{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T04:09:55Z","timestamp":1791259795143,"version":"4.1.0"},"reference-count":44,"publisher":"MDPI AG","issue":"13","license":[{"start":{"date-parts":[[2025,6,23]],"date-time":"2025-06-23T00:00:00Z","timestamp":1750636800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Maxillofacial bone defects present considerable challenges in oral and reconstructive surgery. While autologous bone grafts are the gold standard, their limitations, such as donor site morbidity and limited availability, have driven the search for alternative biomaterials. SmartBone\u00ae, a xeno-hybrid graft, offers potential advantages due to its bioactivity and remodeling capacity. Methods: This analysis of a series of clinical cases, evaluated the performance of SmartBone\u00ae in 10 patients presenting with various maxillofacial bone defects. The patient follow-up period spanned from 2017 to 2019, with a maximum duration of 30 months. Bone grafting was performed, and integration was monitored using Cone-Beam Computed Tomography at multiple timepoints. Bone density changes (\u0394CT values) in selected anatomical sites were analyzed to assess graft transformation and integration. Results: SmartBone\u00ae supported effective bone regeneration and selective remodeling in all cases. One patient required a revision procedure, after which successful integration was observed. Cellular colonization began within weeks, with complete remodeling into mature bone occurring between 6\u201312 months. Evidence of cortical wall resorption and reformation on the graft\u2019s external surface confirmed this transformation. \u0394CT values progressively aligned with native bone densities, indicating structural and functional integration. Conclusions: SmartBone\u00ae demonstrates strong osteointegrative and site-specific remodeling capabilities, offering a reliable and predictable alternative for maxillofacial bone reconstruction. The study presents several limitations, including the small sample size, inter-patient variability, possible imaging artifacts due to metallic elements in Cone-Beam Computed Tomography scans and the lack of histological confirmation.<\/jats:p>","DOI":"10.3390\/jcm14134457","type":"journal-article","created":{"date-parts":[[2025,6,23]],"date-time":"2025-06-23T09:08:44Z","timestamp":1750669724000},"page":"4457","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Bone Selective Remodeling of Xeno-Hybrid Grafts: A Case Series"],"prefix":"10.3390","volume":"14","author":[{"given":"Roberto","family":"Ghiretti","sequence":"first","affiliation":[{"name":"Private Practice, 46047 Porto Mantovano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlo F.","family":"Grottoli","sequence":"additional","affiliation":[{"name":"Industrie Biomediche Insubri SA, Via Cantonale 67, 6805 Mezzovico-Vira, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Massimo","family":"Molinari","sequence":"additional","affiliation":[{"name":"de G\u00f6tzen S.r.l., Acteon Group, 21054 Fagnano Olona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-8320-7686","authenticated-orcid":false,"given":"Minh Tam Davide","family":"Huynh","sequence":"additional","affiliation":[{"name":"Novartis AG, Campus Novartis, 4056 Basel, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiara","family":"Bonizzi","sequence":"additional","affiliation":[{"name":"Roche Diagnostics International AG, Via Forrenstrasse 2, 6343 Rotkreuz, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudio","family":"Giani","sequence":"additional","affiliation":[{"name":"de G\u00f6tzen S.r.l., Acteon Group, 21054 Fagnano Olona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-1485-8950","authenticated-orcid":false,"given":"Raffaella","family":"De Pace","sequence":"additional","affiliation":[{"name":"Department of Chemical, Pharmaceutical and Agricultural Sciences, University of Ferrara, 44121 Ferrara, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Perale","sequence":"additional","affiliation":[{"name":"Industrie Biomediche Insubri SA, Via Cantonale 67, 6805 Mezzovico-Vira, Switzerland"},{"name":"Faculty of Biomedical Sciences, University of Southern Switzerland (USI), Via G. Buffi 13, 6900 Lugano, Switzerland"},{"name":"Ludwig Boltzmann Institute for Experimental and Clinical Traumatology, Donaueschingenstrasse 13, 1200 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,6,23]]},"reference":[{"key":"ref_1","unstructured":"Trimmel, B. (2021, October 22). Should Bone Grafts in the Upper Jaw Be Allowed to Heal for 3 or 6 Months Before Inserting Dental Implants?. Available online: https:\/\/www.isrctn.com\/ISRCTN10993769."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Ghiretti, R., Grottoli, C.F., Cingolani, A., and Perale, G. (2020). Clinical Case Employing Two Different Biomaterials in Bone Regeneration. Appl. Sci., 10.","DOI":"10.3390\/app10134516"},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Zhao, R., Yang, R., Cooper, P.R., Khurshid, Z., Shavandi, A., and Ratnayake, J. (2021). 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