Search Results (753)

Background/Objectives: Alveolar ridge atrophy following tooth extraction complicates subsequent prosthetic rehabilitation and implant placement. This systematic review seeks to provide a comprehensive evaluation of existing evidence regarding the effectiveness of xenogeneic bone graft materials in socket preservation, particularly emphasizing their influence on the adjacent soft tissues. Methods: A systematic literature search was carried out across the CENTRAL, Embase, MEDLINE, PubMed, and Scopus databases. The search targeted randomized controlled trials (RCTs) published in English between January 2015 and September 2025 that examined xenogenic bone grafts used for ridge preservation in comparison either to spontaneous socket healing or to other types of grafting materials. The primary outcomes of interest were bone regeneration and alterations in soft tissues. Multiple independent reviewers performed study screening, data extraction, and risk of bias evaluation using the RoB 2 tool. Results: From 2242 initial records, 4 RCTs (138 patients) met the inclusion criteria. Studies compared xenografts (deproteinized bovine bone mineral with/without collagen), often combined with membranes, to unassisted healing. Augmentation techniques consistently showed a trend toward reduced horizontal and vertical ridge contraction compared to controls, though differences often lacked statistical significance (p > 0.05). Histological analysis revealed significantly less vital bone formation and residual graft particles in xenograft sites versus controls, suggesting volume maintenance is largely graft-dependent. Soft tissue contour changes were evaluated using 3D model scanning. Risk of bias varied, with concerns regarding randomization and reported outcomes in some studies. Conclusions: Xenogenic materials demonstrate comparable clinical effectiveness in preserving alveolar ridge dimensions, though radiographic volume stability may be partially attributed to the slow resorption of the graft material itself rather than new bone formation. Full article

Surface functionalization of metallic implants is widely explored to enhance their performance and functionality. In this study, multifunctional hydrogel coatings based on poly(vinylpyrrolidone) and polyethylene glycol were developed and functionalized with a taxifolin (TAX) inclusion complex and collagen to introduce bioactive features. TAX, a naturally occurring flavonoid with antioxidant and anti-inflammatory properties, was incorporated using β-cyclodextrin to improve its stability and enable controlled release. The coatings were applied to titanium-hydroxyapatite composites and titanium sheet substrates to evaluate their applicability across surfaces with varying morphologies, ranging from porous to relatively smooth. The ceramic phase was modified with magnesium ions to enhance its bioactivity and better mimic the composition of natural bone tissue. FTIR and SEM analyses confirmed hydrogel formation and effective surface coverage. Degradation and incubation studies in simulated physiological environments demonstrated the material’s stability, while UV–Vis analysis indicated TAX release, highlighting the system’s potential as a carrier for flavonoid-based compounds. Indirect cytotoxicity studies using MC3T3-E1 preosteoblasts indicated low cytotoxicity and a favorable biological response of collagen- and taxifolin-modified systems. The developed coatings represent a versatile platform for surface modification of titanium-based biomaterials and demonstrate potential for application across substrates with diverse surface characteristics. Further studies are required to assess their biological potential. Full article

Objective: To present a split-mouth bilateral case report comparing a graft-free sinus lift technique developed by C.S. and A.P. using a resorbable magnesium membrane with a standard lateral sinus augmentation using xenograft and collagen membrane. The two approaches were evaluated through clinical, radiographic, and histological outcomes. Methods: A healthy 68-year-old female patient underwent bilateral sinus augmentation in the posterior maxilla. On the right side, a standard sinus lift was performed using a xenogeneic bone graft in combination with a resorbable collagen membrane. On the left side, a graft-free approach was done using only a resorbable magnesium membrane to support the elevated sinus membrane. Results: After a six-month healing period, implants were placed, and bone core biopsies were harvested for histological evaluation. Histological analysis revealed 56.4% newly formed bone in the graft-free magnesium membrane site and 22.5% in the grafted control site. A two-year radiological follow-up confirmed complete bone maturation and implant stability on both sides. Conclusions: This case promotes the potential of a graft-free sinus lift approach using a resorbable magnesium membrane as a promising alternative to conventional grafting protocols. The beneficial clinical, radiological and histological outcomes suggest that this technique may simplify the sinus augmentation procedure and should be further explored in larger clinical studies. Full article

Skin injuries are common and can result from surgeries, burns, pressure sores, cuts, and diseases. Proper wound healing is crucial for maintaining homeostasis; wounds can be classified as acute or chronic. Acute wounds heal in four sequential phases: hemostasis, inflammation, proliferation, and remodeling. Chronic wounds arise when this process fails, often due to prolonged inflammation. Existing treatments for chronic wounds are limited, and antibiotic resistance complicates infection control, highlighting the urgent need for new therapies. Biomaterials, particularly gelatin, have gained attention for their biomimetic properties, biocompatibility, and ability to promote healing. Gelatin’s ECM-like structure supports tissue metabolism, and it can be enriched with bioactive compounds to enhance tissue regeneration, collagen deposition, angiogenesis, and antimicrobial activity. This study evaluates the effectiveness of a 3D gelatin-based patch in vivo, using Hirudo verbana as a model. The patch, functionalized with chitosan and bioactive apatite nanoparticles, was implanted in injured leeches, with tissue samples collected at 72 h, 1 week, and 2 weeks. Scaffold integration, cell colonization, and healing effects were assessed through morphological, immunohistochemical, and ultrastructural analyses. The findings confirm H. verbana as a robust in vivo model for regenerative medicine and demonstrate the promising potential of gelatin-based patches. 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

Severe traumatic brain injury (TBI) is one of the leading causes of mortality and disability worldwide. To date, there are no clinically effective neuroprotective agents. Biomaterials that combine structural support for damaged tissue with a depot for therapeutic agents may represent a key solution to this problem. To evaluate the neuroprotective potential of a collagen matrix derived from the jellyfish Rhizostoma pulmo (R. pulmo) and modified with sodium thiosulfate (Na₂S₂O₃) as an hydrogen sulfide (H₂S) donor in a bioengineered platform for the treatment of severe TBI. Comprehensive characterization of the collagen matrix (electrophoresis, fluorescence microscopy), its implantation in a mouse model of severe TBI, and subsequent morphological, histological, ultrastructural, and immunohistochemical analyses of connexin 43 (Cx43) and p53 protein (p53) were performed. In addition, molecular dynamics simulations of the interactions between sulfur-containing compounds and target proteins were conducted. The effects were compared with inhibition of endogenous H₂S synthesis using aminooxyacetic acid (AOAA). The collagen matrix retains the properties of type I collagen and forms a three-dimensional porous structure with high hydrophilicity and biocompatibility. Implantation ensures effective defect filling, reduces cystic degeneration, and preserves cortical structure. Modification with Na₂S₂O₃ results in a significant reduction in both nuclear and cytoplasmic accumulation of p53, prevention of Cx43 dysregulation, a decrease in the proportion of damaged neurons and inflammatory infiltration, and preservation of tissue ultrastructure. In contrast, inhibition of CBS with AOAA exacerbates pathological changes. Molecular modeling demonstrated that S₂O₃²⁻ is capable of forming stable electrostatic interactions with domains of p53 and Cx43 under conditions of acidosis and elevated Ca²⁺. A collagen matrix derived from R. pulmo and modified with Na₂S₂O₃ represents a promising biodegradable platform that combines structural support with local H₂S-dependent regulation of key mechanisms of secondary brain injury. This approach provides a multilevel neuroprotective effect and opens new opportunities for the development of therapeutic implants for severe TBI. Full article

Background: Sugaya type III rotator cuff re-tears are characterized by preserved tendon continuity with reduced thickness and are often associated with persistent pain and functional impairment. Bioinductive collagen implants may enhance tendon healing, but clinical evidence in this population remains limited. This study aimed to evaluate the clinical and radiologic outcomes of arthroscopic repair with bioinductive collagen implant augmentation in patients with Sugaya type III re-tears. Methods: This retrospective case series (Level IV) included 15 patients (mean age 61.7 years) with MRI-confirmed Sugaya type III re-tears. An a priori power analysis based on a large effect size (Cohen’s d = 0.80) indicated that a sample size of 15 would provide 80% power to detect clinically meaningful changes in the primary endpoint. Clinical outcomes were assessed preoperatively and at 6 and 12 months postoperatively using VAS, ASES, SANE, and WORC scores. MRI was used to evaluate changes in supraspinatus tendon thickness. Non-parametric statistical analysis with Bonferroni correction was applied. Results: The median VAS pain score improved from 6.5 (IQR, 6.0–7.0) preoperatively to 2.8 (IQR, 2.0–3.5) at 6 months and to 2.1 (IQR, 1.5–2.8) at 12 months (adjusted p < 0.001). The median ASES score increased from 45.0 (IQR, 39.0–51.0) to 78.0 (IQR, 72.0–85.0), with a median improvement of 33 points. SANE and WORC scores also showed significant improvements. Supraspinatus tendon thickness increased from 4.8 mm (IQR, 3.7–5.7) to 6.9 mm (IQR, 5.4–8.3) at 12 months (adjusted p < 0.001). No graft failure was observed on follow-up MRI. Conclusions: Arthroscopic repair with bioinductive collagen implant augmentation may be associated with short-term improvements in pain, function, and tendon thickness in patients with Sugaya type III re-tears. Given the small sample size and lack of a control group, these findings should be interpreted cautiously, and further prospective comparative studies are needed. Full article

Tissue engineering using the self-assembly approach represents a promising technology. However, age-related reductions in extracellular matrix deposition by stromal cells limit the mechanical robustness of reconstructed tissues what can be critical for midurethral sling reconstruction. Indeed, stress urinary incontinence predominantly affects women over 50 years of age and is commonly treated by implantation of midurethral slings, whose synthetic versions have raised concerns regarding safety and long-term tolerance. In this study, we investigated whether biochemical modulation could enhance collagen deposition and mechanical properties of self-assembled dermal tissues reconstructed from female donors of different ages. Dermal fibroblasts were cultured in the presence of ascorbic acid, and the effects of hormonal supplementation, metabolic and hypoxia-related stimuli, and insulin signaling activation were evaluated using collagen quantification, histological analyses, and mechanical testing. Fibroblasts derived from younger donors deposited significantly more collagen than those from older female donors. Among all tested conditions, insulin like growth factor 1 (IGF 1) markedly increased collagen deposition in a dose-dependent manner, including in fibroblasts from women over 50 years of age, whereas β-estradiol and progesterone had no significant effect on collagen content. Although β-estradiol slightly increased tissue thickness, only IGF-1 supplementation resulted in substantial improvements in perforation strength, stiffness, displacement at break, and toughness. These results demonstrate that IGF-1 is a potent enhancer of extracellular matrix production and mechanical performance in dermal tissues reconstructed by the self-assembly approach, and represents a promising strategy to improve the development of biological midurethral slings. 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: The aim of this study was to compare the augmentation stability and clinical outcomes of L-shaped collagenated soft block bone substitutes (BBS) used in combination with either a self-assembly technology (SAT)-based physically crosslinked resorbable collagen membrane (RCM) or a conventional non-crosslinked RCM for peri-implant dehiscence defects. Methods: This retrospective cohort study included 30 patients who underwent guided bone regeneration (GBR) with simultaneous implant placement. The patients were treated with either a physically crosslinked membrane (PCM group, n = 15) or a non-crosslinked membrane (NCM group, n = 15). Clinical, radiographic, and profilometric parameters were evaluated at baseline, immediately post-GBR, and at re-entry surgery. Early wound healing complications and patient-reported outcomes were also assessed. Results: Both groups achieved significant defect resolution without severe adverse events. The mean reductions in defect width and height were 4.47 ± 1.82 mm (92.9%) and 4.07 ± 2.19 mm (89.4%) in the PCM group and 3.80 ± 1.59 mm (89.5%) and 4.13 ± 1.64 mm (86.9%) in the NCM group, respectively. Both groups showed comparable dimensional changes in hard and soft tissues, with no statistically significant differences in radiographic or profilometric outcomes. The incidence of wound healing complications, as well as patient-reported postoperative pain and swelling, were similar between the groups. Conclusions: Within the limitations of this retrospective pilot cohort study, SAT-based physically crosslinked RCMs used in combination with L-shaped soft BBS demonstrated clinical, radiographic, profilometric, and patient-reported outcomes similar to those observed with conventional non-crosslinked RCMs, without major short-term postoperative complications. These preliminary findings suggest that SAT-based RCMs may represent a feasible membrane option for GBR; however, these findings should be interpreted as preliminary and hypothesis-generating and should be confirmed in larger, adequately powered prospective clinical studies. Full article

Background/Objectives: Horizontal alveolar ridge resorption following tooth loss often compromises implant placement and requires augmentation procedures to restore adequate bone volume. This pilot case series descriptively evaluated the clinical, radiographic, and histological outcomes of lateral ridge augmentation (LRA) using a collagenated porcine-derived xenograft combined with autogenous bone. Methods: Three consecutive partially edentulous patients presenting with severe horizontal ridge deficiency (residual bone width ≤ 4 mm) underwent LRA using a mixture of porcine-derived xenograft and autogenous bone covered with a resorbable collagen membrane. After a healing period of 3–5 months, core biopsies were harvested at implant placement and subjected to histological and histomorphometric analysis, including TRAP staining. Results: All sites healed uneventfully without intraoperative or postoperative complications. Radiographic evaluation demonstrated substantial horizontal bone gain, allowing placement of standard-diameter implants. Histological analysis revealed newly formed trabecular bone, residual graft material, and well-vascularized connective tissue, indicating active bone regeneration and biomaterial integration. TRAP-positive multinucleated giant cells (MNGCs) were observed at the biomaterial interface, suggesting ongoing remodeling. Long-term follow-up (mean 54.2 months) showed stable implant function without biological or mechanical complications. Conclusions: Within the limitations of this pilot case series, LRA using a collagenated porcine-derived xenograft combined with autogenous bone demonstrated preliminary favorable clinical, radiographic, and histological outcomes. Full article

Minimally invasive thread lifting has emerged as an effective strategy for soft tissue repositioning and facial rejuvenation; however, currently used absorbable threads generally lack intrinsic antimicrobial functionality, which may increase the risk of postoperative infection. Here, we report a biodegradable antibacterial lifting thread based on a nanocellulose/MOF composite system. The thread was fabricated via a green wet-spinning strategy using carboxymethylated cellulose nanofibrils (CCNF, prepared with cellulose derived from Astragalus residue) and sodium alginate (SA) as the structural matrix, while tetracycline hydrochloride-loaded ZIF-8 nanoparticles were incorporated to provide sustained antibacterial activity. The resulting antibacterial CCNF/SA thread (AB-CCNF/SA) exhibited a uniform morphology and a tensile strength of 80 MPa. The porous ZIF-8 carriers enabled efficient drug loading and controlled release, providing effective antibacterial activity against Staphylococcus aureus and Escherichia coli. Meanwhile, the composite threads showed favorable biodegradability, with approximately 45% degradation within 56 days, together with excellent cytocompatibility as demonstrated by fibroblast viability above 90%. In vivo studies further revealed inflammatory responses comparable to those of commercial collagen threads, confirming the good biocompatibility of the system. Overall, this work establishes a strategy for integrating nanocellulose structural materials with MOF-enabled antibacterial drug delivery, providing a multifunctional platform that combines mechanical support, biodegradability, and sustained antibacterial activity for minimally invasive soft tissue lifting and related biomedical implant applications. Full article

Objectives: This study aimed to investigate the therapeutic efficacy of a hydrogel loaded with Wharton’s Jelly mesenchymal stem cells (WJ-MSCs) and melatonin, administered to the liver either via mesh–hydrogel implantation or intraperitoneal hydrogel injection, in a thioacetamide (TAA)-induced liver fibrosis animal model. Methods: A collagen-based hydrogel containing WJ-MSCs and melatonin was prepared for injection as well as combined with electrospun mesh for implantation. Hydrogel and mesh were characterized with respect to morphology, degradation, and mechanical properties. In in vivo studies, liver fibrosis was induced in rats by intraperitoneal injection of TAA for 6 weeks. After fibrosis induction, animals received either hydrogel injection or implantation of the combined construct. After 21 days, serum and liver tissues were collected, and biochemical, histopathological, and ultrastructural analyses were performed through comparative evaluation of experimental groups. Results: SEM results demonstrated that hydrogel, with appropriate porosity, was well integrated with the mesh without any detachment. The mesh, composed of submicron-scale fibers, exhibited a Young’s modulus of 10.37 ± 2.33 MPa. The hydrogel presented a degradation profile with a 40% mass loss in 24 h, reaching approximately 50% by day 30. Biochemical results indicated significant improvement in liver regeneration with both treatment strategies, particularly with the implanted construct. Histopathological analysis revealed decreased inflammation and hepatocyte vacuolization following both treatments; however, collagen accumulation was significantly reduced in the implant group. Ultrastructural analysis showed preserved nuclear integrity and reduced endoplasmic reticulum dilation and degenerative changes in implant group. Conclusions: The combination of WJ-MSCs and melatonin-loaded hydrogel with supportive mesh particularly enhanced tissue regeneration in liver fibrosis. Full article

Objectives: This study aimed to compare vertical bone gain (VBG) and horizontal bone gain (HBG) after guided bone regeneration using titanium-reinforced dense PTFE (TiR-dPTFE) versus reinforced PTFE mesh (RPM) at 9 and 12 months on three-dimensional tomographic imaging, and to perform histological assessment in selected cases. Materials and Methods: This prospective comparative case series included 14 patients (46 vertical ridge defect sites) treated with guided bone regeneration using either Ti-reinforced dPTFE membranes (TiR-dPTFE; n = 23) or resorbable porcine collagen membranes (RPM; n = 23). All sites received a 60:40 mixture of autogenous bone chips and anorganic bovine bone mineral (ABBM). After 9 months, during implant placement, a protective secondary augmentation using a 70:30 ABBM/autogenous mixture was performed and covered with a collagen membrane. Vertical and horizontal bone gain (VBG, HBG) were assessed on standardized matched CBCT cross-sections obtained at 9 and 12 months. Core biopsies were harvested at implant placement (9 months) for histological evaluation. Surgical and healing complications were recorded. Results: Both membranes produced significant VBG. TiR-dPTFE achieved greater VBG than RPM at 9 months (p = 0.045) and 12 months (p = 0.012) and remained stable from 9 to 12 months, whereas RPM showed a significant decline over time (MDa −0.48 mm; 95% CI −0.64 to −0.31; p < 0.001). HBG was similar between groups at both time points (p = 0.918 and p = 0.922). No major clinical complications occurred. Histology at 9 months confirmed vital bone formation and graft integration in both groups. Conclusions: Both TiR-dPTFE and RPM are reliable options for vertical ridge augmentation; TiR-dPTFE yielded superior and more stable vertical gains over 12 months, with comparable horizontal outcomes. Clinical Relevance: TiR-dPTFE may offer enhanced vertical augmentation, while both membranes remain suitable for implant site development. Full article

Surgical sutures are widely used biomaterials in clinical practice. Like all other biomaterials, they induce a foreign body response after implantation that involves inflammation and angiogenesis. Although it is well known that these processes differ in males and females, sex-specific differences in the tissue response to sutures have not been investigated so far. To do this in the present study, polypropylene sutures were implanted into the dorsal skinfold chamber and subcutaneous flank tissue of male and female mice to assess their acute and chronic effects on the local tissue microenvironment using intravital fluorescence microscopy and immunohistochemistry over 14 and 28 days, respectively. Microhemodynamic parameters and the numbers of rolling and adherent leukocytes in venules next to the implants were comparable in male and female mice. Immunohistochemical analyses on day 14 revealed a stronger neutrophilic (myeloperoxidase (MPO)⁺ cells: 526 ± 29 mm⁻²) and macrophage (CD86⁺ cells: 188 ± 21 mm⁻²; CD163⁺ cells: 269 ± 25 mm⁻²) response, as well as reduced T-cell activation (CD3⁺ cells: 31 ± 4 mm⁻²) in females when compared to males (MPO⁺ cells: 221 ± 25 mm⁻²; CD86⁺ cells: 120 ± 15 mm⁻²; CD163⁺ cells: 101 ± 19 mm⁻²; CD3⁺ cells: 62 ± 13 mm⁻²), while microvessel density and collagen deposition in the forming granulation tissue around the implants did not differ between sexes. In the flank model, there were no detectable sex-specific differences in the chronic foreign body response. These findings demonstrate that polypropylene sutures provoke a stronger early activation of the innate immune system in females, whereas the chronic foreign body response to the implants is comparable in both sexes. Full article