A comparative analysis of particulate bovine bone substitutes for oral regeneration: a narrative review

Abstract

Purpose: Particulate bovine bone substitutes (BS) are commonly used in oral regeneration. However, more literature is needed focusing on comparative analyses among various particulate bovine BS. This study evaluates pre-clinical and clinical data of different particulate bovine BS in oral regeneration.

Methods: A narrative review was conducted by screening the PubMed database Included in the review were pre-clinical and clinical studies until 2024 comparing a minimum of two distinct particulate bovine BS. In addition to examining general data concerning manufacturing and treatment processes, biological safety, physical and chemical characteristics, and graft resorption, particular emphasis was placed on assessing pre-clinical and clinical data related to ridge preservation, sinus floor elevation, peri-implant defects, and various forms of alveolar ridge augmentation utilizing particulate bovine BS.

Results: Various treatment temperatures ranging from 300 to 1,250 °C and the employment of chemical cleaning steps were identified for the manufacturing process of particulate bovine BS deemed to possess biosecurity. A notable heterogeneity was observed in the physical and chemical characteristics of particulate bovine BS, with minimal or negligible graft resorption. Variations were evident in particle and pore sizes and the porosity of particulate bovine BS. Pre-clinical assessments noted a marginal inclination towards favorable outcomes for particulate bovine BS subjected to higher treatment temperatures. However, clinical data are insufficient. No distinctions were observed regarding ridge preservation, while slight advantages were noted for high-temperature treated particulate bovine BS in sinus floor elevation.

Conclusions: Subtle variances in both pre-clinical and clinical outcomes were observed in across various particulate bovine BS. Due to inadequate data, numerous considerations related to diverse particulate bovine BS, including peri-implant defects, must be more conclusive. Additional clinical studies are imperative to address these knowledge gaps effectively.

Keywords: Narrative review; Oral regeneration; Particulate bovine bone substitute; Peri-implant defects; Ridge preservation; Sinus floor elevation.

Fig. 1

Histological sections (H&E-stained) 5–8 months after sinus floor elevation with a low-temperature treated bovine BS (Bio-Oss®). (A) Early osteogenesis around bone substitute (BS) granules forming woven bone (b), ct = connective tissue, black arrows = osteoblasts; original magnification (o.m.) 20-fold. (B) Advanced osteogenesis around BS residual granules, b = newly formed woven bone, ct = connective tissue; o.m. 20-fold

Fig. 2

Histological sections (H&E-stained) 5–8 months after sinus floor elevation with a high-temperature treated bovine BS (cerabone®). (A) Early osteogenesis around bone substitute (BS) granules forming woven bone (b), granules mostly lost due to decalcification, ct = highly vascularized connective tissue, v = vessels; original magnification (o.m.) 10-fold. (B) Advanced osteogenesis around BS granules forming woven bone (b) partly remodeling into lamellar bone, granules mostly lost due to decalcification, ct = connective tissue; o.m. 10-fold

Fig. 3

Histological sections (H&E-stained) 5–8 months after sinus floor elevation with a bovine BS (MinerOss®). (A) Early osteogenesis around cluster of small bone substitute (BS) granules forming woven bone (b), ct = connective tissue; original magnification (o.m.) 10-fold. (B) Advanced osteogenesis around larger BS granules forming woven bone (b), ct = connective tissue; o.m. 10-fold