Bone Augmentation Research Articles

This preclinical study evaluated the influence of two defect morphologies on graft material displacement (GMD) during primary wound closure in horizontal bone augmentation (HBA). Secondary aims included assessing the effect of membrane stabilization and the role of local soft tissue characteristics on GMD. Standardized HBA procedures following guided bone regeneration principles were performed on fresh pig hemimandibles. Each mandible received two sequential HBAs, randomized for defect morphology-partially contained (PCD) vs. contained (CD)-and membrane stabilization with (+Pins) or without (-Pins) four fixation pins. GMD was assessed using cone-beam computed tomography and intraoral scanning by comparing graft dimensions before and after wound closure, at ninelevels from the implant platform and across nine delimited sections, respectively. Sixty HBA procedures were analyzed. A notable GMD was observed for both PCD and CD, with no significant differences between them. In contrast, membrane stabilization significantly reduced three-dimensional GMD across all sections, with the most pronounced effect in the central-crestal section (p < 0.001). At the implant platform level, GMD was -15.8% ± 25.6% with pins vs. -38.1% ± 27.4% without pins (p < 0.001). Across all groups, GMD occurred in an apico-lateral direction, with the greatest volume loss in the central-crestal, mesial, and distal crestal sections. Soft tissue phenotype did not affect GMD (p ≥ 0.240). Defect morphology did not significantly influence the notable apico-lateral GMD. However, membrane stabilization using pins effectively reduced graft displacement, minimizing movement during primary wound closure.

Guided bone regeneration (GBR) has been widely used in the repair and reconstruction of alveolar bone defects. However, conventional GBR techniques often fail to achieve the desired bone augmentation for severe bone defects (diameter≥5 mm). To address this limitation, several innovative GBR-based approaches, such as the tenting and sausage techniques have been developed, achieving varying degrees of clinical success. Nonetheless, these methods still face considerable challenges, including secondary trauma from autogenous bone harvesting, high technical sensitivity, and limited scalability. In response, our team proposed a novel treatment concept centered on the principle of "stability-core", and developed a new therapeutic strategy that avoids the use of autogenous bone. This strategy involves the development of a new series of tent-peg medical devices and the introduction of the pouch technique, which has been successfully applied in clinical practice. This case report presents the successful use of the pouch technique for vertical ridge augmentation in the maxillary posterior region. At 8-month follow-up, substantial vertical bone gain and restoration of the alveolar ridge contour were achieved. Implant placement and prosthetic rehabilitation were completed with satisfactory functional recovery. The patient reported a positive treatment experience. This technique offers a promising and practical solution for alveolar bone reconstruction.

Injectable light-cured and bioabsorbable silk fibroin/hyaluronic acid (SF-HA) hydrogel tissue barrier for accelerating guided bone regeneration.

There is demand for new biomaterials that reduce the morbidity associated with a second graft site needed for autologous bone grafting and facilitate the surgical procedure. Here we compared bone volume gain using a supercritical CO2-processed allogeneic bone paste and bone powder in partially edentulous patients requiring bone augmentation of alveolar ridges by guided bone regeneration (GBR) to place one or more implants. Eighty-six patients with bone defects requiring horizontal and/or vertical bone augmentation were randomly assigned to receive allogeneic bone paste or bone powder for GBR. The primary outcome was horizontal bone gain at implant placement measured by cone-beam computed tomography (CBCT) 4-6 months post grafting. Secondary outcomes were ease of graft manipulation, surgery duration, absolute bone gain, peri-implant marginal bone height, implant survival, and complications. Of 42 bone paste patients receiving 51 implants and 40 bone powder patients receiving 53 implants analyzed per protocol, 38% and 72% achieved horizontal bone gain corresponding to the desired pregraft bone volume, respectively (p<0.001). Both groups showed stable bone gain during initial healing and after implant placement, with 88.6% and 90.6% of implants maintained in the bone paste and bone powder groups at study completion, respectively (p=0.43). Six implants were lost in the bone paste group and five in the bone powder group. Supercritical CO2-processed bone paste allografts are safe, augment bone, and result in acceptable implant survival for alveolar ridge augmentation by GBR. However, suboptimal material properties due to the viscoelastic consistency of the bone paste resulted in significantly less bone gain than bone powder, which will guide the choice of material clinically. The trial is registered at the US National Library ClinicalTrials.gov (NCT04141215). This first randomized controlled trial of supercritical CO2-processed bone paste allografts confirms their safety, adequate bone augmentation, and implant survival, but inadequate mechanical strength resulted in significantly less bone gain than with bone powder.

To plan an implantation surgery with prior bone augmentation in the area of the maxillary sinus floor, it is necessary to study the anatomy of the maxillary sinus in detail. The anatomical characteristics of the maxillary sinus include its shape, type of pneumatization, symmetry, presence of internal partitions - septa, ratio of the volume of compact and spongy bone tissue in the area of the lower wall, structure of the maxillary sinus floor. Of particular clinical importance is the volume of the sinus, which affects the choice of the surgical technique for restoring the integrity of the dentition on the upper jaw. The aim of the study was to study the volume of the maxillary sinus in men and women in different age groups depending on the composition of the dentition according to CBCT data. 496 CBCT were studied. The subjects were divided into age groups and groups depending on the presence and/or absence of chewing teeth (except for third molars). The results of determining the average volume of the maxillary sinuses using CBCT showed that the largest sinus volume was observed in men aged 55–64 years and amounted to 40.75 ± 1.18 cm3 in the presence of premolars and molars, 41.15 ± 1.03 cm3 in the group with a missing premolar and/or molar, 41.51 ± 1.37 cm3 on the right in the group with complete absence of premolars and molars. The smallest average sinus volume according to CBCT data was noted in men in the age group of 45–54 years. The sinus volume on the right was larger than on the left in most of the observed cases. Most of the sinuses examined were asymmetrical. As a result of the loss of chewing teeth, the volume of the maxillary sinus increases.

Subject. In the research we present the long-term results of strength and stability of dental implants in 4, 6, 12 months dynamics in case of jaw bone tissue augmentation by the different methods. The authors highlighted the relevance and significance of this research issue, especially in the cases when implantation is the only possible way for fixed (relatively fixed) prosthetic treatment. Contemporary treatment protocols are aimed at extending of implants and their dental prostheses life term [1, 4, 12, 15]. In this context, analysis of the results of jaw bone tissue augmentation operation efficiency and stability of dental implants in dynamics have the particular importance. The authors made data analyses of actual local and foreign researches. The objective of the study is the analyses of jaw bone tissue augmentation operation by the method of autotransplantation and guided bone regeneration with using of xenogenic filler material efficiency in dynamics 4, 6, 12 months after operation. Methodology: Statistical analyses were done with using of JMP Pro Statistical Discovery (v. 18.0) Mann-Whitney’s and Kolmogorov-Smirnov tests/ In this research 48 patients with severe atrophy of bone tissue were included. The study included 43 clinical cases of severe bone tissue atrophy, in which 76 implants were placed in augmented bone tissue. The effectiveness of dental implantation was evaluated after 4, 6, and 12 months based on clinical signs and torque testing using the Periotest M device. The results: After 4 months, we recorded cases of adequate osseointegration in the autoplasty group 23% more often than in the second group. Torque testing after 6 and 12 months recorded adequate average values of implant stability in both groups. The conclusion: while using autoplastic materials during augmentation of jaw bone tissue, the average measures of the implant secondary stability in 4 months after-operation period statistically significant have better measures than in the group after the using of xenotransplants, which allows for earlier timing of orthopedic alignment.

Xenograft bone, autologous bone grafts or allogeneic bones from a bone bank are used for bone augmentation, reconstruction or other purposes, when the volume, shape, and size of each jawbone defect require different bone materials. In the case of some bigger and locally advanced bone defects, the use of allogeneic bone can be suitable and used with great success if the wound and bone are especially carefully maintained; however, the healing period of each bone depends on good and stable wound closure followed by improved local antiseptic protocol. The individuality of each bone defect might also require additional prophylactic titanium plating in order to decrease the risk of possible mandibular fracture or to help improve bone stability, reduce bone mobility and possible inflammation or granulation tissue formation. Early radiological estimation of bone healing evaluation might be troublesome and not fully visible in radiological evaluation in the early stages of bone healing. On the other hand, possible bone inflammation, radiolucent defects, and granulation formation could be noted in cases of acute or long-lasting bone grafting material inflammation, bacterial contamination within the bone defect area, or the presence of fistula. The presented case describes a very good outcome from a dentigerous cyst removal with bone defect grafting and plating; however, because of wound dehiscence and allogeneic bone graft exposure, the patient required one additional procedure.

Bone regenerative medicine focuses on restoring damaged tissue, with bone augmentation materials commonly used to fill defects, support recovery and addressing issues related to aging, bone diseases or trauma in dental and orthopedic procedures. To avoid complications associated with harvesting autogenous tissue grafts, novel applications focus on alloplastic materials to support regenerative and healing processes. However, current synthetic materials demonstrate shortcomings specifically pertaining to mimicking bone regenerative properties of autogenous bone. Whether bioactive fractions enriched for human platelet lysate derived extracellular vesicles (hPLEV-Fs) could biologize alloplastic materials with their non-immunogenic tissue-restorative potential, stimulate intercellular communication between bone-forming osteoblasts and bone-resorbing osteoclasts and transform alloplastic materials in potent regenerative grafts needs to be determined. This study investigated hPLEV-Fs impact on bone regenerative pathways and evaluated whether combination with a collagen-embedded β-tricalcium phosphate (β-TCP) three-dimensional matrix enhances bone regeneration. Treatment with hPLEV-F improved osteoblasts' proliferation, differentiation and mineralization in both murine and human primary osteoblasts while reducing inflammatory responses, which was further supported by systems-wide phosphoproteome-screening of bone-remodeling pathways. Although initial pre-osteoclastic differentiation was enhanced under hPLEV-F treatment, cells remained in a non-resorbing state, indicating potential for increased net bone formation. Furthermore, hPLEV-F stimulated osteoblasts to increase osteoprotegerin secretion, limiting osteoclast differentiation, especially in combination with β-TCP biomaterial. Our data demonstrate the potential of hPLEV-F to stimulate bone cell interaction and support bone regenerative pathways, thereby suggesting it as a biologizing agent in combination with synthetic biomaterial. This creates innovative possibilities in biointerface engineering thereby advancing patient care in clinical applications.

This scoping review aimed to systematically map and synthesize the current evidence regarding the use of autogenous dentin grafts (ADG) in bone augmentation procedures. The review was conducted following the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) guidelines. A comprehensive search was performed in MEDLINE (PubMed), EMBASE, CINAHL, Cochrane Library, Livivo, LILACS, Web of Science, Scopus, and Google Scholar (gray literature) using the descriptors "Bone Regeneration," "Dentin," and "Dental Implants" combined with the Boolean operator AND. The initial search, conducted on December 23, 2024, retrieved 2,391 records, of which 16 met the eligibility criteria and were included in the final review. The findings indicate that autogenous dentin demonstrates efficacy in bone regeneration and alveolar ridge preservation, frequently exceeding the performance of allografts and xenografts. ADG was associated with increased bone density, enhanced implant stability, and improved soft tissue outcomes, particularly when combined with growth factors. Moreover, it was found to be a cost-effective alternative, producing outcomes comparable to other biomaterials regarding new bone formation and bone quality. Its osteoinductive properties further support long-term bone regeneration. Nonetheless, a lack of standardization in dentin processing protocols was noted across studies. ADG represents an effective and accessible option for implant-supported rehabilitation, and future research should focus on standardizing its clinical application.

To determine whether lateral sinus floor elevation (LSFE) through a less-invasive window design (LIWD) can achieve (1) adequate sinus augmentation and (2) a safe procedure with reduced patient discomfort compared to a large window design (LWD). Sixty LSFE (LIWD:30, LWD:30) with simultaneous implant installation were performed in a randomized controlled clinical trial on 60 subjects (75% males, mean age: 49.87±6.03) and followed for a mean of 30.7±0.41 months. Using CBCT (pre/post-operation), augmented bone height (primary outcome variable) and augmented bone length (secondary outcome variable) were measured to determine the adequacy of the augmentation. Perioperative complications were assessed to determine LIWD safety. The patient's postoperative quality of life (PPOQL) was also measured. Data were analyzed utilizing descriptive statistics, Chi-square tests, T-tests, and correlation analyses conducted with both Pearson and Spearman methods, with a significance level set at P-value< 0.05. The LIWD and LWD groups' mean window sizes were 21.7±3.3 and 58.7±12.0 mm², with significant differences (P-value <0.001). The augmented bone height and length showed no significant difference between the groups (P-value= 0.824, P-value= 0.591). Also, there was no correlation between window size and augmented bone height (r=0.006,P-value=0.96) and length (r=0.063,P-value=0.632). Membrane perforation rates and surgical time showed similar results in both groups. The PPOQL measures revealed less discomfort (P-value<0.0001) in the LIWD group. The LIWD provides a feasible, efficient, and safe approach for LSFE with adequate sinus augmentation. Reducing the window size does not increase surgical risks or duration. LIWD showed significantly less discomfort.

This study aimed to assess the clinical effectiveness of the sausage technique with simultaneous implant placement in the aesthetic zone. A total of 28 patients with horizontal bone defects and consecutive loss of multiple teeth in the maxillary anterior region were included in this retrospective study. Bone augmentation was performed using the sausage technique, and the conventional guided bone regeneration (GBR) technique served as the control. Cone-beam computed tomography (CBCT) was performed preoperatively, postoperatively, and after 6 months of bone healing. The horizontal bone width and bone volume were measured from CBCT images. The changes in horizontal width and bone volume, along with the corresponding resorption rates, were calculated. After 6 months of bone healing, the average bone width increased from 3.18mm to 7.82mm, with an increase of 4.64mm in the sausage technique group. Meanwhile, the horizontal bone width, horizontal bone gain, and bone augmentation volume were significantly higher in the sausage technique group than in the conventional GBR group (P<0.05). The sausage technique resulted in more horizontal bone gain compared with the conventional technique in the cases with horizontal bone defects and consecutive loss of multiple teeth in the anterior maxillary region. When combined with simultaneous implant placement for horizontal bone augmentation, the sausage technique achieves favorable clinical outcomes in the aesthetic zone.

To retrospectively evaluate whether implant apex flush with maxillary sinus notch is associated with greater bone augmentation of the concave sinus floor after graft-less transcrestal sinus floor elevation (TSFE) and simultaneous implant placement. All patients treated with TSFE between January 2017 and June 2020 were screened via radiographs. Patients with concave sinus floor at the planned implant site were selected and divided according to a cohort design as follows: implant apex flush with the maxillary sinus notch (test group) or not (control group). Panoramic images were taken before surgery, immediately, and 4 months after surgery. Two-dimensional augmentation parameters, including endo-sinus bone gain (ESBG), and the ratio of ESBG to implant protrusion length (%ESBG) were measured to evaluate the bone augmentation effect. Sixty-nine patients with a total of 69 implants (39: control group, 29: test group, 1: failure) were included in this retrospective research. At the 4-month follow-up, the ESBG and %ESBG of the test group [ESBG: 1.57 (0.58-2.37), %ESBG: 49.68% (15.38%-75.91%)] were significantly higher than those of the control group [ESBG: 0.48 (0.13-1.47), %ESBG: 11.73% (3.05%-27.96%), p < 0.05]. The present study preliminarily suggests that implant apex flush with the maxillary sinus notch may be associated with better bone augmentation of concave sinus floor in graft-less TSFE. This study is the first to propose the definition of the maxillary sinus notch and preliminarily explore its role in graft-less TSFE, providing novel insights into how implant protrusion length (IPL) affects bone augmentation.

INTRODUCTION. Today, pronounced atrophic changes in the alveolar jaws processes are often diagnosed, requiring bone tissue expansion using autogenic bone tissues of the patient, where various medical instruments and methods are used. Meanwhile, the problems of their improvement, minimizing the trauma of interventions, increasing regenerative processes and clinical effectiveness, have not been fully resolved. Thus, our research related to the optimization of medical instruments and methods remains relevant. AIM is optimization of bone augmentation in patients using the developed method of bone tissue sampling using an angular surgical tip with a protector-retractor with severe atrophy of the alveolar processes in preparation for dental implantation. MATERIALS AND METHODS. We used the developed device and method for creating cortical bone cuts during bone autograft sampling in bone plastic using an angular surgical tip with a retractor protector (patent No. 233201 dated 11.04.2025, published by 11.04.2025 Buhl. No. 11; Patent Application 2025120686, W25048732, issued 27.07.2025). The research was carried out at the surgical department of the dental clinic of North-Eastern Federal University and dental clinic “Avandent” (Yakutsk). Inclusion criteria in the research were associated with the presence of partial secondary adentia with marked alveolar atrophy. Exclusion criteria: generalized pathologies of decompensated form, malignant neoplasms, diseases of the hematopoietic system and intolerance to local anesthetics. Each patient gave his written consent for interventions. There were 2 groups: the main group – 105 patients, aged 42–68 years old; control group – 33, aged 40-69 years old using a protective device made of D.M. Mukhamadiev’s plastic (patent RU 213 284 U1, A61S 1/16 of 05.09.2022). Statistical processing of the material was carried out according to standard methods. RESULTS. The results characterized low-trauma, safety and efficiency of surgical interventions, and design features of developed protector-retractor with metal body and shortened irrigation tube for angular surgical tip provide tight fixation, as well as minimal delamination of mucoperiosteal flap, reusability of practical application and convenience of pre-sterilization cleaning. Whereas, the plastic tread does not have these advantages due to the design features and material of manufacture. CONCLUSIONS. The developed method provides certain advantages associated with the presence of a thin metal protector-retractor body for the angular surgical tip, which provides the best view of the surgical field, increases the safety and effectiveness of surgical interventions.

To evaluate the use and osseointegration of dental implants in combination with 3D-printed hydroxyapatite (3DHA) blocks featuring gyroid porosity for large mandibular bone augmentation. Mandibular lateral bone augmentation with gyroid-3DHA blocks was performed bilaterally on four female Göttingen minipigs. After 8 or 12 weeks of healing, a dental implant was placed into each 3DHA block. Following an additional 12-week healing period, the augmented sites (including 3DHA blocks and dental implants) were harvested for histological and histomorphometric analysis, assessing new bone formation, 3DHA integration, total bone gain, and bone-to-implant contact (BIC). Gyroid-3DHA blocks were easily fixated with screws. Dental implants were placed through the 3DHA blocks with a standard drilling procedure, and good primary stability was achieved. 3DHA blocks demonstrated good osseointegration with 39.17% of new bone and a significant bone gain of 4.73 mm on average. Dental implants showed comparable BIC within the 3DHA and into the native bone (42.79% vs. 34.17%). No significant difference was found between the healing periods. This is the first study to evaluate a 3D-printed bone substitute in combination with a dental implant in an animal study. Gyroid-3DHA blocks and dental implants demonstrated good osseointegration, and the bone augmentation was significant, making it a promising material for large and complex alveolar ridge augmentations.

Background The maxillary sinus lift procedure via a lateral approach is considered an invasive surgery with potential morbidity for patients. Simplifying the surgical technique can lead to better outcomes for both operators and patients. The Thin Wall Technique (TWT) involves creating a thin lateral wall of the maxillary sinus before bone osteotomy and fenestration. Case presentation The TWT aims to achieve this by, first, thinning the lateral wall of the maxillary sinus with a rotary bur, creating a circular osteotomy. Second, performing bone perforation with a blind instrument that leave thin bone attached to the sinus membrane. The sinus membrane is then lifted, and bone augmentation proceeds as in the classical lateral sinus approach. A resorbable collagen membrane was placed to close the lateral wall opening. Flap closure with double layer closure to prevent dehiscence. The time of sinus lift procedures were estimated and ranged between 45-60 minutes. The healing period for the graft material ranged between 6 and 9 months. Post-operative radiograph was taken to evaluate the bone graft augmentation. All cases experience no major complications and bone graft intake was successful. Implant placed with decent stability (35Ncm) and left to heal for 3 months before prosthetic delivery. Conclusion Thin Wall Technique has shown promise in maintaining sinus membrane integrity during osteotomy and lifting. However, further long-term studies are necessary to confirm these findings.

Reconstructive surgery often addresses severe bone defects that impact patients' lives. While microvascular bone transfer is standard, it has drawbacks. Thus, the focus shifts to using alloplastic grafts, avoiding donor sites. This study evaluates the biocompatibility of generatively printed high-performance resins. Six printed materials were compared with titanium scaffolds: native PEEK (poly-ether-ether-ketone) and native PEKK (poly-ether-ketone-ketone) as well as the surface-modified materials MBTg (Mimicking Bone Technology) PEEK, BCP-filled PEEK, 4h-argon-etched PEKK, and So_PPSU [polyphenylsulfone with barium sulfate (BaS8O4)]. The scaffolds were CAD/CAM manufactured and individually dimensioned using Fused Layer Manufacturing. Biocompatibility was assessed through cytotoxicity, osteoblast viability, and differentiation assays. Osteoblast colonization and adhesion were examined using fluorescence and electron microscopy. All materials were noncytotoxic (P<0.05). So_PPSU exhibited the highest cell proliferation rates. MBTg PEEK, BCP-filled PEEK, and native PEKK also showed significant increases over time (P<0.05). Alkaline phosphatase activity increased for all materials, with 4h-argon-etched PEKK, MBTg PEEK, and BCP-filled PEEK showing the greatest increases. Microscopy validated these findings. The tested materials were noncytotoxic, with MBTg-functionalized PEEK, 4h-argon-etched PEKK and BCP-filled PEEK showing the best biocompatibility. Furthermore, the study demonstrated the feasibility of a time-saving 3D printing process for the reproducible production of customized and functionally designed medical products.

Background: Osseointegration, first proposed by Dr. Brånemark, revolutionized dental implantology. However, traditional implants often present challenges in cases of severe bone atrophy, sinus enlargement, or systemic conditions such as uncontrolled diabetes. Basal or cortical implants, with their unique design enabling anchorage in the basal cortical bone, eliminate the need for bone augmentation and allow immediate functional loading. Objectives: To present a case series demonstrating the clinical application and outcomes of basal implant placement with immediate loading in patients with compromised bone conditions. Results: Two female patients aged 24 and 25 years underwent basal implant placement with immediate loading. The procedures, including socket preparation, implant placement, impression taking, and crown fabrication, were completed with minimal invasiveness and rapid recovery. Multi-cortical engagement principles were applied, achieving stable anchorage and functional restoration without bone grafting. Both cases demonstrated successful outcomes with immediate function and patient satisfaction. Conclusion: Basal implantology, based on multi-cortical engagement and immediate loading, provides a time- efficient, cost-effective, and reliable solution for dental rehabilitation in patients with inadequate bone volume for conventional implants. This approach offers predictable results even in anatomically or medically compromised cases.

Abstract Introduction Modern maxillofacial surgery increasingly emphasizes the restoration and regeneration of oral tissues, particularly the hard tissues of the jaws. Bone defects may arise from disease, trauma, or congenital anomalies. Guided bone regeneration (GBR) using barrier membranes is a widely accepted technique for managing such defects. However, standard titanium and PTFE membranes require a secondary surgical procedure for removal, limiting their clinical convenience. Although resorbable collagen membranes avoid this issue, they often lack sufficient structural integrity, making them less effective for vertical or complex bone augmentation. Aim This study aimed to evaluate the physicochemical properties of biodegradable membranes based on polylactic acid (PLA), its copolymers, and composite materials for potential use in GBR. In addition, the effects of sterilizing doses of ionizing radiation were assessed to determine an optimal sterilization protocol. Materials and Methods The materials tested included pure PLA, PLA reinforced with hydroxyapatite (PLA/HAP), and polyglycolic acid (PLGA) in two compositions: 85:15 and 60:40. Physicochemical properties and responses to electron beam sterilization (25 kGy) were analyzed. Biodegradation was evaluated in phosphate-buffered saline at 37 °C. Sample morphology and molecular structure were assessed using infrared (IR) spectroscopy and scanning electron microscopy (SEM). Results After one month, PLGA (60:40) samples exhibited approximately 40% mass loss, while PLGA (85:15) showed only about 5%. Pure PLA remained largely intact, with less than 1% mass loss. Non-irradiated PLA/HAP samples degraded inconsistently, with mass loss ranging from negligible to 19%, while irradiated PLA/HAP samples exhibited minimal degradation (up to 2%). This increased stability may be due to radiation-induced crystallinity, though further investigation is needed. In some cases, a slight mass increase was observed, possibly due to water diffusion into deeper composite layers. Among all tested materials, pure PLA demonstrated the highest stability, retaining its shape and showing minimal degradation throughout the study period. Conclusion The results support the potential use of PLA and its copolymers for developing biodegradable membranes in GBR. Ionizing radiation appears to be a viable sterilization method, with minimal impact on material integrity. Further optimization of physicochemical properties and degradation behavior is warranted to facilitate clinical application in maxillofacial surgery.

Color doppler flow imaging (CDFI) and cone-beam computed tomography (CBCT) were utilized to evaluate changes in mucosal vascular parameters and the osteogenic effects following guided bone regeneration (GBR) in the maxillary anterior region using trapezoidal or modified triangular flaps. Patients undergoing single maxillary anterior dental implant surgery with GBR were randomly allocated into two groups: a trapezoidal flap group and a modified triangular flap group. After GBR surgery, the mucosal vascular parameters at the surgical site were assessed at various time intervals (preoperative, 2 h, 1 and 3 days, and 1, 2, and 4 weeks postoperative) using CDFI. In addition, the effects of bone augmentation were evaluated through the analysis of CBCT images obtained preoperatively, 2 h, and 6 months postoperative. The buccal mucosa in the edentulous area had a lower blood flow rate than the corresponding tooth in the same jaw, and the difference was statistically significant (P<0.001). The mucosal blood flow rate in the surgical area increased compared with that in the preoperative period. The peak flow rate was recorded at 2 weeks postoperatively and then decreased to levels comparable to those of the reference tooth. A statistically significant difference was observed between the two groups (P<0.05). The buccal alveolar ridge width of the implant platform was reduced by (1.3±0.9) mm in the trapezoidal flap group and (0.9±0.7) mm in the modified triangular flap group, respectively, at 6 months postoperatively, compared with 2 h postoperative. The buccal alveolar ridge width of the 5 mm from the implant platform was reduced by (0.9±0.6) mm and (0.3±0.6) mm, respectively. The buccal alveolar ridge width of the 10 mm from the implant platform was reduced by (0.6±0.8) mm and (0.2±0.6) mm, respectively. The height of the alveolar ridge was reduced by (1.9±1.4 ) mm and (1.4±1.3) mm. The change in graft volume was (136±78 ) mm3 and (114±85) mm3. However, the differences between the two groups were not statistically significant (P>0.05). When a tooth is missing, blood flow to the buccal mucosa on the side of the missing tooth is reduced. The modified triangular flap group demonstrated superior microcirculation of blood flow in the operative area after GBR of the maxillary anterior teeth. Trapezoidal and modified triangular flaps achieved the anticipated bone augmentation during bone augmentation surgery in the maxillary anterior region, with no considerable effect on the changes in alveolar bone size parameters.

Clinical Research: Sticky Bone-Sausage Technique For Vertical Bone Augmentation