mucogingival management for optimal results in implant rehabilitation. Additionally, histological analysis revealed that the incorporation of hyaluronic acid and polynucleotides resulted in improved cellular activity, reduced inflammatory responses, and enhanced overall bone quality. Conclusions: These results highlight the potential role of biomodulators in regenerative procedures. While the findings suggest promising clinical applications, further long-term studies are necessary to validate the outcomes and establish standardized protocols for the integration of advanced biomaterials in implantology. Full article

Purpose: To evaluate the clinical and histological outcomes of patients that receive implant-supported crowns after vacuum plasma surface treatment (VPST) of biomaterials used in socket preservation (SP) and guided bone regeneration (GBR). Materials and methods: This study was designed as a case series. Patients in need of tooth extraction and socket preservation or guided bone regeneration were enrolled. The socket preservation technique was performed after tooth extraction using a heterologous collagen bone graft and a collagen xenomatrix, both activated with vacuum plasma. Meanwhile, a two-stage horizontal ridge augmentation was performed using a customized titanium mesh and a mix of autologous (untreated) and heterologous (treated) bone grafts, along with a treated collagen membrane. ACTILINK Reborn with Universal Vortex Holder (Plasmapp Co., Ltd., Daejeon, Republic of Korea) was used to treat all biomaterials. The outcome measures were implant and prosthesis failures, complications, and histological examination. Soft and hard tissue samples were collected at the time of implant placement only in patients treated with SP. Results: A total of six patients were treated—three with socket preservation and delayed implant placement, and three with staged GBR. No implant or prosthesis failed. One customized titanium mesh broke after plasma treatment, requiring replacement with a pericardium membrane. No other complications occurred. Histological analysis at three months post-surgery revealed well-vascularized newly formed bone at different stages of maturation with integrated bone graft particles, while the soft tissue appeared to be physiologically structured. Conclusion: VPST may enhance the hydrophilicity of biomaterials, supporting favorable healing outcomes in SP and GBR. Further randomized controlled trials with appropriate sample size calculations are needed to confirm these preliminary results. Full article

Background: Alveolar ridge preservation (ARP) following tooth extraction plays a vital role in maintaining ridge dimensions and supporting subsequent implant therapy. Objectives: This study histologically and radiographically evaluates the efficacy of techBiomat bone^®—a deproteinized bovine bone mineral (DBBM)—for alveolar ridge preservation (ARP), comparing the results of bone formation, residual graft particles, and nonmineralized tissue to those of spontaneous healing in human tooth sockets. Methods: A split-mouth study was conducted to evaluate the radiographic and histologic outcomes in human sockets with and without ARP. Results: A significant improvement in bone fill was observed compared to untreated sockets. Radiographically, 87% of the treated sockets demonstrated more than 75% bone fill, whereas only 7% of the untreated sockets did. Histologically, the percentage of new bone formation was greater in treated sockets (42%) than in untreated sockets (25%). The findings also highlighted a lower proportion of nonmineralized tissue in grafted sites, suggesting improved healing over spontaneous healing. The residual graft material in the treated sockets had a moderate resorption rate, with almost complete replacement by the host bone after six months. The use of techBiomat bone^® demonstrated promising results, with a resorption rate conducive to optimal bone regeneration, with less than 9% residual graft material remaining after six months. Conclusions: This study supports the efficacy of techBiomat bone^® graft material for ARP, highlighting its potential in maintaining ridge volume. Further studies with larger sample sizes are needed to confirm these findings. Full article

This study developed electrosprayed deferoxamine (DFO)-loaded poly(lactic-co-glycolic acid) microspheres (DFO-MS) combined with a sucrose acetate isobutyrate (SAIB) depot (DFO-MS@SAIB) for bone-defect repair, targeting the coordinated regulation of angiogenesis and osteogenesis in vascularized bone regeneration—where new blood vessels support functional bone integration. In vitro/in vivo evaluations confirmed its dual pro-angiogenic and pro-osteogenic effects via HIF-1α pathway activation. Background/Objectives: Emerging evidence underscores the indispensability of vascularization in bone-defect repair, a clinical challenge exacerbated by limited intrinsic healing capacity. While autologous grafts and growth-factor-based strategies remain mainstream, their utility is constrained by donor-site morbidity, transient bioactivity, and poor spatiotemporal control over angiogenic–osteogenic coupling. Here, we leveraged DFO, a hypoxia-mimetic HIF-1α stabilizer with angiogenic potential, to engineer an injectable DFO-MS@SAIB depot. This system was designed to achieve sustained DFO release, thereby synchronizing vascular network formation with mineralized tissue regeneration in critical-sized defects. Methods: DFO-MS were fabricated via electrospraying and combined with SAIB (DFO-MS@S) to form an injectable sustained-release depot. Their physicochemical properties, including morphology, encapsulation efficiency, degradation, release kinetics, and rheology, were systematically characterized. In vitro, the angiogenic capacity of HUVECs co-cultured with DFO-MS was evaluated; conditioned HUVECs were then co-cultured with BMSCs to assess the BMSCs’ cytocompatibility and osteogenic differentiation. In vivo bone regeneration in a rat calvarial defect model was evaluated using micro-CT, histology, and immunohistochemistry. Results: The DFO-MS@SAIB system achieved sustained DFO release, stimulating HUVEC proliferation, migration, and tubulogenesis. In a Transwell co-culture model, pretreated HUVECs promoted BMSC migration and osteogenic differentiation via paracrine signaling involving endothelial-secreted factors (e.g., VEGF). HIF-1α pathway activation upregulated osteogenic markers (ALP, Col1a1, OCN), while in vivo experiments demonstrated enhanced vascularized bone regeneration, with significantly increased bone volume/total volume (BV/TV) and new bone area compared with controls. Conclusion: The DFO-MS@SAIB system promotes bone regeneration via sustained deferoxamine release and HIF-1α-mediated signaling. Its angiogenesis–osteogenesis coupling effect facilitates vascularized bone regeneration, thereby offering a translatable strategy for critical-sized bone-defect repair. Full article

Background/Objectives: Guided bone regeneration (GBR) is a regenerative technique used to treat maxillary osseous defects to enable implant placement for prosthetic rehabilitation. It is generally performed with the use of barrier membranes and bone substitute materials of human or animal origin. Here, we report the clinical and histological outcomes of a horizontal GBR, treated using only synthetic biomaterials. Methods: A graft of nanocrystalline hydroxyapatite (NH) embedded in a silica gel matrix was used to fill a horizontal bone defect. The graft was covered with a titanium-reinforced dense polytetrafluoroethylene (TR-dPTFE) membrane, and primary closure was completed and maintained for 10 months. Then, the site was re-opened for membrane removal and implant insertion. During implant bed preparation, a bone biopsy was obtained for histological evaluation. A metal–ceramic crown was fitted, and the 5-year follow-up after prosthetic loading showed clinical and radiographically healthy tissues. Results: Histological examination revealed good integration of the biomaterial into the surrounding tissues, which were composed of lamellar bone trabeculae and connective tissue. New bone formation occurred not only around the NH granules but even inside the porous amorphous particles. Conclusions: The combination of NH and the TR-dPTFE membrane produced good clinical and histological results, which remained stable for 5 years. Full article

Background: To reconstruct and maintain hard tissues over time, it is necessary to follow effective protocols and use appropriate materials. The selection of the graft material and its properties can also affect the final outcomes. For this purpose, numerous graft materials have been suggested. Among the valuable alternatives to these biomaterials, interest in using teeth as graft material has grown in recent years. Aim: The aim of the study was to investigate the histomorphometric outcomes of using tooth-derived materials when used as a bone substitute. Methods: We evaluated the histological results of autologous demineralized tooth graft material prepared using a Tooth Transformer device. A total of 187 histological samples from 186 subjects (52% male and 48% female, with an average age of 56.30 ± 12.97 years) were analyzed. The analysis focused on the total bone volume (BV%), residual tooth material (residual graft, TT%), and vital bone (VB%). The differences between the presence and absence of the resorbable membrane were also analyzed. Results: The amount of VB was 36.28 ± 19.09%, the residual graft TT was 9.6 ± 10.76%, and 46.96 ± 13.85% was the total bone volume (BV). The presence of membrane increased the amount of BV% and reduced the time to produce bone. Conclusions: The procedure using demineralized autologous tooth-derived biomaterial may be a predictable method for producing new vital bone capable of supporting dental implant rehabilitation and the use of membrane allow better results. Full article

Background: The socket preservation technique involves filling the bone defect created after tooth extraction with a bone substitute material. This helps to reduce bone resorption of the post-extraction alveolar ridge. Various types of bone substitute biomaterials are used as augmentation materials, including autogeneic, allogeneic, and xenogeneic materials. The purpose of this study was to evaluate changes in alveolar ridge dimensions and alterations of optical bone density in sockets grafted with two different biomaterials. Additionally, bone biopsies taken from the grafted sites underwent histological evaluation. Methods: This study enrolled 10 generally healthy patients, who were divided into two equal groups. Patients in the first group were treated with an allogeneic material (BIOBank^®, Biobank, Paris, France), while patients in the second group were treated with an xenogeneic material (Geistlich Bio-Oss^®, Geistlich Pharma AG, Wolhusen, Switzerland). Tooth extraction was performed, following which the appropriate material was placed into the debrided socket. The material was secured with a collagen membrane (Geistlich Bio-Gide^®, Geistlich Pharma AG, Wolhusen, Switzerland) and sutures, which were removed 7 to 10 days after the procedure. Micro-CBCT examinations were performed, for the evaluation of alveolar ridge dimensions and bone optical density, at 7–10 days and six months after the procedure. Bone trepanbiopsy was performed simultaneously to the implant placement, six months after socket preservation. The retrieved biopsy was subjected to histological examination via hematoxylin and eosin (H&E) staining and Masson’s trichrome staining. Results: The results showed that the allogeneic material was more effective in preserving alveolar buccal height and was probably more rapidly transformed into the patient’s own bone. Sockets grafted with the xenogeneic material presented higher optical bone density after six months. Both materials presented similar effectiveness in alveolar width preservation. Conclusions: Based on the outcomes of this study, it can be concluded that both materials are suitable for the socket preservation technique. However, the dimensional changes in the alveolar ridge and the quality of the newly formed bone may vary depending on the type of biomaterial used. Full article