Bone Graft Material Research Articles

Treatment of furcation defects using various bone grafts and guided tissue regeneration membranes: A review on single-center institutional studies

Abstract Bone formation in class II furcation is least due to the morphology of the root in case of multirooted teeth performed by conventional procedure. Hence, various bone grafts with membranes have been tried in the current study to evaluate its efficacy by comparing test and control groups. This collection of research from a single center presents a bone graft and guided tissue regeneration (GTR) membrane-based furcation therapy. Bio-Oss and Bio-Gide, PerioGlas and Atrisorb, Periobone G and Resolut XT, as well as PepGen P-15 and Atrisorb, were among the bone graft materials used, both with and without the GTR barrier. Patients were divided into four groups based on the periodontal regenerative materials used. A periodontal flap procedure was performed where periodontal intraosseous defect along with furcation defects were present. The results show that the bone formation in the furcation area was more with Group C (Periobone G and Resolut XT) as compared to the least amount of bone formation in Group A (Bio-Oss and Bio-Gide) in the test group, and this same group shows least bone formation in control. To conclude, clinical outcomes observed with the combined use of Atrisorb as a GTR barrier and PerioGlas as a bone graft material improved the clinical measurements of furcation defect depth compared to the use of PerioGlas alone.

Mechanical and thermal characterization of additive manufactured fish scale powder reinforced PLA biocomposites

This research work is aimed to convert fish scale wastes as an effective reinforcement in polylactic acid (PLA) as a new bio-composite filament for fused deposition-based 3D printing applications. Various concentrations of fish scale particles (0, 10, 20, and 30%) were used to make the filaments. The performance of the developed filaments was assessed by printing the filament into various test specimens to perform tensile, flexural, impact, hardness, and water absorption experiments as per the ASTM standards. The outcomes of the results show that the PLA/fish scale powder (20%) composite has performed well than the remaining composites. Furthermore, the adding 20% fish scale powder increased the tensile strength and flexural strength of the 3D printed PLA composite by 15% and 39.78% respectively. This is evident that the novel bio-composite exhibited better properties than the pure polymer making it a potential replacement as bone-grafting material and scaffolds for bio-engineering applications.

Re-understanding the role of enamel matrix proteins in periodontal regeneration

Enamel matrix proteins (EMP) are deposited on the surface of developing roots before dentin formation and may play a role in osteogenesis. Amelogenins (Am) are the main and active component in EMPs. Studies had showed great clinical values of EMPs in periodontal regenerative treatment and other fields. By affecting the expression of growth factors and inflammatory factors, EMPs could act on various periodontal regeneration-related cells to promote angiogenesis, anti-inflammation, bacteriostasis and tissue healing, achieving the clinical effect of periodontal tissue regeneration (newly generated cements and alveolar bones as well as functionally penetrated periodontal ligament). EMPs alone or combined with bone graft material and barrier can be used for regenerative surgical treatment in intrabony defects and degree Ⅱ furcation-involved at maxillary buccal or mandibular teeth. EMPs can also be adjunctively used to treat recession type 1 or 2 gingival recessions, forming periodontal regeneration on the exposed root surface. Through a comprehensive understanding of the principle and current clinical application of EMPs on periodontal regeneration, we can look forward to their future development. The development of recombinant human amelogenin to replace animal-derived EMPs through bioengineering technologies, the study of the clinical application of EMPs combined with other collagen biomaterials, and the specific application of EMPs in severe soft and hard periodontal tissue defects and peri-implant lesions are all important development directions of future EMPs-related researches.

Radiographic evaluation of immediate placement implant in fresh extraction socket with bone graft (HYPRO-OSS)

Introduction: Xenograft play role in osseointegration of immediate placement dental implant. The study’s objective is to assess the effectiveness of xenograft (Hypro-oss) in radiographically documenting the osseointegration of immediate dental implants. Patients and methods: This study, which involved 8 patients aged 18 to 48, was carried out. divided into two equal groups, 12 immediate dental implants; (Control Group): Immediate placement of a dental implant after atraumatic extraction of a single-rooted tooth or remaining root, (Study Group): Single-rooted teeth in the maxillary arch’s anterior region should be extracted without trauma, and any remaining roots should be immediately replaced with dental implants and sealed with Hypro-Oss bone graft material. Clinical examinations done for all patients prior to surgery include examination of oral and para oral tissues and evaluation the intermaxillary space and the type of occlusion. In order to measure the density of the formed bone between living bone and the implant surface, radio- graphic evaluations using CBCT were performed at intervals of 15, 90, 180, and 270 days after surgery. Result: None of the patients displayed any indications or symptoms of soft tissue pain, tenderness, redness, or inflammation around the implant site. The soft tissue and bone around the implant should heal normally. The follow-up period was continued by all patients. Radiographic evaluation showed significant higher bone density in study group than control group after 15, 90, 180 and 270 days. Conclusion: The bone density around the implant increased when the Hypro-Oss bone graft was used.

The Concept of Scaffold-Guided Bone Regeneration for the Treatment of Long Bone Defects: Current Clinical Application and Future Perspective.

The treatment of bone defects remains a challenging clinical problem with high reintervention rates, morbidity, and resulting significant healthcare costs. Surgical techniques are constantly evolving, but outcomes can be influenced by several parameters, including the patient's age, comorbidities, systemic disorders, the anatomical location of the defect, and the surgeon's preference and experience. The most used therapeutic modalities for the regeneration of long bone defects include distraction osteogenesis (bone transport), free vascularized fibular grafts, the Masquelet technique, allograft, and (arthroplasty with) mega-prostheses. Over the past 25 years, three-dimensional (3D) printing, a breakthrough layer-by-layer manufacturing technology that produces final parts directly from 3D model data, has taken off and transformed the treatment of bone defects by enabling personalized therapies with highly porous 3D-printed implants tailored to the patient. Therefore, to reduce the morbidities and complications associated with current treatment regimens, efforts have been made in translational research toward 3D-printed scaffolds to facilitate bone regeneration. Three-dimensional printed scaffolds should not only provide osteoconductive surfaces for cell attachment and subsequent bone formation but also provide physical support and containment of bone graft material during the regeneration process, enhancing bone ingrowth, while simultaneously, orthopaedic implants supply mechanical strength with rigid, stable external and/or internal fixation. In this perspective review, we focus on elaborating on the history of bone defect treatment methods and assessing current treatment approaches as well as recent developments, including existing evidence on the advantages and disadvantages of 3D-printed scaffolds for bone defect regeneration. Furthermore, it is evident that the regulatory framework and organization and financing of evidence-based clinical trials remains very complex, and new challenges for non-biodegradable and biodegradable 3D-printed scaffolds for bone regeneration are emerging that have not yet been sufficiently addressed, such as guideline development for specific surgical indications, clinically feasible design concepts for needed multicentre international preclinical and clinical trials, the current medico-legal status, and reimbursement. These challenges underscore the need for intensive exchange and open and honest debate among leaders in the field. This goal can be addressed in a well-planned and focused stakeholder workshop on the topic of patient-specific 3D-printed scaffolds for long bone defect regeneration, as proposed in this perspective review.

3D-printed mesoporous bioactive glass scaffolds for enhancing bone repair via synergetic angiogenesis and osteogenesis

Blood vessels play an important role in bone growth and fracture healing by providing nutrients and oxygen. Although great progress has been made in bone graft materials with good biological and physicochemical properties, vascularization of these materials remains an urgent challenge for bone regeneration. Herein, we report a novel 3D-printed mesoporous bioactive glass (MBG) scaffold (ICA/TMP@MBG) incorporating two unique extracts from Chinese medicine, namely tetramethylpyrazine (TMP) and icariin (ICA), for enhanced vascularization and bone repair. In vitro results showed that ICA/TMP@MBG could significantly upregulate VEGF secretion, thereby facilitating the formation of angiogenesis tubes in human umbilical vein endothelial cells (HUVECs). On the other hand, it can also promote the osteogenic differentiation of rat bone marrow mesenchymal stem cells (rBMSCs) by stimulating the expression of OPN, ALP, OCN and BMP-2. In addition, in vivo tests further demonstrated that ICA/TMP@MBG could significantly enhance vascularization and accelerate bone healing in a mouse skull defect model. Therefore, the 3D-printed ICA/TMP@MBG has great potential to promote angiogenesis and osteogenesis in bone regeneration.

Continuously released Zn2+ in 3D-printed PLGA/β-TCP/Zn scaffolds for bone defect repair by improving osteoinductive and anti-inflammatory properties.

Long-term nonunion of bone defects has always been a major problem in orthopedic treatment. Artificial bone graft materials such as Poly (lactic-co-glycolic acid)/β-tricalcium phosphate (PLGA/β-TCP) scaffolds are expected to solve this problem due to their suitable degradation rate and good osteoconductivity. However, insufficient mechanical properties, lack of osteoinductivity and infections after implanted limit its large-scale clinical application. Hence, we proposed a novel bone repair bioscaffold by adding zinc submicron particles to PLGA/β-TCP using low temperature rapid prototyping 3D printing technology. We first screened the scaffolds with 1wt% Zn that had good biocompatibility and could stably release a safe dose of zinc ions within 16 weeks to ensure long-term non-toxicity. As designed, the scaffold had a multi-level porous structure of biomimetic cancellous bone, and the Young's modulus (63.41±1.89MPa) and compressive strength (2.887±0.025MPa) of the scaffold were close to those of cancellous bone. In addition, after a series of in vitro and in vivo experiments, the scaffolds proved to have no adverse effects on the viability of BMSCs and promoted their adhesion and osteogenic differentiation, as well as exhibiting higher osteogenic and anti-inflammatory properties than PLGA/β-TCP scaffold without zinc particles. We also found that this osteogenic and anti-inflammatory effect might be related to Wnt/β-catenin, P38 MAPK and NFkB pathways. This study lay a foundation for the follow-up study of bone regeneration mechanism of Zn-containing biomaterials. We envision that this scaffold may become a new strategy for clinical treatment of bone defects.

Autologous tooth for bone regeneration: dimensional examination of Tooth Transformer® granules.

Since 1967, when the osteoinduction properties of autogenous demineralized dentin matrix were discovered, autologous tooth grafts have been advocated as a viable option to autologous or heterologous bone graft. Tooth graft materials may be extracted from the patient's whole tooth using a granulating device. The aim of this study was to examine the size of granules obtained by the Tooth Transformer (TT)® device, using a laser instrument with high precision. The TT® device can obtain bone graft material in a short period from an extracted tooth. The resulting material can act as an osteoconductive scaffold, providing a mineral substrate during resorption, including platelet growth factors and morphogenetic proteins. Different studies have investigated the dimension and behavior of various graft material particles, since the size of the grafted particles may play a role in osteogenesis and bone regeneration. Different dimensions of granules are available: small (< 400 µm), medium (400 µm-1,000 µm) and large (1,000 µm-2,000 µm). From 4.03 µm to 100 µm the percentage of granules was 14.52 ± 1.93%. A larger part of the granules was up to 100 µm, while 85.47 ± 1.93% of the granules were from 100 µm to 1,000 µm. 85% of the granules produced were in accordance with the dimensions suggested in the literature.

Determination of Osteoblast Cell Viability and Histological Changes of Samples Obtained from Different Implant Drills during Osteotomy.

The bone particles collected during osteotomy could be used as autogenous bone graft materials for dental implant surgery. Different factors such as drill design may influence its clinical viability. This study examined the effect of drill design on the osteoblast viability and histopathology parameters of bone collected during the preparation of dental implant site. In this experimental study, 90 samples were obtained from three different bone drilling systems including Bego, Implantium, and Dio during fixture installation in patients requiring treatment at the Department of Periodontology, Dentistry University Hamedan. The MTT (3-4,5-Dimethylthiazol2,5-diphenyltetrazolium bromide) was used to determine percentage of cell viability. Samples were fixed in 10% formaldehyde for histological evaluation. Then, they were kept in 10% EDTA solution for 4 weeks for decalcification. The provided slides were evaluated regarding bone structure and osteocytes counts for assessment of viability. Tukey test and SPPS 21 software were used for statistical analysis. The result showed the viability of osteoblast obtained by Dio (0.45±0.04) was significantly better than Bego (0.37±0.05) and Implantium (0.37±0.04) systems. In histopathological evaluation, the grafting material obtained by Dio presented the best osteoblast morphology. It might be concluded that drill geometry has significantly influenced the viability of bone particles collected during the preparation of implant sites .Moreover, characteristic geometry alone cannot represent the performance of a particular drill, and several geometric features should be concerned. The results of this study showed that the geometry of the Dio drill was the best considering the viability and histopathological evaluations.

Particulate bone graft materials for periodontal and implant surgery: A narrative review and case series

Particulate bone graft materials for periodontal and implant surgery: A narrative review and case series

A Study of Two Novel Techniques for One-stage Closure of Chronic Oroantral Fistula and Sinus Floor Lift.

This study aimed to compare two novel techniques for chronic oroantral fistula (OAF) closure combined with maxillary sinus floor elevation. Ten patients who had implant installation needs but suffered from a chronic OAF were enrolled in the study from January 2016 to June 2021. The technique applied involved OAF closure and simultaneous sinus floor elevation by either a transalveolar or lateral window approach. Bone graft material evaluation results, postoperative clinical symptoms and complications were compared between the two groups. Student's t -test and χ 2 test were used to analyze the results. In this study, 5 patients with a chronic OAF were treated with the transalveolar approach (group I), and 5 were treated with the lateral window approach (group II). The alveolar bone height was significantly higher in group II than in group I ( P ＜0.001). The pain at 1 day ( P =0.018) and 3 days ( P =0.029) postoperatively and facial swelling at 7 days ( P =0.016) postoperatively were obviously greater in group II than in group I. There were no severe complications in either group. The techniques combined OAF closure with sinus lifting to reduce surgical frequency and risks. The transalveolar approach resulted in milder postoperative reactions, but the lateral approach could provide more bone volume.

A novel rodent model of chronic spinal implant-associated infection

BACKGROUND CONTEXTBacterial infection of spinal instrumentation is a significant challenge in spinal fusion surgery. Although the intraoperative local application of powdered vancomycin is common practice for mitigating infection, the antimicrobial effects of this route of administration are short-lived. Therefore, novel antibiotic-loaded bone grafts as well as a reliable animal model to permit the testing of such therapies are needed to improve the efficacy of infection reduction practices in spinal fusion surgery. PURPOSEThis study aims to establish a clinically relevant rat model of spinal implant-associated infection to permit the evaluation of antimicrobial bone graft materials used in spinal fusion. STUDY DESIGNRodent study of chronic spinal implant-associated infection. METHODSInstrumentation anchored in and spanning the vertebral bodies of L4 and L5 was inoculated with bioluminescent methicillin-resistant Staphylococcus aureus bacteria (MRSA). Infection was monitored using an in vivo imaging system (IVIS) for 8 weeks. Spines were harvested and evaluated histologically, and colony-forming units (CFUs) were quantified in harvested implants and spinal tissue. RESULTSPostsurgical analysis of bacterial infection in vivo demonstrated stratification between MRSA and phosphate-buffered saline (PBS) control groups during the first 4 weeks of the 8-week infection period, indicating the successful establishment of acute infection. Over the 8-week chronic infection period, groups inoculated with 1 × 105 MRSA CFU and 1 × 106 MRSA CFU demonstrated significantly higher bioluminescence than groups inoculated with PBS control (p = 0.009 and p = 0.041 respectively). Histological examination at 8 weeks postimplantation revealed the presence of abscesses localized to implant placement in all MRSA inoculation groups, with the most pervasive abscess formation in samples inoculated with 1 × 105 MRSA CFU and 1 × 106 MRSA CFU. Quantification of CFU plated from harvested spinal tissue at 8 weeks post-implantation revealed the 1 × 105 MRSA CFU inoculation group as the only group with a significantly greater average CFU count compared to PBS control (p = 0.017). Further, CFU quantification from harvested spinal tissue was greater than CFU quantification from harvested implants across all inoculation groups. CONCLUSIONOur model demonstrated that the inoculation dosage of 1 × 105 MRSA CFU exhibited the most robust chronic infection within instrumented vertebral bodies. This dosage had the greatest difference in bioluminescence signal from control (p < 0.01), the lowest mortality (0% compared to 50% for samples inoculated with 1 × 106 MRSA CFU), and a significantly higher amount of CFUs from harvested spine samples than CFUs from control harvested spine samples. Further, histological analysis confirmed the reliability of this novel rodent model of implanted-associated infection to establish infection and biofilm formation of MRSA for all inoculation groups. CLINICAL SIGNIFICANCEThis model is intended to simulate the infection of instrumentation used in spinal fusion surgeries concerning implant locality and material. This model may evaluate potential antimicrobial and osteogenic biomaterials and investigate the relationship between implant-associated infection and failed fusion.

Functional Biomaterials for Local Control of Orthodontic Tooth Movement.

Orthodontic tooth movement (OTM) occurs with the application of a controlled mechanical force and results in coordinated tissue resorption and formation in the surrounding bone and periodontal ligament. The turnover processes of the periodontal and bone tissue are associated with specific signaling factors, such as Receptor Activator of Nuclear factor Kappa-β Ligand (RANKL), osteoprotegerin, runt-related transcription factor 2 (RUNX2), etc., which can be regulated by different biomaterials, promoting or inhibiting bone remodeling during OTM. Different bone substitutes or bone regeneration materials have also been applied to repair alveolar bone defects followed by orthodontic treatment. Those bioengineered bone graft materials also change the local environment that may or may not affect OTM. This article aims to review functional biomaterials that were applied locally to accelerate OTM for a shorter duration of orthodontic treatment or impede OTM for retention purposes, as well as various alveolar bone graft materials which may affect OTM. This review article summarizes various types of biomaterials that can be locally applied to affect the process of OTM, along with their potential mechanisms of action and side effects. The functionalization of biomaterials can improve the solubility or intake of biomolecules, leading to better outcomes in terms of increasing or decreasing the speed of OTM. The ideal timing for initiating OTM is generally considered to be 8 weeks post-grafting. However, more evidence is needed from human studies to fully understand the effects of these biomaterials, including any potential adverse effects.

Cranioplasty with autograft and bone grafting material: a clinical case study

A clinical study of the effectiveness of delayed cranioplasty with an autologous bone flap using allogenic bone grafting material was performed. The autograft was preserved, saturated with human collagen type 1, lyophilized and sterilized. Bone-plastic material was used to fill diastases. The patient was followed up in the postoperative period for 24 months. No clinical complications were registered. Radiological and radioisotope analysis showed normal fixation of the autograft after 6, 12 and 24 months. Biopsy analysis after 12 months showed the presence of regenerative processes in the absence of inflammation. The clinical result was assessed as successful.

Cranioplasty with autograft and bone grafting material: a clinical case study

A clinical study of the effectiveness of delayed cranioplasty with an autologous bone flap using allogenic bone grafting material was performed. The autograft was preserved, saturated with human collagen type 1, lyophilized and sterilized. Bone-plastic material was used to fill diastases. The patient was followed up in the postoperative period for 24 months. No clinical complications were registered. Radiological and radioisotope analysis showed normal fixation of the autograft after 6, 12 and 24 months. Biopsy analysis after 12 months showed the presence of regenerative processes in the absence of inflammation. The clinical result was assessed as successful.

Lateral Bone Augmentation Using a Three-Dimensional-Printed Polymeric Chamber to Compare Biomaterials.

The aim of this study was to test the suitability of calcium phosphate cement mixed with poly(lactic-co-glycolic acid) (CPC-PLGA) microparticles into a ring-shaped polymeric space-maintaining device as bone graft material for lateral bone augmentation. Therefore, the bone chambers were installed on the lateral portion of the anterior region of the mandibular body of mini-pigs. Chambers were filled with either CPC-PLGA or BioOss® particles for comparison and left for 4 and 12 weeks. Histology and histomorphometry were used to obtain temporal insight in material degradation and bone formation. Results indicated that between 4 and 12 weeks of implantation, a significant degradation of the CPC-PLGA (from 75.1% to 23.1%), as well as BioOss material, occurred (from 40.6% to 14.4%). Degradation of both materials was associated with the presence of macrophage-like and osteoclast-like cells. Furthermore, a significant increase in bone formation occurred between 4 and 12 weeks for the CPC-PLGA (from 0.1% to 7.2%), as well as BioOss material (from 8.3% to 23.3%). Statistical analysis showed that bone formation had progressed significantly better using BioOss compared to CPC-PLGA (p < 0.05). In conclusion, this mini-pig study showed that CPC-PLGA does not stimulate lateral bone augmentation using a bone chamber device. Both treatments failed to achieve "clinically" meaningful alveolar ridge augmentation.

Optimized osteogenesis of biological hydroxyapatite-based bone grafting materials by ion doping and osteoimmunomodulation.

Biological hydroxyapatite (BHA)-based bone grafting materials have been widely used for bone regeneration in implant surgery. Much effort has been made in the improvement of their osteogenic property as it remains unsatisfactory for clinical use. Osteoimmunomodulation plays a significant role in bone regeneration, which is highly related to active inorganic ions. Therefore, attempts have been made to obtain osteoimmunomodulatory BHA-based bone grafting materials with optimized osteogenic property by ion doping. To summarize and discuss the active inorganic ions doped into BHA and their effects on BHA-based bone grafting materials. A literature search was performed in databases including Google Scholar, Web of Science and PubMed, with the elementary keywords of "ion doped" and "biological hydroxyapatite", as well as several supplementary keywords. All document types were included in this search. The searching period and language were not limited and kept updated to 2022. A total of 32 articles were finally included, of which 32 discussed the physiochemical properties of BHA-based biomaterials, while 12 investigated their biological features in vitro, and only three examined their biological performance in vivo. Various ions were doped into BHA, including fluoride, zinc, magnesium and lithium. Such ions improved the biological performance of BHA-based biomaterials, which was attributed to their osteoimmunomodulatory effect. The doping of active inorganic ions is a reliable strategy to endow BHA-based biomaterials with osteoimmunomodulatory property and promote bone regeneration. Further studies are still in need to explore more ions and their effects in the crosstalk between the skeletal and immune systems.

Expression of Stro-1, Runx-2, Osterix, and Alp in Alveolar Bone Regeneration Process Following the Administration of Hydroxyapatite Gypsum Puger (HAGP) Scaffold

Introduction: Tooth extraction before denture placement could result in trauma and damage to up to 50% of the alveolar bone, inducing bone resorption, and affecting the patient’s quality of life. Hydroxyapatite Gypsum Puger (HAGP) can be used as an alternative to bone graft material which degrades slowly, affecting the proliferation and activity of cells that are responsible for bone tissue engineering. This study aimed to analyze the regeneration mechanism of alveolar bone by administering the HAGP scaffold and observing the Stro-1, Runx-2, Osterix, and ALP expression. Methods: Laboratory experimental research was conducted and we used 150-355µm HAGP scaffold particles, applied in vivo inside alveolar sockets of the rats for 7, 14, and 28 days, followed by immunohistochemical examination of Stro-1, Runx-2, Osterix, and ALP expressions. Results: The HAGP scaffold group showed that the Stro-1 expression was significantly higher than the K(-) group, and the Runx-2 expression increased on day 7 and decreased on day 28 in the HAGP and K(-) groups. Osterix expression increased from day 7, 14, to day 28. The high expression of Osterix on day 28 means it took over the Runx-2 function. In ALP there was a significant increase on day 7. ALP expression was a sign of early osteoblast differentiation and production by cells, this extracellular matrix mineralization is an indicator of the osteogenic process. Conclusion: Alveolar bone regeneration mechanism in rats revealed that the expression of Stro-1, Runx-2, Osterix, and ALP was higher in the HAGP scaffold group compared to the control group on days 7,14, and 28.

Octacalcium phosphate, a promising bone substitute material: a narrative review.

Biomaterials have been used to supplement and restore function and structure by replacing or restoring parts of damaged tissues and organs. In ancient times, the medical use of biomaterials was limited owing to infection during surgery and poor surgical techniques. However, in modern times, the medical applications of biomaterials are diversifying owing to great developments in material science and medical technology. In this paper, we introduce biomaterials, focusing on calcium phosphate ceramics, including octacalcium phosphate, which has recently attracted attention as a bone graft material.

Osseointegration evaluation of an experimental bone graft material based on hydroxyapatite, reinforced with titanium-based particles.

Bone graft materials are more and more frequently used in dentistry for improving the periodontal support and for creating a bone support favorable for the insertion of dental implants. The experimental study carried out on laboratory animals aimed to evaluate the biocompatibility and the manner of integration of an experimental bone augmentation material, based on hydroxyapatite (HAp), reinforced with titanium-based particles by comparison with a commercial synthetic graft material already existing on the profile market, also based on HAp. We noticed a common pattern of evolution, although there were differences related to the speed of new bone tissue formation and implicitly the morphological elements captured at the two moments of time. In the presence of both synthetic materials, ossification also begins from the center of the cavity at distance from the margins of the bone defect, with a common pattern with an appearance with the presence of osteon-like structures. The experimental material generally determined a more intense initial inflammatory reaction, followed by the generation of a repair bone tissue with a denser appearance but with a less uniform structure and a greater number of residual particles.