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Which Bonding Protocol Provides the Most Durable Zirconia Adhesion after In Vitro Artificial Aging: A Systematic
Yessy Ariesanti1, Rosalina Tjandrawinata2, Wiwiek Poedjiastoeti3
1Doctoral Program Faculty of Dentistry, Universitas Trisakti, Jakarta, Indonesia; Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Universitas Trisakti, Jakarta, Indonesia, Orcid: https://orcid.org/0000-0002-7067-8402.
Aims:
The aim of this study is to systematically review the scientific publications on animal model studies investigating the histological analysis of hydroxyapatite (HA) and collagen from biowaste as bone substitutes for bone regeneration.
Methods:
A systematic review 1992-2023 was conducted using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and registered in PROSPERO. PubMed, Scopus, and ProQuest were searched for animal model studies. The Participants, Intervention, Control, and Outcome (PICO) framework used was as follows: (P) Animal models received HA or collagen; (I) sensitization/irritation or intracutaneous reactivity/systemic toxicity/sub-chronic toxicity/implantation of HA or collagen from biowaste; (C) no material implantation; synthetic HA (SHA)/collagen; (O) bone regeneration in defects. The factors retrieved and analyzed were based on author, year, study design, animal model, test category, biomaterial agent, implantation area, follow-up, intervention, control, histological analysis, result, and conclusion. The selected studies were appraised for methodological quality using SYRCLE's risk of bias (RoB) tool.
Results:
On search, 13,946 studies were yielded for systematic review, out of which 13 studies were included for the systematic review evaluation. Five different animal models were utilized. In all studies, HA and collagen were used as biomaterials and implanted in 10 designated sites. Bone regeneration was assessed through histological analysis. The biocompatibility and efficacy of HA and collagen derived from biowaste were confirmed, demonstrating their ability to safely promote bone formation in living tissues. Several studies reported blinding, but most lacked methodological details, resulting in a generally low RoB in one study and a moderate risk in 12 studies.
Conclusion:
This review highlights HA and collagen derived from biowaste as promising biomaterials for bone regeneration, whether used separately or in combination. Histological analyses confirm their excellent biocompatibility and capacity to enhance bone repair, supporting their potential for clinical application.
Clinical Significance:
Bone regeneration is a challenge in clinical settings; this review emphasizes the need for affordable, biocompatible alternatives for repair. Hydroxyapatite and collagen from biowaste provide a sustainable solution, with strong potential for clinical use. Further research could establish these materials as effective bone substitutes, improving healing and regeneration, particularly in resource-limited settings. How to cite this article: Ariesanti Y, Tjandrawinata R, Poedjiastoeti W, et al. Histological Analysis of Bone Regeneration after Implantation of Hydroxyapatite and Collagen in Animal Model: Systematic Review. J Contemp Dent Pract 2025;26(12):1228-1244.
