One-Year Clinical and Radiographic Outcomes of Alveolar Bone Regeneration Using 3D-Printed β-Tricalcium Phosphate Biomaterials for Single Implant Rehabilitation: A Retrospective Study.
Aug 2026· E -journal of dentistry· pp.
106990
· 0 citations· 44 references
Medicine
TL;DR
3D-printed β-TCP biomaterials demonstrated favourable clinical and radiographic outcomes for alveolar ridge regeneration supporting single implant rehabilitation and may provide a predictable alternative for localized alveolar ridge regeneration supporting single implant rehabilitation.
Abstract
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.
Horizontal ridge deficiencies in the anterior maxilla frequently compromise ideal implant positioning and esthetic outcomes. This randomized controlled clinical trial evaluated the clinical performance of customized CAD/CAM zirconia membranes compared with conventional collagen membranes for guided bone regeneration (GBR) performed simultaneously with early implant placement. Twenty systemically healthy patients requiring single-tooth replacement in the anterior maxilla underwent early implant placement (4–8 weeks after tooth extraction) combined with simultaneous contour augmentation using a composite graft of autogenous bone and deproteinized bovine bone mineral (1:1). Participants were randomly assigned to receive either a customized CAD/CAM zirconia membrane (test group, n = 10) or a double-layer collagen membrane (control group, n = 10). The primary outcome was horizontal bone gain (HBG) at 6 months, assessed by standardized CBCT superimposition. Secondary outcomes included soft tissue healing evaluated using the Modified Wound Healing Index (MWHI), membrane exposure (wound dehiscence), and patient-reported postoperative pain assessed using a visual analogue scale (VAS). All implants survived during the 6-month follow-up period (100% survival rate). Mean HBG was 6.18 ± 0.60 mm in the test group and 5.85 ± 0.37 mm in the control group, with no statistically significant difference between groups (p = 0.158). Membrane exposure occurred in all patients receiving customized zirconia membranes (10/10, 100%), whereas no membrane exposure was observed in the collagen membrane group (0/10, 0%). Despite the higher exposure rate, graft stability and horizontal bone regeneration were not adversely affected. Soft tissue healing was significantly more favorable in the collagen membrane group. Postoperative pain decreased significantly over time in both groups, with no significant intergroup differences. Customized CAD/CAM zirconia membranes achieved horizontal bone augmentation comparable to conventional collagen membranes when used for simultaneous GBR during early implant placement. Although customized zirconia membranes were associated with a substantially higher membrane exposure rate, regenerative outcomes and implant survival remained unaffected, indicating that customized rigid barriers may represent a predictable alternative for horizontal ridge augmentation while offering potential advantages in surgical precision and procedural efficiency. Trial registration: ClinicalTrials.gov NCT06987149.
Mohammed Mashhout Anas, A. M. Gabr, Yasser El‐Makaky et al.· International Journal of Imp...· 0 citations
Objectives: The aim of the study was to compare CBCT (Cone Beam Computed Tomography)-derived radiographic hard tissue gain after hydraulic transcrestal sinus floor elevation performed with versus without cross-linked hyaluronic acid (HA) and to assess associated clinical, radiographic, and patient-reported outcomes. Materials and Methods: This single-center, prospective clinical study enrolled 58 patients with 2–6 mm residual bone height in the posterior maxilla, assigned in a non-randomized parallel-group design to HA (n = 29) or No Graft (n = 29). The primary endpoint was CBCT-based 3D CBCT-derived radiographic hard-tissue volume gain at 12 months; secondary endpoints included vertical bone gain, marginal bone loss (MBL) at 12 and 24 months, implant stability quotient (ISQ), implant survival/success, complications, and patient-reported outcomes (VAS pain, OHIP-14). Analyses used ANCOVA and appropriate comparative statistics. Results: At 12 months, mean CBCT-derived radiographic hard-tissue volume gain was higher with HA (1210 +/− 610 mm3) than with No Graft (858 +/− 605 mm3; adjusted difference +352 mm3, 95% CI: 140–564; p = 0.002). ISQ at 12 months was greater with HA (p = 0.028), while MBL at 12/24 months did not differ significantly. Twenty-four-month implant survival was 98.1% (HA) vs. 94.3% (No Graft; p = 0.041). Complication rates were low and comparable; VAS pain at 72 h was modestly lower with HA. Conclusions: In this non-randomized prospective clinical study, cross-linked hyaluronic acid was associated with greater CBCT-derived radiographic hard-tissue volume gain and vertical radiographic gain after hydraulic transcrestal sinus floor elevation compared with clot stabilization alone. Clinical outcomes were favorable in both groups during the 24-month observation period. These findings support the interpretation of cross-linked hyaluronic acid as a potential space-maintaining adjunct in posterior maxillary sites with limited residual bone height; however, because no histological or histomorphometric assessment was performed, they should not be interpreted as proof of vital mature bone regeneration or superior bone quality.
G. Marenzi, G. Ruggiero, Fabrizio Bergaminelli et al.· Prosthesis· 0 citations
The 39.1% early failure rate within the first 12 months was followed by stable marginal bone levels through 36 months in implants that achieved successful osseointegration, underlining the need for peri-implant maintenance.
M. Jennes, Z. Mao, Ece Atay et al.· International Journal of Imp...· 0 citations
Nanostructured calcium-incorporated titanium dental implants have demonstrated favorable biological activity in preclinical studies; however, supporting clinical evidence remains limited. This retrospective cross-sectional study evaluated the survival and marginal bone loss (MBL) of calcium-incorporated implants placed in routine clinical practice at a university dental hospital. Consecutive implants were included when patients were ≥18 years old, had radiographic data, and completed at least 12 months of follow-up after final prosthesis delivery or experienced implant failure before that time. All implants were internal-connection fixtures with nanostructured calcium-incorporated surfaces, and guided bone regeneration or sinus augmentation was performed when clinically indicated. The primary outcome was cumulative survival rate, estimated using Kaplan–Meier analysis. MBL progression according to functional duration was assessed using linear regression and natural cubic spline modeling. A total of 753 implants were followed for 24–124 months. The cumulative survival rate was 99.6%, with three failures attributed to osseointegration failure, fixture fracture, and peri-implantitis. MBL increased minimally over time, with a linear slope of 0.016 mm/year. Spline analysis indicated a stable, non-accelerating pattern of bone remodeling. Within the limitations of the retrospective design, these implants showed excellent clinical survival and limited long-term MBL progression.
Unicameral bone cysts (UBCs) are fluid-filled, osteolytic lesions commonly affecting children and adolescents. Minimally invasive treatments such as percutaneous injection have become increasingly popular. Calcium phosphate cement (CPC), a biocompatible artificial bone substitute with mechanical strength and osteoconductivity, and may be suitable for such applications. This study aimed to evaluate the mid- to long-term clinical and radiographic outcomes of percutaneous calcium phosphate cement injection for UBCs, with particular emphasis on late recurrence, repeat injection, cortical remodeling, and cavity filling.
A retrospective review was conducted on 31 patients with UBC treated by CPC injection between January 2013 and January 2025, with at least 1 year of follow-up. Postoperative outcomes were assessed radiographically, functionally, and for complications. We recorded the patients’ age, sex, preoperative and postoperative visual analog scale (VAS) scores, Musculoskeletal Tumor Society (MSTS) scores, modified Neer classification and Capanna classification, cortical thickness ratio, cavity filling, recurrence, repeat intervention, and complications.
The mean follow-up duration was 61.1 months (range, 13–149 months). Among them, 14 patients experienced pathological fractures. Postoperatively, pain and functional outcomes improved significantly, with the median VAS score decreasing to 0 and the median MSTS score improving to 30 at final follow-up (
P
< 0.001). Recurrence after the first injection occurred in four patients (12.9%). Among them, three patients underwent repeat percutaneous CPC injection, and one patient was managed with observation because of adequate cortical thickness and clinical stability. At final follow-up after all treatments, all patients achieved modified Neer grade I or II outcomes, and most patients achieved Capanna grade I or II healing. One patient experienced delayed wound healing, and no severe complications were observed.
Percutaneous CPC injection was associated with pain relief, functional improvement, and radiographic stabilization in patients with UBCs. Repeat CPC injection appeared to provide stable outcomes in recurrent cases, whereas observation was considered reasonable for one clinically stable lesion with adequate cortical thickness. The observed cortical remodeling and cavity filling suggest that CPC injection may represent a potential minimally invasive strategy for reconstruction of UBC-related bone defects.
Meng-Zhang Xie, Zhengxiao Lai, Yi Luo et al.· Frontiers in Surgery· 0 citations
The clinically meaningful esthetic advantages of IIP support its preferential use in the anterior zone when anatomical conditions permit and when combined with guided protocols and customized healing abutments, IIP and EIP yield comparable 12-month marginal bone outcomes.
Sara N. El Touliani, Ahmed M. Abdel-Hamid, Nada M. H. Fahmy et al.· Frontiers in Dental Medicine· 0 citations
