Bone defects represent an everyday challenge for clinicians who work in the fields of orthopedic surgery, maxillofacial and oral surgery, otorhinolaryngology, and dental implantology. Various bone substitutes have been developed and utilized, according to the needs of bone reconstructive surgery. Carbonate apatite has gained popularity in recent years, due to its excellent tissue behavior and osteoconductive potential. This systematic review aims to evaluate the role of carbonate apatite in bone reconstructive surgery and tissue engineering, analyze its advantages and limitations, and suggest further directions for research and development. The Web of Science, PubMed, and Scopus electronic databases were searched for relevant review articles, published from January 2014 to 21 July 2023. The study was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Eighteen studies were included in the present review. The biological properties and medical applications of carbonate apatite (CO₃Ap) are discussed and evaluated. The majority of articles demonstrated that CO₃Ap has excellent biocompatibility, resorbability, and osteoconductivity. Furthermore, it resembles bone tissue and causes minimal immunological reactions. Therefore, it may be successfully utilized in various medical applications, such as bone substitution, scaffolding, implant coating, drug delivery, and tissue engineering.

Background: The growing demand for effective methods of bone tissue regeneration highlights the relevance of studying modern bone substitutes and their applications in regenerative medicine. The aim of this work was to conduct a comprehensive analysis of the biological, mechanical, and clinical characteristics of various types of bone substitutes to determine their potential in regenerative medicine. Methods: The study was performed as a systematic literature review in accordance with PRISMA guidelines, analyzing 68 high-quality scientific sources from 2019 to May 2025, using the PubMed, Scopus, Web of Science, and Google Scholar databases. Results: It was established that autogenous grafts exhibit the highest osteogenic properties due to the presence of growth factors BMP-2, BMP-7, and concentrated growth factors; however, their use is limited by donor site morbidity in 20–30% of patients and the requirement to treat 6% of fractures complicated by non-union. Allogeneic and xenogeneic substitutes provide structural support for large defects but require intensive processing in accordance with European Directives 2004/23/EC and 2006/86/EC to minimize the risk of infection transmission. Synthetic substitutes based on calcium phosphate ceramics with pore sizes ranging from 23 to 210 micrometres demonstrate excellent biocompatibility and controlled degradation, with β-tricalcium phosphate exhibiting optimal characteristics for long-term applications compared to calcium sulphate. Conclusions: The findings of the study highlight the necessity of a personalized approach in selecting bone substitutes, considering the specific requirements of medical specialities, and support the development of hybrid biomaterials to combine structural strength with biological activity.

Undecalcified bone histology is a valuable diagnostic method for studying bone microarchitecture and provides information on bone formation, resorption, and turnover. It has various clinical and research applications. Toluidine blue has been widely adopted as a staining technique for hard-tissue specimens. It provides a clear identification of bone structural and cellular features and the distinctions between them. Furthermore, the method allows for an excellent definition of the cement lines that mark the fields of bone remodeling. Some of the suggested and currently used processing and staining protocols are too complex and time-consuming, which necessitates their modification and/or optimization. This research aims to develop a simplified protocol for staining plastic-embedded undecalcified bone specimens with toluidine blue. The samples were obtained from the tibial bones of rabbits, and experiments with and without pre-etching were conducted. Our results demonstrated that the optimal visualization of the bone microstructure and its cellular components was achieved in the samples without acid pre-etching and dehydration after staining.

Bone histology and histomorphometry are reliable diagnostic tools for the assessment of the bone–implant interface, material safety and biocompatibility, and tissue response. They allow for the qualitative and quantitative analysis of undecalcified bone specimens. This scoping review aims to identify the most common staining techniques, study models for in vivo experiments, and histomorphometric parameters used for quantitative bone evaluation of osseointegrated dental implants in the last decade. The Web of Science, PubMed, and Scopus databases were searched on 1 July 2024 for relevant articles in English, published in the last ten years, and the data were exported to an MS Excel spreadsheet. A total of 115 studies met the eligibility criteria and were included in the present review. The results indicate that the most common study models are dogs, rabbits, and pigs. Some of the most frequently used methods for the assessment of the bone–implant interface are the Toluidine blue, Stevenel’s blue with Van Gieson, and Levai–Laczko stainings. The results from this study demonstrate that the most commonly used histomorphometric parameters in implant dentistry are the bone-to-implant contact (BIC), bone area fraction occupancy (BAFO), bone area (BA), and bone density (BD). This review presents the recent trends in histomorphometric analysis of dental implants and identifies some research gaps that necessitate further research.

In recent years, there has been a sharp increase in the number of chronic periodontal diseases. The problem of their widespread distribution and the need for their treatment is one of the priorities of modern dentistry. Periodontal bone defects are the result of chronic periodontitis if timely measures are not taken to stop the inflammatory process. The goal of periodontal treatment is to remove all deposits of supra- and subgingival dental plaque and calculus (containing periodontopathogens) and their plaque-retentive factors and to promote complete regeneration of the tooth-supporting structures lost up to that point. Until now, autogenous, platelet-rich plasma has been widely used in various fields of medicine. Because of the equivalent results obtained and the lower cost, in dentistry, autogenous platelet-rich plasma is increasingly the preferred material over others that have proven to be reliable over time. Summarizing the results of various authors who used autogenous platelet-rich plasma alone or in combination with other materials for the purpose of regeneration of vertical bone defects, it is clear that PRP significantly accelerates the restorative and regenerative processes in the periodontium.

With the implementation of bone substitute materials, regeneration strategies have inevitably evolved over the years. Histomorphometry is the optimal means of quantitative evaluation of bone structure and morphology. This systematic review focuses on determining study models, staining methods and histomorphometric parameters used for bone regeneration research on non-decalcified plastic-embedded specimens over the last 10 years. After being subjected to the inclusion and exclusion criteria, 118 studies were included in this review. The results establish the most commonly selected animal model is rat, followed by rabbit, sheep and dog. Strong preference for staining samples with toluidine blue was noted. With regard to histomorphometric parameters, terms related to bone were most frequently assessed, amounting to almost half of recorded parameters. New bone formation was the main descriptor of this category. Residual bone graft and non-bone tissue parameters were also often evaluated. With regard to dynamic histomorphometry, mineral apposition rate (MAR) was the parameter of choice for most researchers, with calcein green being the preferred dye for fluorochrome labelling. An overview of the contemporary literature, as well as weaknesses in the current research protocols have been discussed.