Bone regeneration after transcrestal sinus lift using nanoscale super-hydrophilic versus standard implant surfaces: a single-center, 12-month, parallel controlled clinical trial
Aug 2026· Oral and Maxillofacial Surgery· Vol 30· 0 citations· 34 references
Medicine
TL;DR
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.
Abstract
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.
Introduction: This study aimed to compare implant stability and crestal bone loss between titanium platelet-rich fibrin (T-PRF)-treated implants and conventional implants. Methods: A prospective, randomized, split-mouth clinical trial was conducted in 10 healthy patients, with 20 implants per mouth (test and control). Each patient received one T-PRF-treated implant and one conventional implant. Implant stability was assessed using implant stability quotient (ISQ) at placement and at 3 months. Crestal bone loss was evaluated radiographically at 3 and 6 months. Soft tissue parameters were assessed at follow-up visits. Results: The T-PRF group showed higher ISQ values and reduced bone loss, with trends favoring the intervention at the three-month follow-up compared with the control group. Bone loss at three and six months was lower around anterior implants in the T-PRF group than in the control group. At this time, T-PRF may help improve soft tissue measurements; however, the measured values did not differ significantly from those of the control groups. Due to limitations such as a small sample size, a relatively short follow-up period, and varying baseline crestal bone levels, these findings should be interpreted with caution. Conclusion: Due to the restrictions of this split-mouth study, T-PRF-treated sites showed a trend towards increased early implant stability and decreased crestal bone loss compared to control sites. However, because of the small sample size and short follow-up period, conclusive evidence cannot be drawn about the clinical superiority of T-PRF. Further appropriately powered randomized controlled trials with prolonged follow-up periods are necessary to determine the long-term clinical efficacy of T-PRF in implant therapy. Clinical Trial Registration number: CTRI/2022/11/047159.
Anuraga Tejaswi Thotimpuri, M. Pasupuleti, G. Penmetsa et al.· Journal of Advanced Periodon...· 0 citations
The addition of rhBMP-2 to a biphasic calcium phosphate graft did not confer significant clinical advantages over the graft alone following immediate dental implant placement, suggesting limited additional benefit relative to its cost.
Aya A. Saeed, A. Abbas· The Journal of craniofacial...· 0 citations
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.
Priyadharshini Annamalai Senthur Pandian, Aniz Amanullah, Lakshmiganthan Mahalingam et al.· Journal of Clinical and Diag...· 0 citations
Background: This study aimed to evaluate the performance of CMFlex® bone grafts in regenerating bone and restoring anatomical contour of large, irregular mandibular defects in a porcine model.
Methods: Two adult (6-9 months of age) Yorkshire pigs with ramus defects (~12.7 cm2 area), treated with CMFlex® bone grafts (experimental) or left untreated (negative control). Animals were euthanized at 16- and 32-weeks post-implantation. Bone regeneration was assessed using CT, micro-CT, histology and mechanical testing to evaluate new bone formation, scaffold integration and contour restoration.
Findings: CT imaging showed that CMFlex® grafts promoted significant bone formation, with substantial defect filling by 12-16 weeks. Two out of three defects successfully restored the jawline contour, while the third showed partial extrusion of new bone due to scaffold displacement. Micro-CT imaging confirmed scaffold material integrated within the bone and surrounding tissues at both time points. Histological analysis revealed active bone formation and maturation around and within the scaffold, along with evidence of scaffold degradation. Mechanical testing via nanoindentation showed no significant difference in Young’s Modulus between regenerated bone and native bone, suggesting comparable mechanical properties.
Conclusion: This pilot study demonstrates that CMFlex® bone grafts can effectively regenerate bone in large (>5 cm2, which is ~25 mm diameter) mandibular defects and restore anatomical contour. These findings support the potential of CMFlex® as a promising scaffold-based solution for large-scale bone defects in human patients, warranting further clinical investigation.
Derek J. Milner, A. Jakus, R. Shah et al.· Journal of Regenerative Medi...· 0 citations
Neither the choice of drilling technique nor the implant macrogeometry significantly influences insertion torque or stability levels in regions of low bone density in this randomized controlled clinical study.
Worood A Akram, S. Bede· The Journal of craniofacial...· 0 citations
Background: Limited residual bone height in the posterior maxilla often necessitates sinus floor elevation before implant placement. Piezosurgery-assisted crestal sinus floor elevation offers a minimally invasive approach with reduced membrane-related complications. Concentrated growth factor (CGF) has been proposed to enhance bone regeneration; however, the additional benefit of combining CGF with allograft remains unclear. This randomized clinical trial compared radiographic, clinical, and biochemical outcomes following crestal sinus floor elevation using CGF with or without demineralized freeze-dried bone allograft (DFDBA).
Methods: Twenty posterior maxillary implant sites requiring indirect sinus floor elevation were randomly allocated into two groups (n=10 each): group A, piezosurgery-assisted crestal sinus elevation with CGF + DFDBA; and group B, CGF alone. Simultaneous implant placement was performed in all sites. Vertical bone height (VBH) and bucco-palatal width (BPW) were assessed using cone-beam computed tomography at baseline and 6 months. Implant stability quotient (ISQ) was measured at baseline and 3 months. Osteopontin (OPN) levels in peri-implant crevicular fluid were evaluated at 15, 45, and 90 days using enzyme-linked immunosorbent assay.
Results: Both groups demonstrated significant increases in vertical bone height and implant stability over time (p<0.05). Group A showed significantly greater vertical bone gain at 6 months compared with group B (p<0.05). Bucco-palatal width remained relatively stable in both groups, although a significant reduction was observed in group B. OPN levels increased progressively in both groups during healing and were significantly higher in group A at all-time intervals (p<0.05).
Conclusions: Piezosurgery-assisted crestal sinus floor elevation using CGF, with or without allograft, resulted in favorable clinical and radiographic outcomes. The addition of DFDBA to CGF yielded greater vertical bone gain and higher OPN levels, suggesting enhanced regenerative activity during early healing.
Tanya Attre, S. Malhotra, R. Chowdhry et al.· International Journal of Cli...· 0 citations
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