Impact of biomaterials on intra-sinus bone changes around dental implants following indirect sinus augmentation: A randomized clinical trial

Efficacy of injectable platelet-rich fibrin associated with particulated deproteinized bovine bone mineral in horizontal maxillary regeneration – a randomized, triple blinded, split-mouth controlled clinical trial

Comparative Evaluation of Bone Ring versus Particulate Bone Graft using CBCT in Buccal Bone Augmentation with Simultaneous Implant Placement: A Randomised Controlled Trial

The Bone Ring Technique (BRT) is a newer viable option for restoring complex defects around dental implants with three-dimensional bone augmentation with significant height and width augmentation of buccal bone.

Effect of Titanium-Prepared Platelet-Rich Fibrin on Extraction Socket Preservation: A CBCT-Based Volumetric Analysis

Objective: Alveolar ridge remodeling following tooth extraction may compromise subsequent implant placement. Titanium-prepared platelet-rich fibrin (T-PRF) has been proposed as an autologous biomaterial that may enhance socket healing and minimize post-extraction dimensional changes. This study aimed to compare the radiographic healing of extraction sockets treated with T-PRF and those left to heal spontaneously using cone-beam computed tomography (CBCT)-based volumetric analysis. Methods: A total of 30 systemically healthy patients (18 males and 12 females) requiring tooth extraction followed by implant placement were enrolled in this randomized clinical trial. A total of 58 extraction sockets were included, with 27 sockets allocated to the T-PRF group and 31 sockets assigned to spontaneous healing (control group). The initial CBCT examination (baseline assessment) was performed 7–10 days after tooth extraction, and a follow-up CBCT examination was performed 3 months after extraction. Baseline socket volume, residual non-ossified socket volume, and the estimated percentage of socket fill were assessed using dedicated volumetric analysis software. Because some participants contributed more than one extraction socket, generalized estimating equations (GEE) were used to account for within-patient clustering. Results: Baseline socket volumes were comparable between the groups (p = 0.752). At 3 months, the residual non-ossified socket volume was significantly lower in the T-PRF group than in the control group (0.043 cm³ vs. 0.087 cm³; p = 0.013). Both groups demonstrated progressive socket healing over time; however, the estimated percentage of socket fill was significantly higher in the T-PRF group than in the control group (80.1% vs. 57.3%). Conclusion: Within the limitations of this randomized clinical trial, T-PRF was associated with improved radiographic healing of extraction sockets, as reflected by a lower residual non-ossified socket volume after 3 months compared with spontaneous healing. T-PRF may represent a simple, autologous, and clinically useful adjunct for socket preservation prior to implant placement.

ASSESSMENT OF THE BIO- STIMULATORY IMPACT OF T-PRF COMPARED TO T-PRF AUGMENTED WITH DIODE LASER IN DENTAL IMPLANTS FOR THE REPLACEMENT OF POSTERIOR MANDIBULAR TEETH: A RANDOMIZED CONTROL TRIAL

Background: Successful dental implant therapy primarily depends on osseointegration, a biological process involving sequential bone healing and remodeling around the implant surface. Bio-stimulatory approaches such as Titanium Prepared Platelet Rich Fibrin (T-PRF) and Low-Level Laser Therapy (LLLT) have gained attention because of their potential to enhance tissue regeneration, improve implant stability, and accelerate healing. Aim: To assess and compare the bio-stimulatory impact of T-PRF alone and T-PRF augmented with diode laser therapy in dental implants placed for replacement of posterior mandibular teeth. Materials and Methods: This prospective randomized controlled clinical trial included 50 patients with unilateral posterior mandibular edentulous spaces requiring implant-supported rehabilitation. Patients were randomly allocated into two equal groups: Group A received T-PRF alone, whereas Group B received T-PRF combined with LLLT. Implant stability was assessed using Resonance Frequency Analysis and Implant Stability Quotient (ISQ) values at baseline, 3 months, and 6 months. Bone density was evaluated using Cone Beam Computed Tomography (CBCT), while postoperative pain was assessed using Numerical Rating Scale (NRS) scores at different postoperative intervals. Statistical analysis was performed using SPSS software with p<0.05 considered statistically significant. Results: Both groups demonstrated progressive improvement in implant stability and peri-implant bone density during follow-up. The T-PRF + LLLT group showed lower postoperative pain scores compared with T-PRF alone, with a statistically significant difference observed on postoperative Day 2 (p<0.05). However, no statistically significant differences were observed between groups regarding implant stability or bone density. Conclusion: Adjunctive use of LLLT with T-PRF effectively reduced early postoperative pain but did not provide significant additional benefits regarding implant stability or bone density compared with T-PRF alone.

One-Year Clinical and Radiographic Outcomes of Alveolar Bone Regeneration Using 3D-Printed β-Tricalcium Phosphate Biomaterials for Single Implant Rehabilitation: A Retrospective Study.

OBJECTIVES To evaluate the one-year clinical and radiographic outcomes of single implant rehabilitation performed following alveolar ridge regeneration using 3D-printed β-tricalcium phosphate (β-TCP) biomaterials applied according to three different regenerative protocols. METHODS Thirty consecutive patients requiring localized alveolar ridge augmentation before or during single implant rehabilitation were retrospectively included. According to the regenerative protocol, patients were allocated to delayed block regeneration (DBR; n = 9), simultaneous block regeneration (SBR; n = 9), or simultaneous granular regeneration (SGR; n = 12). In total, 9 Naturactis® and 21 iBone® implants (Lyra ETK, Sallanches, France) were placed. Clinical outcomes included regenerative success, implant survival, biological and prosthetic complications. Radiographic outcomes were assessed by cone beam computed tomography (CBCT) and endoral radiographs and included horizontal and vertical bone gain together with peri-implant marginal bone remodelling after one year of functional loading. RESULTS Primary regenerative success was achieved in 26 of 30 patients (86.7%). Four regenerative failures (13.3%) occurred exclusively in the block groups (DBR: 22.2%; SBR: 22.2%), whereas no failures were observed following granular regeneration. All unsuccessful cases were successfully managed through secondary augmentation, resulting in complete final regenerative success and successful completion of implant rehabilitation in all patients. Implant survival was 100% after one year of functional loading. Mean horizontal bone gain was 4.3 ± 1.2 mm, while mean vertical bone gain was 2.8 ± 1.1 mm. Mean peri-implant marginal bone loss was 0.42 ± 0.24 mm, with no significant differences among the three treatment protocols (p > 0.05). CONCLUSIONS 3D-printed β-TCP biomaterials demonstrated favourable clinical and radiographic outcomes for alveolar ridge regeneration supporting single implant rehabilitation. Although primary regenerative failures occurred only following block regeneration, successful secondary treatment resulted in complete final regenerative success and 100% implant survival. Larger prospective studies with longer follow-up are required to confirm these preliminary findings and further clarify the biological differences between block and granular formulations. STATEMENT OF CLINICAL RELEVANCE 3D-printed β-TCP biomaterials may provide a predictable alternative for localized alveolar ridge regeneration supporting single implant rehabilitation.

Bone regeneration after transcrestal sinus lift using nanoscale super-hydrophilic versus standard implant surfaces: a single-center, 12-month, parallel controlled clinical trial

Wettability of dental implants surface might be an additional key variable in the regeneration process and osseointegration. The aim of the study was to evaluate the effect of a new nanoscale roughness, combined with super-hydrophilic surface on bone volume change after trans-crestal sinus floor lift procedure for implant positioning. The study was reported according to SPIRIT guidelines. A 12-month, single-center, parallel group clinical trial was conducted to compare changes in bone regeneration and crestal bone level as shown on x-ray, following trans-crestal sinus floor lift using a collagenated hydroxyapatite graft and insertion of single dental implants with two different surfaces: moderately rough surface implants (Control Group – CG) and nanoscale super-hydrophilic surface implants (Test Group – TG). Radiographic bone volume and maximum height of regenerated bone as well as peri-implant crestal bone level were evaluated immediately following implant insertion and after 12 months. A multivariate regression model was built to address the impact of surface characteristics and clinical variables on the outcome. The study was completed by 25 participants (12 in the TG and 13 in the CG). CG achieved a volume change of 94.54mm3 (SD 70.24), while the TG increased by 207.41mm3 (SD 168.10) Focusing on bone height gain, CG presented 6.25 mm (SD 1.88), compared to 5.02 mm (SD 1.71) in the TG. For both outcomes, no statistically significant differences were found between the two groups (p = 0.087 for bone volume change; p = 0.123 for bone height gain). Multivariate linear regression models only partially explained observed variance (respectively 8.6 and 35.4%), resulting in non-statistically significant predictions. Despite the trend of a higher bone volume observed in the hydrophilic surface group, taking into consideration all the variables, this study did not reveal any significant differences in terms of bone regeneration between groups. Within the limitations of this study, implants with a nanoscale super-hydrophilic surface did not result in significantly greater bone regeneration than conventional moderately rough implants following transcrestal sinus floor elevation, although a trend toward increased bone volume was observed. Further clinical studies are required to clarify the potential regenerative advantages of hydrophilic implant surfaces.