Regeneration of human bone using different bone substitute biomaterials

The present study aimed to assess clinical and biological performances of several bone substitute biomaterials (BSBs).

The evaluation was conducted at 6 months and after several years on 295 patients undergoing sinus augmentation with 13 different BSBs; the data belonging to previously published studies have been analyzed using innovative mathematical models to evaluate the bone regenerative index (Br) and the structural density index (Ds).

After 6 months, compared to the Ds index of native bone, the regenerated bone showed a D3 bone type; while, after several years, the regenerated bone type was D2, with an evident increase in the density of the regenerated bone over time. Moreover, the values of Br were higher for combined biomaterials indicating a fewer amount of residual particles and marrow spaces, while the values of Ds were higher for anorganic bovine bone indicating a greater new bone formation and a lesser amount of marrow spaces. After 20 years, the bone regenerated using hydroxyapatite still had a D4 bone quality.

After 6 months of healing, the regenerated bone had a composite structure resembling poor D3 bone type, and covered approximately one-third of the space filled by BSBs. None of the evaluated biomaterials seemed to be ideal.