Comparison of the biocompatibility and osteogenesis potential of whitlockite and an activin A/BMP2 chimera using a rat calvarial defect model: a pilot study.

PURPOSE: The aim of this study was to evaluate bone regeneration using whitlockite (WH) nanoparticles, collagenated bovine bone mineral, and an activin A/BMP2 chimera (AB204) on calvarial defects in rats. METHODS: This study was conducted using 8 rats. Five-millimeter circular defects were formed on each side of the calvaria. The defects were randomly assigned to 3 groups (BO group: BioOss collagen, BO/WH group: BO + WH, and BO/WH/AB204 group: BO + WH + AB204). After healing periods of 2 and 4 weeks, histological and histomorphometric analyses were performed after sacrifice. RESULTS: The BO/WH/AB204 group showed superior bone healing compared to the other 2 groups (BO and BO/WH). In the BO and BO/WH groups, new bone formation was found in the defect margin. However, in the BO/WH/AB204 group, new bone was observed on the upper and lower surfaces of the grafted area. The new bone area of the BO/WH/AB204 group at 4 weeks was significantly higher than that of the same group at 2 weeks. At 4 weeks, the total augmented area and material area in the BO/WH/AB204 group were significantly lower than the corresponding values at 2 weeks. CONCLUSIONS: The BO/WH/AB204 group showed superior results of bone regeneration at 2 and 4 weeks compared to the BO and BO/WH groups. AB204 seems to play an important role in bone regeneration.

Multiple-Layer Chitosan-Based Patches Medicated With LTX-109 Antimicrobial Peptide for Modulated Local Therapy in the Management of Chronic Wounds.

In response to the critical issue of chronic wound management, this research explores the development of a multiple-layer biomaterial loaded with LTX-109 a novel broad-spectrum topical antimicrobial peptide currently investigated for the treatment of bacterial skin infections. The novel patch is conceived to load and preserve the function of LTX-109, release it on site in a progressive manner, and therefore make available a device for simultaneous wounds disinfection and tissues healing. Chitosan, tannic acid and glycerol along with the solvent casting process are selected for the development of a multilayer structure in which each single layer is designed by choosing a specific composition and stability to tune its behavior and function. On the top, a protective layer to protect the wound from external contaminations, in the middle a medicated layer loaded with LTX-109 and at the bottom a multifunctional layer to modulate the release of LTX-109. Extensive characterizations show that the patch meets the essential requirements for creating an effective wound healing environment, such as absorption of exudate, maintenance of good oxygen and moisture permeability, biodegradability, biocompatibility, and sustained release of LTX-109 with fully retained antibacterial activity as demonstrated by MIC values obtained against reference bacteria.

Inside out: Exploring edible biocatalytic biosensors for health monitoring.

Edible biosensors can measure a wide range of physiological and biochemical parameters, including temperature, pH, gases, gastrointestinal biomarkers, enzymes, hormones, glucose, and drug levels, providing real-time data. Edible biocatalytic biosensors represent a new frontier within healthcare technology available for remote medical diagnosis. The main challenges to develop edible biosensors are: i) finding edible materials (i.e. redox mediators, conductive materials, binders and biorecognition elements such as enzymes) complying with Food and Drug Administration (FDA), European Food Safety Authority (EFSA) and European Medicines Agency (EMEA) regulations; ii) developing bioelectronics able to operate in extreme working conditions such as low pH (∼pH 1.5 gastric fluids etc.), body temperature (between 37 °C and 40 °C) and highly viscous bodily fluids that may cause surface biofouling issues. Nowadays, advanced printing techniques can revolutionize the design and manufacturing of edible biocatalytic biosensors. This review outlines recent research on biomaterials suitable for creating edible biocatalytic biosensors, focusing on their electrochemical properties such as electrical conductivity and redox potential. It also examines biomaterials as substrates for printing and discusses various printing methods, highlighting challenges and perspectives for edible biocatalytic biosensors.

Decomposition and Changes in In Vivo Post-HA Filler Injection: A Review.

BACKGROUND: Hyaluronic acid (HA) fillers are widely used in aesthetic medicine, but their in vivo behavior and long-term effects are not fully understood. AIMS: To review the decomposition and changes occurring in the body following HA filler injections, focusing on crosslinking agents, degradation processes, and tissue responses. METHODS: This review analyzed oxidative and enzymatic degradation processes of HA fillers, evaluated the impact of 1,4-Butanediol Diglycidyl Ether (BDDE) crosslinking, and examined histological changes post-injection. RESULTS: Uncrosslinked HA degrades rapidly due to endogenous hyaluronidase, while crosslinked HA undergoes slower degradation via free radicals and hyaluronidase. Complete cross-linking (C-MoD) showed better durability compared to partially cross-linked BDDE (P-MoD). The concept of modification efficiency (MoE) was proposed to optimize filler safety and viscoelastic properties. Histological analysis revealed collagen capsule formation and autologous tissue replacement, affecting long-term outcomes. The degree of chemical modification (MoD) influences filler durability and safety, with concerns raised about potential delayed immune reactions from accumulated pendent BDDE. CONCLUSIONS: Clinicians should consider injection site, tissue conditions, and filler properties for safe and effective HA filler use. Emphasizing thorough BDDE removal and optimal crosslinking can enhance treatment safety and efficacy. The balance between achieving desired viscoelastic properties and minimizing potential risks is crucial. Future studies should include diverse ethnic groups to validate findings and further explore long-term tissue responses to HA fillers.

In Vivo Evaluation of Tissue Biocompatibility of Calcium Silicate-based and Epoxy Resin-based Sealers.

Introduction: Calcium silicate-based sealers are an alternative to be used into root canal, mainly to their biological properties. However, some biological parameters need to be determined in an in vivo animal research model. So, the aim of the present study was to evaluate in vivo the tissue biocompatibility of a calcium silicate-based sealer (EndoSequence BC Sealer) and an epoxy resin-based sealer (AH-Plus). Materials and Methods: Polyethylene tubes were filled with freshly mixed sealers and implanted in connective subcutaneous tissue of 25 rats (5/euthanasia day) (Rattus norvegicus albinus). Empty tubes were used as controls and no tubes as sham. Histopathological (hematoxylin eosin) and histochemical (Picrosirius red) examinations were conducted at 3, 7, 15, 30 and 60 days (five rats/day) after the implantation procedure (n=5/group). The type/intensity of inflammation and collagenesis was analyzed statistically with Friedman or Kruskal-Wallis/Dunn tests (P<0.05). Results: The profile of inflammation induced by AH-Plus (Median=2, Range=2-3) was significantly greater than that by Endosequence BC Sealer (Median=1, Range=1-1) during the 15-day experimentation period (P=0.018). After 30 days, both materials produced similar tissue reaction (P>0.05). AH-Plus and Endosequence BC Sealer (Median=2, Range=1-2) induced a high level of fibrosis after 60-day than control (Median=1, Range=1-1) and sham (Median=0, Range=0-0) groups (P<0.001) of fibrosis based in type I collagen increase (P=0.025 and P=0.021, respectively). Tissue necrosis was not observed and the bioceramic sealer showed significant signs of endocytosed (Median=1, Range=1-1) material after 7 days than other groups (Median=0, Range=0-0) (P<0.05). The calcium silicate-based sealer induced tissue repair faster than the epoxy resin-based sealer tested. However, both materials showed adequate biocompatibility and tolerance by subcutaneous tissues, with few differences in inflammatory profiles, formation of granulation tissue, and collagenesis. Conclusions: It may be concluded that calcium silicate-based sealer (EndoSequence BC Sealer) and an epoxy resin-based sealer (AH-Plus) presented suitable biocompatibility.

Bibliometric analysis of the current status and trends in dental applications of glass fiber-reinforced composites from 1998 to 2022.

Over the last few years, considerable attention has been devoted to glass fiber-reinforced composites (GFRCs) in the field of dentistry. Glass fiber-reinforced composites are useful in prosthodontics, endodontics, restorative dentistry, orthodontics, and periodontics. This study considered various aspects related to GFRCs to assess the publications and citations on the subject from 1998 to 2022.A bibliometric method of analysis was adopted to conduct the study. The relevant papers published within the established time frame were identified. A document-type filter was applied to retrieve only those results that were peer-reviewed. The most influential authors, journals, institutions, and countries were identified, as indicated by the number of citations, as well as the most frequently used keywords.The findings of the bibliometric analysis revealed that the first article on GFRCs in the context of dentistry was published in 1998. The greatest number of papers on this subject was published in 2011 (n = 51), while the number of citations reached its peak in 2008 (n = 1,546). The University of Turku in Finland published the greatest number of articles, whereas Brazil was the most prolific country, producing the highest number of publications on dental fiber. Researchers from Brazil, Italy and Germany mainly collaborated with researchers from other countries, including the USA and Finland. The analysis revealed that publications of multiple authors were more likely to be cited.Significant advancements have been made in the field of GFRCs, as demonstrated by an increased collaboration amongst different countries, organizations and investigators, which enhanced the development and progression of research related to GFRCs.

Innovative 3D bioprinting approaches for advancing brain science and medicine: a literature review.

The rapid advancements in 3D printing technology have revolutionized the field of tissue engineering, particularly in the development of neural tissues for the treatment of nervous system diseases. Brain neural tissue, composed of neurons and glial cells, plays a crucial role in the functioning of the brain, spinal cord, and peripheral nervous system by transmitting nerve impulses and processing information. By leveraging 3D bioprinting and bioinks, researchers can create intricate neural scaffolds that facilitate the proliferation and differentiation of nerve cells, thereby promoting the repair and regeneration of damaged neural tissues. This technology allows for the precise spatial arrangement of various cell types and scaffold materials, enabling the construction of complex neural tissue models that closely mimic the natural architecture of the brain. Human-induced pluripotent stem cells (hiPSCs) have emerged as a groundbreaking tool in neuroscience research and the potential treatment of neurological diseases. These cells can differentiate into diverse cell types within the nervous system, including neurons, astrocytes, microglia, oligodendrocytes, and Schwann cells, providing a versatile platform for studying neural networks, neurodevelopment, and neurodegenerative disorders. The use of hiPSCs also opens new avenues for personalized medicine, allowing researchers to model diseases and develop targeted therapies based on individual patient profiles. Despite the promise of direct hiPSC injections for therapeutic purposes, challenges such as poor localization and limited integration have led to the exploration of biomaterial scaffolds as supportive platforms for cell delivery and tissue regeneration. This paper reviews the integration of 3D bioprinting technologies and bioink materials in neuroscience applications, offering a unique platform to create complex brain and tissue architectures that mimic the mechanical, architectural, and biochemical properties of native tissues. These advancements provide robust tools for modelling, repair, and drug screening applications. The review highlights current research, identifies research gaps, and offers recommendations for future studies on 3D bioprinting in neuroscience. The investigation demonstrates the significant potential of 3D bioprinting to fabricate brain-like tissue constructs, which holds great promise for regenerative medicine and drug testing models. This approach offers new avenues for studying brain diseases and potential treatments.

Oral Patch/Film for Drug Delivery-Current Status and Future Prospects.

In recent years, there has been extensive research into drug delivery systems aimed at enhancing drug utilization while minimizing drug toxicities. Among these systems, oral patches/films have garnered significant attention due to their convenience, noninvasive administration, ability to bypass hepatic first-pass metabolism, thereby enhancing drug bioavailability, and their potential to ensure good compliance, particularly among special patient populations. In this review, from the perspective of the anatomical characteristics of the oral cavity and the advantages and difficulties of oral drug delivery, we illustrate the design ideas, manufacturing techniques, research methodologies, and the essential attributes of an ideal oral patch/film. Furthermore, the applications of oral patches/films in both localized and systemic drug delivery were discussed. Finally, we offer insights into the future prospects of the oral patch/film, aiming to provide valuable reference for the advancement of oral localized drug delivery systems.

Evaluation of Clinical Efficacy of Biodegradable Chip Containing Salvadora persica (miswak) Extract in Chitosan Base as an Adjunct to Scaling and Root Planing in the Management of Periodontitis.

Objectives: This study attempted to develop 2 biodegradable periodontal chips containing Salvadora persica (miswak) or benzyl isothiocyanate (BITC) extracts and evaluate their clinical effectiveness in managing periodontitis. Methods: This clinical trial was conducted at the Faculty of Dentistry, Universiti Teknologi MARA Shah Alam, Selangor, Malaysia, from September 2010 to April 2012. Periodontal chips were formulated using S. persica, benzyl isothiocyanate (BITC) and chitosan extracts. All patients were treated with full mouth scaling and root planing at baseline. Thereafter, the periodontal pockets (≥5 mm in length) were divided into 4 groups: the control group; group 2 (plain chitosan chip); group 3 (S. persica extract); and group 4 (BITC extract). Plaque index (PI), bleeding on probing (BOP), periodontal probing pocket depth and clinical attachment levels were recorded at days 0 and 60 only. Results: A total of 12 patients participated in this study. Overall, 240 periodontal pockets were evaluated. The study revealed significant improvements in PI, BOP and reduction in periodontal pocket depth in all 4 groups (P <0.05). The improvement in clinical attachment level was significantly higher (P <0.001) among the group that received S. persica chips compared to the control and other chip-treated groups. Conclusion: Periodontal chips containing S. persica can be used as adjuncts to treat patients with periodontitis.

A comparison of several separation processes for eggshell membrane powder as a natural biomaterial for skin regeneration.

BACKGROUND: Numerous studies have focused on skin damage, the most prevalent physical injury, aiming to improve wound healing. The exploration of biomaterials, specifically eggshell membranes (ESMs), is undertaken to accelerate the recovery of skin injuries. The membrane must be separated from the shell to make this biomaterial usable. Hence, this investigation aimed to identify more about the methods for membrane isolation and determine the most efficient one for usage as a biomaterial. METHODS AND MATERIALS: For this purpose, ESM was removed from eggs using different protocols (with sodium carbonate, acetic acid, HCl, calcium carbonate, and using forceps for separation). Consequently, we have examined the membranes' mechanical and morphological qualities. RESULTS: According to the analysis of microscopic surface morphology, the membranes have appropriate porosity. MTT assay also revealed that the membranes have no cytotoxic effect on 3T3 cells. The results indicated that the ESM had acquired acceptable coagulation and was compatible with blood. Based on the obtained results, Provacol 4 (0.5-mol HCl and neutralized with 0.1-mol NaOH) was better than other methods of extraction and eggshell separation because it was more cell-compatible and more compatible with blood. CONCLUSION: This study demonstrates that ESMs can be used as a suitable biomaterial in medical applications.

Poly-d,l-lactic Acid (PDLLA) Application in Dermatology: A Literature Review.

Poly-d,l-lactic acid (PDLLA) is a biodegradable and biocompatible polymer that has garnered significant attention in dermatology due to its unique properties and versatile applications. This literature review offers a comprehensive analysis of PDLLA's roles in various dermatological conditions and wound-healing applications. PDLLA demonstrates significant benefits in enhancing skin elasticity and firmness, reducing wrinkles, and promoting tissue regeneration and scar remodeling. Its biodegradable properties render it highly suitable for soft tissue augmentation, including facial and breast reconstruction. We discuss the critical importance of understanding PDLLA's physical and chemical characteristics to optimize its performance and safety, with a focus on how nano- and micro-particulate systems can improve delivery and stability. While potential complications, such as granuloma formation and non-inflammatory nodules, are highlighted, effective monitoring and early intervention strategies are essential. PDLLA's applications extend beyond dermatology into orthopedics and drug delivery, owing to its superior mechanical stability and biocompatibility. This review underscores the need for ongoing research to fully elucidate the mechanisms of PDLLA and to maximize its therapeutic potential across diverse medical fields.

Carbon fiber felt scaffold from Brazilian textile PAN fiber for regeneration of critical size bone defects in rats: A histomorphometric and microCT study.

The objective of the present study was to evaluate the carbon fiber obtained from textile PAN fiber, in its different forms, as a potential scaffolds synthetic bone. Thirty-four adult rats were used (Rattus norvegicus, albinus variation), two critical sized bone defects were made that were 5 mm in diameter. Twenty-four animals were randomly divided into four groups: control (C)-bone defect + blood clot, non-activated carbon fiber felt (NACFF)-bone defect + NACFF, activated carbon fiber felt (ACFF)-bone defect + ACFF, and silver activated carbon fiber felt (Ag-ACFF)-bone defect + Ag-ACFF, and was observed by 15 and 60 days for histomorphometric, three-dimensional computerized microtomography (microCT) and mineral apposition analysis. On histomorphometric and microCT analyses, NACFF were associated with higher proportion of neoformed bone and maintenance of bone structure. On fluorochrome bone label, there was no differences between the groups. NACFF has shown to be a promising synthetic material as a scaffold for bone regeneration.

Comparative Effectiveness of an Autologous Dentin Matrix for Alveolar Ridge Preservation.

An urgent issue is the preservation or reconstruction of the volume of bone tissue in planning and surgical treatment in the fields of medicine, such as traumatology, orthopedics, maxillofacial surgery and dentistry. After tooth extraction, resorption of the bone tissue of the alveolar crest of the jaws occurs, which must either be further eliminated by performing additional operations or using osteoplastic material for socket preservation at the extraction stage. Background and Objectives: The aim of the study was a comparative analysis of various osteoplastic materials used to preserve the volume of bone tissue in the preimplantation period. Materials and Methods: As part of the study, 80 patients were treated, who underwent socket preservation using xenografts, plasma enriched with growth factors, an autologous dentin matrix (ADM) and hydroxyapatite. Results: The results of the treatment 16 weeks after removal were comprehensively analyzed using a morphometric analysis of the bone's volume, cone beam tomography and morphological examination of burr biopsy specimens, as well as by determining the stability of the installed implant at different stages of treatment. Conclusions: The lowest level of bone tissue resorption according to the CBCT data was noted in the ADM and xenograft groups. It should be noted that the use of osteoplastic material in jaw surgery when reconstructing alveolar defects is an essential procedure for preventing the atrophy of bone tissue.

Electrospun Poly-ε-Caprolactone Nanofibers Incorporating Keratin Hydrolysates as Innovative Antioxidant Scaffolds.

This manuscript describes the development and characterization of electrospun nanofibers incorporating bioactive hydrolysates obtained from the microbial bioconversion of feathers, a highly available agro-industrial byproduct. The electrospun nanofibers were characterized using different instrumental methods, and their antioxidant properties and toxicological potential were evaluated. Keratin hydrolysates (KHs) produced by Bacillus velezensis P45 were incorporated at 1, 2.5, and 5% (w/w) into poly-ε-caprolactone (PCL; 10 and 15%, w/v solutions) before electrospinning. The obtained nanofibers were between 296 and 363 nm in diameter, showing a string-like morphology and adequate structural continuity. Thermogravimetric analysis showed three weight loss events, with 5% of the mass lost up to 330 °C and 90% from 350 to 450 °C. Infrared spectroscopy showed typical peaks of PCL and amide bands corresponding to keratin peptides. The biological activity was preserved after electrospinning and the hemolytic activity was below 1% as expected for biocompatible materials. In addition, the antioxidant capacity released from the nanofibers was confirmed by DPPH and ABTS radical scavenging activities. The DPPH scavenging activity observed for the nanofibers was greater than 30% after 24 h of incubation, ranging from 845 to 1080 µM TEAC (Trolox equivalent antioxidant capacity). The antioxidant activity for the ABTS radical assay was 44.19, 49.61, and 56.21% (corresponding to 972.0, 1153.3, and 1228.7 µM TEAC) for nanofibers made using 15% PCL with 1, 2.5, and 5% KH, respectively. These nanostructures may represent interesting antioxidant biocompatible materials for various pharmaceutical applications, including wound dressings, topical drug delivery, cosmetics, and packaging.

Synthesis of Hydrofluoric (HF) Acid Free, Two-Dimensional (2D) Tantalum Carbide MXene Nanosheets and Quantum Dots.

MXenes are two-dimensional (2D) transition metal-based carbides, nitrides, and carbonitrides that are synthesized from its precursor MAX phase. The selective etching of the "A" from the MAX phase yields multi-functional MXenes that hold promise in a wide range of energy-based applications and biomedical applications. Based on its intended application, MXenes are prepared as multilayered sheets, monolayer flakes, and quantum dots. Conventionally, MXenes are prepared using hydrofluoric (HF) acid etching; however, the use of HF impedes its effective use in biomedical applications. This calls for the use of nontoxic HF-free synthesis protocols to prepare MXenes safe for biological use. Therefore, we have discussed a facile process to synthesize biocompatible, HF-free MXene nanosheets and quantum dots.

Comparison of bioactive material failure rates in vital pulp treatment of permanent matured teeth - a systematic review and network meta-analysis.

Mineral Trioxide Aggregate (MTA) is the gold standard for vital pulp treatment (VPT), but its superiority over novel calcium silicate-based cements in permanent teeth lacks systematic evidence. This study aimed to compare the efficacy of these materials in VPT through a network meta-analysis. A systematic search was conducted in MEDLINE, EMBASE, Cochrane Library, and Web of Science until January 20, 2024. The inclusion criteria were randomized controlled trials involving VPT with biomaterials and reversible or irreversible pulpitis diagnoses in mature permanent teeth. The primary outcome was the odds ratio (OR) of failure rates with 95% confidence intervals. In the 21 eligible trials, failure rates were significantly higher with calcium-hydroxide than MTA at six (OR 2.26 [1.52-3.36]), 12 (OR 2.53 [1.76-3.62]), and 24 months (OR 2.46 [1.60-3.79]). Failure rates for Totalfill at six (OR 1.19 [0.55-2.58]) and 12 months (OR 1.43 [0.71-2.92]), and Biodentine at six (OR 1.09 [0.66-1.78]), 12 (OR 1.21 [0.74-1.96]), and 24 months (OR 1.47 [0.81-2.68]) were not significantly different from MTA. The results were similar in the direct pulp capping subgroup, whereas, in the partial and full pulpotomy subgroup, there was not enough evidence to achieve significant differences. MTA, Biodentine, and Totalfill are the most efficient materials for VPT. However, calcium-hydroxide-based materials are not recommended in VPT.

Choline and geranate ionic liquid for subgingival biofilm control.

Periodontitis is a chronic inflammatory disease that causes destruction of the periodontium and eventual tooth loss. The priority in the periodontal treatment is to remove the subgingival biofilm. Chemical removal of biofilms using antimicrobial agents has been applied in clinical practice. However, their clinical effect is still limited because the agents must overcome biofilm's significant drug tolerance, which is primarily caused by the extracellular matrix, a physical barrier that attenuates drug diffusion. This study aimed to study the use of ionic liquids (ILs), a new class of biocompatible materials, for controlling subgingival biofilms because of their excellent permeability. Choline and geranate (CAGE) IL was tested for its highly potent antiseptic behavior and permeability. Antibacterial tests revealed that the significant efficacy of CAGE against periodontopathic microorganisms was derived from their ability to destroy cell membrane, as demonstrated by membrane permeability assay and transmission electron microscopy imaging. Antibiofilm tests using two pathogenic biofilm models revealed that CAGE exerted efficacy against the biofilm-embedded bacteria, conspicuously neutralized the biofilms, and eventually destroyed the biofilm structure. Furthermore, the penetration of CAGE into the biofilm was visually confirmed using confocal laser scanning microscopy. This study highlighted the potential of CAGE as a powerful antibiofilm therapeutic.

Neovaginoplasty With Nile Tilapia Skin Graft in A Patient With Gonadal Dysgenesis: A Case Report.

BACKGROUND: Gonadal dysgenesis, a genetic condition characterized by incomplete of defective formation of the gonads, can present with vaginal agenesis in individuals with 46, XY karyotype. CASE: We report an innovative intervention in the management of vaginal agenesis in a 19-year-old female with gonadal dysgenesis. Despite initial attempts with vaginal dilators, the patient presented unresponsive, leading to the adoption of a neovaginoplasty using Nile Tilapia Fish Skin (NTFS) as graft. The procedure, based on the McIndoe technique, involved the creation of a 10 cm x 3 cm vaginal canal with an NTFS-wrapped acrylic mold without complications. CONCLUSION: The use of NTFS as a graft for neovaginoplasty in gonadal dysgenesis, a novel approach not previously reported in medical literature for this diagnosis, demonstrated favorable outcomes in terms of functionality and patient well-being.

Cephalometric evaluation of skeletal stability and pharyngeal airway changes after mandibular setback surgery: Bioabsorbable versus titanium plate and screw fixation.

Purpose: This study compared sequential changes in skeletal stability and the pharyngeal airway following mandibular setback surgery involving fixation with either a titanium or a bioabsorbable plate and screws. Materials and Methods: Twenty-eight patients with mandibular prognathism undergoing bilateral sagittal split osteotomy by titanium or bioabsorbable fixation were randomly selected in this study. Lateral cephalometric analysis was conducted preoperatively and at 1 week, 3-6 months, and 1 year postoperatively. Mandibular stability was assessed by examining horizontal (BX), vertical (BY), and angular measurements including the sella-nasion to point B angle and the mandibular plane angle (MPA). Pharyngeal airway changes were evaluated by analyzing the nasopharynx, uvula-pharynx, tongue-pharynx, and epiglottis-pharynx (EOP) distances. Mandibular and pharyngeal airway changes were examined sequentially. To evaluate postoperative changes within groups, the Wilcoxon signed-rank test was employed, while the Mann-Whitney U test was used for between-group comparisons. Immediate postoperative changes in the airway were correlated to surgical movements using the Spearman rank test. Results: Significant changes in the MPA were observed in both the titanium and bioabsorbable groups at 3-6 months post-surgery, with significance persisting in the bioabsorbable group at 1 year postoperatively (2.29°±2.28°; P<0.05). The bioabsorbable group also exhibited significant EOP changes (-1.21±1.54 mm; P<0.05) at 3-6 months, which gradually returned to non-significant levels by 1 year postoperatively. Conclusion: Osteofixation using bioabsorbable plates and screws is comparable to that achieved with titanium in long-term skeletal stability and maintaining pharyngeal airway dimensions. However, a tendency for relapse exists, especially regarding the MPA.

Human Acellular Collagen Matrices-Clinical Opportunities in Tissue Replacement.

The field of regenerative medicine is increasingly in need of effective and biocompatible materials for tissue engineering. Human acellular dermal matrix (hADM)-derived collagen matrices stand out as a particularly promising candidate. Their ability to preserve structural integrity, coupled with exceptional biocompatibility, positions them as a viable choice for tissue replacement. However, their clinical application has been largely confined to serving as scaffolds. This study aims to expand the horizon of clinical uses for collagen sheets by exploring the diverse cutting-edge clinical demands. This review illustrates the clinical utilizations of collagen sheets beyond traditional roles, such as covering skin defects or acting solely as scaffolds. In particular, the potential of Epiflex®, a commercially available and immediately clinically usable allogeneic membrane, will be evaluated. Collagen sheets have demonstrated efficacy in bone reconstruction, where they can substitute the induced Masquelet membrane in a single-stage procedure, proving to be clinically effective and safe. The application of these membranes allow the reconstruction of substantial tissue defects, without requiring extensive plastic reconstructive surgery. Additionally, they are found to be apt for addressing osteochondritis dissecans lesions and for ligament reconstruction in the carpus. The compelling clinical examples showcased in this study affirm that the applications of human ADM extend significantly beyond its initial use for skin defect treatments. hADM has proven to be highly successful and well-tolerated in managing various etiologies of bone and soft tissue defects, enhancing patient care outcomes. In particular, the application from the shelf reduces the need for additional surgery or donor site defects.