{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T16:41:06Z","timestamp":1787071266216,"version":"build-2736575974"},"reference-count":25,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"Suppl 1","license":[{"start":{"date-parts":[[2021,6,1]],"date-time":"2021-06-01T00:00:00Z","timestamp":1622505600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2021,6]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Cystic defects that are critical sized or larger require bone replacement strategies. However, due to inherent disadvantages of the various types of grafts, none of the available materials are best suited for these defects. Among the alloplastic materials, hydroxyapatite (HA)-based grafts are the most popular, due to their osteoconductive nature and resemblance to mineral bone. The aim of the study was to assess the utility of the novel material \u201cChitra-HASi\u201d as a bone substitute in the maxillofacial region.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods:<\/jats:title>\n                    <jats:p>\n                      In a single-arm, prospective study, patients with radicular and dentigerous cysts were included and the minimum defect size was standardized at 20 \u00d7 20 mm or above. The Chitra\u2013HASi material was developed by a wet precipitation technique and adopted for use following multiple\n                      <jats:italic toggle=\"yes\">in vitro<\/jats:italic>\n                      and\n                      <jats:italic toggle=\"yes\">in vivo<\/jats:italic>\n                      studies, confirming its safety and biocompatibility profile. All cysts underwent enucleation, followed by peripheral ostectomy and apicectomy of the teeth involved. The HASi graft was packed inside the cystic defect in a granular form and covered with a mucoperiosteal flap. Panoramic radiographs were taken preoperatively and at 3, 6, and 12 months postoperatively.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Twenty-three patients were included in the study, of which only 10 patients could be followed up for 12 months after graft placement. The mean preoperative bone density was found to be 14.9% \u00b1 4.97 (standard deviation), whereas the postoperative 3-month, 6-month, and 12-month densities had a mean difference of \u221211.3%, \u221222.9%, and \u221237.3%, respectively, and the differences were statistically significant. Minor complications such as sinus formation (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 7) and extrusion of granules (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 4) were noted, which were managed conservatively. Only two patients required graft removal secondary to infection, leading to a persistent sinus tract.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>The results of the study suggest that Chitra\u2013HASi granules show potential as an alternative to other bone substitutes. The addition of silica to the porous HA material offers superior strength characteristics and needs long-term evaluation to assess its stability in large cystic defects.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/jpbs.jpbs_816_20","type":"journal-article","created":{"date-parts":[[2021,6,5]],"date-time":"2021-06-05T07:46:24Z","timestamp":1622879184000},"page":"S772-S777","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["Utility of Chitra\u2013HASi Granules in Cystic Defects of the Maxillofacial Region: A Pilot Study"],"prefix":"10.4103","volume":"13","author":[{"given":"Manikandhan","family":"Ramanathan","sequence":"first","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery, Meenakshi Ammal Dental College and Hospital, Chennai, Tamil Nadu, India"},{"name":"Meenakshi Cleft and Craniofacial Centre, Meenakshi Academy of Higher Education and Research (Deemed-to-be University), Chennai, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raj Kumar","family":"Tiwari","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery, Meenakshi Ammal Dental College and Hospital, Chennai, Tamil Nadu, India"},{"name":"Department of Oral and Maxillofacial Surgery, Ex-servicemen Contributory Health Scheme (ECHS), Sagar, Madhya Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sunil Paramel","family":"Mohan","sequence":"additional","affiliation":[{"name":"Department of Oral Pathology, Sree Anjaneya Institute of Dental Sciences, Atholi, Calicut, Kerala, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dayasankar Prabhu","family":"Shankar","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery, Meenakshi Ammal Dental College and Hospital, Chennai, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ritvi K.","family":"Bagadia","sequence":"additional","affiliation":[{"name":"Meenakshi Cleft and Craniofacial Centre, Meenakshi Academy of Higher Education and Research (Deemed-to-be University), Chennai, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P. R. Harikrishna","family":"Varma","sequence":"additional","affiliation":[{"name":"Division of Bioceramics, Biomedical Technology Wing, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francis Boniface","family":"Fernandez","sequence":"additional","affiliation":[{"name":"Division of Bioceramics, Biomedical Technology Wing, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S. Suresh","family":"Babu","sequence":"additional","affiliation":[{"name":"Division of Bioceramics, Biomedical Technology Wing, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2021,6,5]]},"reference":[{"key":"R1-20241204","doi-asserted-by":"crossref","first-page":"97","DOI":"10.2113\/GSELEMENTS.4.2.97","article-title":"Bone and tooth mineralization: Why apatite?","volume":"4","author":"Pasteris","year":"2008","journal-title":"Elements"},{"key":"R2-20241204","doi-asserted-by":"crossref","first-page":"891","DOI":"10.1111\/clr.12413","article-title":"Biphasic \u03b2-TCP mixed with silicon increases bone formation in critical site defects in rabbit calvaria","volume":"26","author":"Calvo-Guirado","year":"2015","journal-title":"Clin Oral Implants Res"},{"key":"R3-20241204","doi-asserted-by":"crossref","first-page":"114","DOI":"10.4161\/org.23306","article-title":"Bone grafts, bone substitutes and orthobiologics: The bridge between basic science and clinical advancements in fracture healing","volume":"8","author":"Roberts","year":"2012","journal-title":"Organogenesis"},{"issue":"Suppl 21","key":"R4-20241204","doi-asserted-by":"crossref","first-page":"92","DOI":"10.1111\/jcpe.13058","article-title":"Bone grafts: Which is the ideal biomaterial?","volume":"46","author":"Haugen","year":"2019","journal-title":"J Clin Periodontol"},{"key":"R5-20241204","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1302\/2058-5241.3.170056","article-title":"Bioceramics and bone healing","volume":"3","author":"Ginebra","year":"2018","journal-title":"EFORT Open Rev"},{"key":"R7-20241204","doi-asserted-by":"crossref","first-page":"2215","DOI":"10.1007\/s00586-007-0501-0","article-title":"Effect of hydroxyapatite porous characteristics on healing outcomes in rabbit posterolateral spinal fusion model","volume":"16","author":"Motomiya","year":"2007","journal-title":"Eur Spine J"},{"key":"R8-20241204","doi-asserted-by":"crossref","first-page":"902","DOI":"10.1002\/jbm.b.32895","article-title":"The effect of particle size on the osteointegration of injectable silicate-substituted calcium phosphate bone substitute materials","volume":"101","author":"Coathup","year":"2013","journal-title":"J Biomed Mater Res B Appl Biomater"},{"key":"R9-20241204","doi-asserted-by":"crossref","first-page":"1016","DOI":"10.1177\/0885328213491790","article-title":"Hydroxyapatite scaffold pore architecture effects in large bone defects in vivo","volume":"28","author":"Guda","year":"2014","journal-title":"J Biomater Appl"},{"key":"R10-20241204","doi-asserted-by":"crossref","first-page":"1469","DOI":"10.1002\/jbm.b.34495","article-title":"Size matters: Effect of granule size of the bone graft substitute (Herafill\u00ae) on bone healing using Masquelet's induced membrane in a critical size defect model in the rat's femur","volume":"108","author":"Leiblein","year":"2020","journal-title":"J Biomed Mater Res B Appl Biomater"},{"key":"R11-20241204","doi-asserted-by":"crossref","first-page":"855","DOI":"10.1002\/jbm.a.32239","article-title":"Tissue regeneration and repair of goat segmental femur defect with bioactive triphasic ceramic-coated hydroxyapatite scaffold","volume":"91","author":"Nair","year":"2009","journal-title":"J Biomed Mater Res A"},{"key":"R12-20241204","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1089\/ten.tea.2009.0207","article-title":"Treatment of goat femur segmental defects with silica-coated hydroxyapatite--one-year follow-up","volume":"16","author":"Nair","year":"2010","journal-title":"Tissue Eng Part A"},{"key":"R13-20241204","doi-asserted-by":"crossref","first-page":"3023","DOI":"10.1016\/S0142-9612(02)00064-9","article-title":"Fibrin glue as an osteoinductive protein in a mouse model","volume":"23","author":"Abiraman","year":"2002","journal-title":"Biomaterials"},{"key":"R14-20241204","doi-asserted-by":"crossref","first-page":"2041731418776819","DOI":"10.1177\/2041731418776819","article-title":"Bone substitutes: A review of their characteristics, clinical use, and perspectives for large bone defects management?","volume":"9","author":"Fernandez de Grado","year":"2018","journal-title":"J Tissue Eng"},{"key":"R15-20241204","doi-asserted-by":"crossref","first-page":"483","DOI":"10.1016\/0030-4220(91)90436-G","article-title":"An in vivo study of the use of a nonresorbable ceramic hydroxyapatite as an alloplastic graft material in periapical surgery","volume":"71","author":"Beck-Coon","year":"1991","journal-title":"Oral Surg Oral Med Oral Pathol"},{"key":"R16-20241204","doi-asserted-by":"crossref","first-page":"299","DOI":"10.1097\/00003086-198604000-00036","article-title":"The critical size defect as an experimental model for craniomandibulofacial nonunions","volume":"205","author":"Schmitz","year":"1986","journal-title":"Clin Orthop Relat Res"},{"key":"R17-20241204","doi-asserted-by":"crossref","first-page":"310","DOI":"10.1097\/00001665-199807000-00004","article-title":"Importance of the critical-size bone defect in testing bone-regenerating materials","volume":"9","author":"Bosch","year":"1998","journal-title":"J Craniofac Surg"},{"key":"R18-20241204","doi-asserted-by":"crossref","DOI":"10.4137\/BTRI.S36138","article-title":"Hydroxyapatite-past, present, and future in bone regeneration","author":"Kattimani","year":"2016","journal-title":"Bone Tissue Regen Insights"},{"key":"R19-20241204","doi-asserted-by":"crossref","first-page":"2041731419896449","DOI":"10.1177\/2041731419896449","article-title":"Clinical study of octacalcium phosphate and collagen composite in oral and maxillofacial surgery?","volume":"11","author":"Kawai","year":"2020","journal-title":"J Tissue Eng"},{"key":"R20-20241204","doi-asserted-by":"crossref","first-page":"316783","DOI":"10.1155\/2013\/316783","article-title":"Silicon: A review of its potential role in the prevention and treatment of postmenopausal osteoporosis?","volume":"2013","author":"Price","year":"2013","journal-title":"Int J Endocrinol"},{"key":"R21-20241204","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1016\/j.actbio.2007.07.004","article-title":"A triphasic ceramic-coated porous hydroxyapatite for tissue engineering application","volume":"4","author":"Nair","year":"2008","journal-title":"Acta Biomater"},{"issue":"Suppl 1","key":"R22-20241204","doi-asserted-by":"crossref","first-page":"S251","DOI":"10.1007\/s10856-008-3598-8","article-title":"Triphasic ceramic coated hydroxyapatite as a niche for goat stem cell-derived osteoblasts for bone regeneration and repair","volume":"20","author":"Nair","year":"2009","journal-title":"J Mater Sci Mater Med"},{"key":"R23-20241204","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1111\/j.1744-7402.2008.02191.x","article-title":"Biodegradation and cytocompatibility studies of a triphasic ceramic-coated porous hydroxyapatite for bone substitute applications","volume":"5","author":"John","year":"2008","journal-title":"Int J Appl Ceram Technol"},{"key":"R24-20241204","doi-asserted-by":"crossref","first-page":"491","DOI":"10.1111\/j.1744-7402.2011.02622.x","article-title":"Osteogenesis of a bioactive ceramic-calcium phosphosilicate composite system in goat femur defect","volume":"8","author":"John","year":"2011","journal-title":"Int J Appl Ceram Technol"},{"key":"R25-20241204","doi-asserted-by":"crossref","first-page":"e0031","DOI":"10.2106\/JBJS.CC.19.00031","article-title":"First report of a tissue-engineered graft for proximal humerus gap non-union after chronic pyogenic osteomyelitis in a child: A case report","volume":"10","author":"Madhuri","year":"2020","journal-title":"JBJS Case Connect"},{"key":"R26-20241204","doi-asserted-by":"crossref","first-page":"455","DOI":"10.1007\/s00266-010-9473-2","article-title":"The fate of porous hydroxyapatite granules used in facial skeletal augmentation","volume":"34","author":"Mendelson","year":"2010","journal-title":"Aesthet Plast Surg"}],"container-title":["Journal of Pharmacy and Bioallied Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/jpbs.JPBS_816_20","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T15:43:54Z","timestamp":1787067834000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/jpbs.JPBS_816_20"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,6]]},"references-count":25,"journal-issue":{"issue":"Suppl 1","published-print":{"date-parts":[[2021]]}},"URL":"https:\/\/doi.org\/10.4103\/jpbs.jpbs_816_20","relation":{},"ISSN":["0976-4879","0975-7406"],"issn-type":[{"value":"0976-4879","type":"print"},{"value":"0975-7406","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,6]]},"assertion":[{"value":"2020-12-08","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-12-16","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}