Search Results (135)

Tooth extraction induces changes in both hard and soft tissues, which may compromise implant placement. Leukocyte- and platelet-rich fibrin (L-PRF) is used to promote tissue healing, either alone or in combination with other grafting materials. Objective: This study aimed to compare post-extraction socket healing using L-PRF alone or combined with a biphasic calcium phosphate graft (HA/β-TCP) after eight weeks. Materials and Methods: 15 patients, both sexes, mean age 56.7 ± 8.2 years, requiring alveolar ridge preservation after single-rooted tooth extraction for subsequent implant placement, were included. Sockets were randomly assigned to four groups: control with blood clot only (CTR), autogenous bone graft (AB), L-PRF membrane (LPRF), and L-PRF combined with HA/β-TCP (LPRFHA). The protocol consisted of tooth extraction and immediate graft placement, followed by bone biopsy at 8 weeks for histomorphometric analysis and implant installation. New Bone Formation (NBF) was quantified from ten photomicrographs per sample using ImageJ software (version 1.54, 5 February 2025). One-way ANOVA with Bonferroni post hoc tests was applied, with statistical significance set at p ≤ 0.05. Results: A significant difference in NBF (%) was observed between the control and LPRFHA groups (p = 0.014), with greater bone formation in the control group (62.4 ± 18.6%) compared with LPRFHA (55.8 ± 17.2%; p = 0.012). No significant differences were found among AB, LPRF, and LPRFHA groups. LPRF and AB showed comparable bone formation (60.2 ± 17.5% and 60.1 ± 20.0%, respectively). Conclusions: L-PRF, either alone or combined with HA/β-TCP, can be used for alveolar ridge preservation in maxillary sockets. L-PRF, alone or with synthetic HA/β-TCP graft, effectively preserves the anterior maxillary ridge for early loading at eight weeks. All treatments achieved bone formation for implant placement, with the blood clot alone showing superior results. Full article

In this research, aluminium-doped biphasic calcium phosphate (Al-BCP) was synthesized by co-precipitation and formulated with hydrolyzed collagen and acetylsalicylic acid (ASA) to yield composites designed as a new class of bone-regenerative biomaterials with enhanced biological performance. Undoped and Al-modified powders (5/10 wt% Al precursor) were prepared at 40 °C (pH ~ 11) and calcined at 700 °C, and composites were produced at a 1:1:0.1 mass ratio (ceramic–collagen–ASA). Structure and chemistry were assessed by X-ray diffraction (XRD), Fourier-transform infrared (FTIR) and Raman spectroscopies, and X-ray photoelectron spectroscopy (XPS). Morphology and elemental distribution were examined by scanning electron microscopy/energy-dispersive X-ray spectroscopy (SEM/EDX). Biological performance was preliminarily evaluated using HaCaT (immortalized human keratinocytes) viability and antibacterial assays against Staphylococcus aureus and Escherichia coli. XRD confirmed a biphasic hydroxyapatite/β-tricalcium phosphate system and showed that Al incorporation shifted the phase balance toward hydroxyapatite (HAp fraction 54.8% in BCP vs. ~68.6–68.7% in Al-doped samples). FTIR/Raman preserved BCP vibrational signatures and revealed collagen/ASA bands in the composites. XPS/EDX verified the expected composition, including surface N 1s from organics and Al at ~2–5 at% for doped samples, with surface Ca/P ≈ 1.15–1.16. SEM revealed multigranular microstructures with homogeneous Al distribution. All composites were non-cytotoxic (≥70% viability); M_Al10_Col_ASA exceeded 90% viability at 12.5% dilution. Preliminary antibacterial assays against Gram-positive and Gram-negative strains showed modest, time-dependent reductions in CFU relative to controls. These results corroborate the compositional/structural profile and preliminary biological performance of Al-BCP–collagen–ASA composites as multifunctional bone tissue engineering materials that foster a bone-friendly microenvironment, warranting further evaluation for bone regeneration. 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

Background: Alveolar bone resorption remains a major challenge in implant and prosthetic rehabilitation. While autologous bone grafts are still considered the gold standard, their biological and surgical limitations have promoted the use of synthetic biomaterials such as biphasic calcium phosphate (BCP), β-tricalcium phosphate (β-TCP), nanocrystalline hydroxyapatite, and bioactive glass. Methods: This systematic review, conducted in accordance with PRISMA guidelines, was based on a comprehensive search performed in March 2025 across PubMed, MEDLINE, Embase, and Google Scholar. A total of 11 clinical studies—including both randomized and non-randomized comparative trials—were identified. Due to the marked heterogeneity of study designs and outcome measures, meta-analysis was not feasible. Reported outcomes focused on bone volume preservation, residual biomaterial, implant stability, histological integration, and postoperative complications. Results: Overall, synthetic biomaterials achieved satisfactory bone regeneration and implant stability, with mean bone preservation ranging between 85% and 95%, often comparable to xenografts and other grafting materials. Among the materials analyzed, β-TCP and BCP generally demonstrated superior resorption control and dimensional stability, while bioactive glass showed favorable integration and remodeling rates. The addition of bioactive agents such as rhBMP-2, rhPDGF-BB, or platelet-rich plasma further enhanced new bone formation. Conclusions: Within the limits of current evidence, synthetic biomaterials show clinical performance comparable to xenografts, particularly in socket preservation and ridge augmentation procedures. Their predictable handling, absence of donor-site morbidity, and potential for bioactive enhancement make them valuable tools for routine clinical use. Larger, standardized trials with long-term follow-up are needed to validate these findings and refine material selection in alveolar bone regeneration. Full article

The barrier membrane is a key component in guided bone regeneration (GBR); however, there is no current commercially available membrane universally suitable for all clinical situations. The semi-resorbable bioactive barrier membrane derived from a silk fiber sheet (SF), polyvinyl alcohol (PVA), and biphasic calcium phosphate (BCP) was fabricated to provide improved physical, mechanical, and bioactive properties. There were four experimental groups: PVA/SF, 1BCP/PVA/SF, 3BCP/PVA/SF, and 5BCP/PVA/SF. All fabricated membranes appeared white in color with a smooth texture; however, SEM images revealed a rougher top surface compared to the bottom surface. FTIR and DSC validated the presence of the SF and PVA with or without BCP. All membranes displayed high hydrophilicity, except the PVA/SF group, which remained hydrophobic on the bottom surface. The water uptake of all groups reached the plateau phase within 10 min. The degradation rate fell within the range of 5–20% over a three-month period. Both fibroblastic and osteoblastic cells attached and survived on the BCP-incorporated membranes, comparable to those observed in the commercially available ossifying collagen membrane. Among the fabricated membranes, the 3BCP/PVA/SF formulation demonstrated the most favorable physical, mechanical, and biological properties for GBR applications. Full article

Biphasic calcium phosphate (BCP)scaffolds comprising hydroxyapatite (HA) and β-tricalcium phosphate (β-TCP) were produced from ultra-pure precursors and processed under an α-TCP–avoiding schedule (1100 °C, 2 h). Quantitative X-ray diffraction (Rietveld/Profex) detected no α-TCP above the ~1 wt% limit of detection and quantified post-sintering phase fractions (wt% HA/β-TCP): 99.26/0.74, 68.51/31.49, and 27.57/72.43. Across compositions, SEM/ImageJ yielded similar mean macropore sizes (≈71–80 µm), while open porosity increased with the HA fraction (27.5 ± 1.8%, 39.1 ± 2.0%, 57.1 ± 2.4%). Compressive strength decreased accordingly (1.07 ± 0.25, 0.24 ± 0.01, 0.05 ± 0.02 MPa), consistent with non-load-bearing use. In ISO-compliant simulated body fluid (28 d), medium pH remained stable (7.33–7.43); mass loss and early Ca²⁺ depletion increased with β-TCP content, consistent with more extensive surface apatite formation in β-TCP-rich scaffolds. Collectively, these data are consistent with a composition-dependent sequence—β-TCP content → densification/porosity → strength → degradation/apatite kinetics—within the tested conditions and inform parameter-based tuning of BCP scaffolds for non-load-bearing indications (e.g., alveolar ridge preservation, craniofacial void filling). Full article

Background: Maxillomandibular bone defects present a complex challenge in regenerative medicine due to anatomical and functional intricacies. Calcium phosphate (CP)-based biomaterials have emerged as promising bone graft substitutes due to their biocompatibility, osteoconductivity, and bioactivity. Aim: This Review highlights recent clinical and experimental advancements in CP-based biomaterials for maxillomandibular bone regeneration, bridging the gap from bench to bedside. Method: An in vitro, in vivo, and clinical literature review was conducted to evaluate the performance of CP ceramics, including hydroxyapatite (HA), tricalcium phosphate (TCP), biphasic ceramics, and novel composites with polymers, growth factors, and nanoparticles. Results: Calcium phosphate-based biomaterials demonstrate excellent bone regeneration potential, with Beta-tricalcium phosphate (β-TCP) and HA being the most widely utilized. Composite scaffolds and 3-dimensional (3D)-printed constructs show enhanced mechanical properties and biological integration. Clinical trials have confirmed the safety and efficacy of CP-based materials, yielding promising outcomes in osteoconduction and defect healing. However, limitations persist regarding mechanical strength and long-term degradation profiles. Conclusions: CP-based biomaterials offer significant clinical promise for maxillomandibular bone regeneration. Continued advancements in scaffold design and biofunctionalization are crucial for overcoming current limitations and fully realizing their therapeutic potential. Full article

Calcium phosphate coatings are known for their osteoconductive prowess. In this work, calcium phosphate coatings were studied on a model biodegradable magnesium alloy of AZ31, primarily to provide improved corrosion protection and, more importantly, to confer in vitro cytocompatibility to the AZ31 alloy. Correspondingly, an aqueous-based approach was developed to deposit Sr²⁺-substituted calcium phosphates on micro-arc oxidized AZ31. Micro-arc oxidation was used mainly as a pretreatment technique due to improved homogeneity and adhesion strength in comparison to the coatings formed by the traditionally used alkaline and acidic pretreatment. Calcium phosphate coatings with up to 11.5 mol. % Sr were formed on micro-arc oxidized AZ31 substrates. Despite observation of greater than the intended 10 mol. % Sr to the calcium phosphate coatings as measured within the measurement error, biphasic mixtures of dicalcium phosphate dihydrate and poorly crystalline hydroxyapatite were formed. Micro-arc oxidation treatment, nevertheless, provided a slight improvement in corrosion protection compared to uncoated AZ31. However, much-improved corrosion protection was provided by the calcium phosphate coatings prepared either with or without Sr²⁺. The calcium phosphate coatings prepared with Sr²⁺ were also observed to support improved MC3T3-E1 murine pre-osteoblast cell proliferation compared to the calcium phosphate coated substrates prepared without Sr²⁺. Full article

Bone tissue restoration requires biomaterials, which combine osteoinductivity and the capability to prevent surgical site infections. Magnesium-substituted biphasic calcium phosphate (Mg-BCP) represents a promising solution, as magnesium substitution increases the biodegradation rate of calcium phosphate ceramics and provides inherent antibacterial properties. This study aimed to achieve wet precipitation synthesis of magnesium-substituted (1–10 mol%) biphasic calcium phosphate and to evaluate its drug delivery potential and antibacterial performance. Porous Mg-BCP granules were fabricated via the gelation of Mg-BCP suspension in sodium alginate followed by polymer removal. Drug delivery potential was evaluated using methylene blue as a model compound, with methylcellulose encapsulation implemented to ensure prolonged release. Magnesium content directly ruled the phase composition: low concentrations (1%) favored hydroxyapatite phase prevalence, while higher concentrations led to the β-tricalcium phosphate formation. Further assessment of drug delivery potential revealed that direct drug loading resulted in burst release, whereas methylcellulose encapsulation successfully enabled prolonged drug delivery. Mg-5BCP formulation demonstrated significant antimicrobial activity with growth inhibition of 17.7 ± 4.1% against C. albicans, 20.8 ± 7.0% against E. faecalis, and 12.9 ± 7.5% against E. coli. Therefore, Mg-5BCP–methylcellulose composite granules present a versatile platform for antibacterial drug delivery for bone tissue engineering applications. Full article

The development of efficient antibiotic-releasing materials derived from sustainable and recyclable compounds represents a key area within biomedical materials science, particularly in the treatment of antibacterial infections. Herein, a Fe³⁺/terephthalate-based metal–organic framework (MIL-53) and a novel advanced material made of MIL-53 with biogenic hydroxyapatite (1) were prepared by solvothermal reactions, and these were studied in detail as a Penicillin-G-releasing material. After loading Penicillin G on 1 and MIL-53, the antibiotic percentage release was studied, and the antimicrobial effectiveness of each material was evaluated against two bacterial ATCC strains (E. coli and S. aureus) and various Penicillin-G-resistant uropathogenic strains such as E. coli isolates (HHM 25, ERV 6, and FGI 4). Functional, structural, and morphological characteristics of these materials were thoroughly studied by analytical tools (FTIR, XRD, BET, SEM-EDS, and XPS). The Penicillin G load did not exceed 50% in both materials. The Penicillin G adsorption mechanism involves several types of interactions with the materials. The release of the antibiotic was more efficient from MIL-53, where the load did not exceed 20%. The release was analyzed using mathematical models. They indicated that when Penicillin G is released from MIL-53, the process follows diffusion through a uniform matrix; however, 1 is more porous, which helps with the release by diffusion of Penicillin G, and 1 exhibits more than a 90% inhibition of the growth of bacteria and strains like MIL-53. This suggests a valuable approach to antibiotic activity against resistant pathogens. The use of composite materials derived from the Fe-MOF with a sustainable matrix of hydroxyapatite as antibiotic-releasing materials has been unexplored until now. 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 systematic review aimed to evaluate the effectiveness of teriparatide (TP) in guided bone regeneration (GBR). An electronic search without language or date restrictions was performed in PubMed, Web of Science, Scopus, Scielo, and gray literature for articles published until June 2025. Inclusion criteria considered studies evaluating the effect of TP on bone regeneration, analyzed using SYRCLE’s Risk of Bias tool. Twenty-four preclinical studies were included, covering diverse craniofacial models (mandibular, calvarial, extraction sockets, sinus augmentation, distraction osteogenesis, segmental defects) and employing systemic or local TP administration. Teriparatide consistently enhanced osteogenesis, graft integration, angiogenesis, and mineralization, with potentiated effects when combined with various biomaterials, including polyethylene glycol (PEG), hydroxyapatite/tricalcium phosphate (HA/TCP), biphasic calcium phosphate (BCP), octacalcium phosphate collagen (OCP/Col), enamel matrix derivatives (EMDs), autografts, allografts, xenografts (Bio-Oss), strontium ranelate, and bioactive glass. Critically, most studies presented a moderate-to-high risk of bias, with insufficient randomization, allocation concealment, and blinding, which limited the internal validity of the findings. TP shows promising osteoanabolic potential in guided bone regeneration, enhancing bone formation, angiogenesis, and scaffold integration across preclinical models. Nonetheless, its translation to clinical practice requires well-designed human randomized controlled trials to define optimal dosing strategies, long-term safety, and its role in oral and craniomaxillofacial surgical applications. Full article

Magnesium whitlockite (Mg-WH) has emerged as a promising biomaterial for bone regeneration due to its compositional similarity to natural bone minerals. This study aimed to systematically modify a dissolution–precipitation synthesis method to produce Mg-WH granules with tailored morphologies and controlled phase compositions for possible use in bone regeneration applications. Three distinct precursor granules were prepared by mixing varying amounts of ammonium dihydrogen phosphate and magnesium hydrogen phosphate with calcium sulfate. The precursors were then transformed into biphasic and single-phase Mg-WH granules by means of immersion in magnesium- and phosphate-containing solutions under controlled conditions. The X-ray diffraction results demonstrated that biphasic materials containing Mg-WH and either calcium-deficient hydroxyapatite (CDHA) or dicalcium phosphate anhydrous (DCPA) formed after 24 h of synthesis, depending on the synthesis conditions. Prolonging the reaction time to 48 h resulted in complete transformation into single-phase Mg-WH granules. Fourier-transform infrared spectroscopy confirmed the presence of functional groups characteristic of Mg-WH, CDHA, and DCPA in the intermediate products. The spectra also indicated the absence of precursor phases and the progressive elimination of secondary phases as the reaction time increased. Scanning electron microscopy analyses revealed notable morphological transformations from the raw granules to the product granules, with the latter exhibiting interlocked spherical and rod-like particles composed of fine Mg-WH rhombohedral crystals. N₂ adsorption–desorption analyses exposed significant differences in the surface properties of the synthesized granules. By varying precursor, reaction solution compositions, and reaction times, the study elucidated the phase evolution mechanisms and demonstrated their impact on the structural, morphological, and surface properties of Mg-WH granules. Full article

The present study reports on the manufacturing of biphasic calcium phosphate (BCP) honeycomb scaffolds with tailored microporous walls using phase separation-assisted digital light processing (PS-DLP). To create micropores in BCP walls, camphene was used as the pore-forming agent for preparing BCP suspensions, since it could be completely dissolved in photopolymerizable monomers composed of triethylene glycol dimethacrylate (TEGDMA) and polyethylene glycol diacrylate (PEGDA) and then undergo phase separation when placed at 5 °C. Therefore, solid camphene crystals could be formed in phase-separated BCP layers and then readily removed via sublimation after the photopolymerization of monomer networks embedding BCP particles by DLP. This approach allowed for tight control over the microporosity of BCP walls by adjusting the camphene content. As the camphene content increased from 40 to 60 vol%, the microporosity increased from ~38 to ~59 vol%. Consequently, the overall porosity of dual-scale porosity scaffolds increased from ~51 to ~67 vol%, while their compressive strength decreased from ~70.4 to ~13.7 MPa. The mass transport ability increased remarkably with an increase in microporosity. Full article

Background/Objectives: The rehabilitation of severely resorbed anterior alveolar ridges presents significant clinical challenges due to esthetic demands and the limited bone volume in this region. Basal cortical implants, which are designed to engage dense basal bone, could offer an alternative by providing stable anchorage in compromised sites. Methods: This report evaluates the ARi^® Implant System, which features cortical anchorage and a calcium-incorporated nanostructured surface (XPEED^®) in two anterior ridge defect cases. Soft tissue augmentation using a vascularized interpositional periosteal (VIP) flap was applied in one case, and biphasic calcium phosphate (BCP) grafting and collagen membranes were employed for ridge contouring in both cases. Results: At a two-year follow-up, both cases showed stable peri-implant tissues and satisfactory esthetic results. Conclusions: Although basal cortical implants provide good primary stability, their use does not eliminate the need for bone augmentation, especially in the anterior esthetic region. Future clinical studies are required to substantiate long-term outcomes and broader applicability. Full article