*3.4. Characteristics and Results of the Studies*

In the selected studies, the applications and efficacy of the use of calcium sulfate in oral surgery were assessed. Two articles evaluated its effectiveness in the treatment of periodontal defects [28,29], three studies evaluated its use as a graft material in alveolar preservation [30,32], and one studied its application in the regeneration of maxillary bone defects after the surgical removal of radicular cysts [33] and another in sinus lifts [34].

Only two authors evaluated the efficacy of calcium sulfate in the guided bone regeneration of periodontal defects. First of all, Pandit et al. [29] obtained a decrease in probing depth of 2.67–4 mm, an increase in the clinical attachment of 1.6–2.47 mm, and a reduction in the periodontal defect of about 2 mm, without observing statistically significant differences between the groups. Secondly, Mandlik et al. [29] obtained a decrease in the probing depth and a gain in the clinical attachment level of about 5 mm in both groups without presenting statistically significant differences.

Of the three studies [30–32] that evaluated the use of calcium sulfate in alveolar preservation procedures, Horowitz et al. [32] reported that bone volume and density were maintained after extractions and after 4 months; Matchei et al. [30] and Mayer et al. [31] instead reported a slight bone loss in height of 0.65 mm [30] and 0.3 mm [31] and width of 0.5 mm [30] and 0.03 mm [31], respectively.

All of the studies performed a histopathological analysis. Matchei et al. [30] reported new bone formation in 44.4% and 16.51% of remnant calcium sulfate. Similar results were found in Mayer et al. [31], who observed that the composition of the new bone consists of 47.7% bone, 36.3% connective tissue, and 16% remaining graft material, and finally Horowitz et al. [32] reported that after 4 months the calcium sulfate graft was reabsorbed completely.




*Coatings* **2022**, *12*, 1350


Dudek et al. [33] evaluated the efficacy of calcium sulfate in the regeneration of maxillary bone defects after the surgical removal of radicular cysts compared to the use of xenografts and observed that calcium sulfate achieves slightly faster bone remodeling and has almost complete resorption and a new bone replacement at 3 months.

The use of calcium sulfate as a graft material in lateral membrane sinus lifts was evaluated by Laino et al. [34], who obtained a mean bone height gain of 8.21 ± 1.73 mm after 6 months.
