Clinical applications of avian eggshell-derived hydroxyapatite

Area of Science:

• Biomaterials Science
• Oral and Maxillofacial Surgery
• Regenerative Medicine

Background:

• Bone reconstruction materials are a significant challenge in oral surgery.
• Guided bone regeneration (GBR) requires effective bone substitute materials.
• The clinical performance of novel biomaterials like eggshell in GBR is under investigation.

Purpose of the Study:

• To systematically review the clinical performance of eggshell as a substitute material in guided bone regeneration (GBR) in oral surgery.
• To assess the efficacy and safety of eggshell in various oral GBR procedures.
• To identify research gaps and future directions for eggshell utilization in bone reconstruction.

Main Methods:

• Systematic literature search of five databases (PubMed, Cochrane, Web of Science, Scopus, Embase) up to February 2020.
• Inclusion of clinical trials using eggshell as a bone substitute; exclusion of animal and in vivo studies.
• Risk of bias assessment using ROBINS-I; data extraction on clinical, radiological, and histological outcomes.

Main Results:

• Five clinical studies involving 74 patients and 88 sites were included, with a noted risk of bias.
• Complete healing and statistically significant new bone formation were observed in socket preservation, third molar extraction, and cystic/apicectomy grafting.
• Histological and micro-CT analyses confirmed eggshell's osteogenic potential, comparable to synthetic hydroxyapatite.

Conclusions:

• Within the limitations of the included studies, eggshell appears to be a safe and efficient material for GBR.
• Eggshell demonstrates potential for promoting bone regeneration in oral surgery applications.
• More rigorous clinical research is required to fully establish the long-term efficacy and potential of eggshell in bone reconstruction.