Autogenous grafts remain the “gold standard” in bone tissue grafting procedures; however, limitations such as donor site morbidity, invasiveness, and limited availability have spurred research into alternative materials. Hydroxyapatite (HA), a widely used bioceramic, is known for its bioactivity and biocompatibility. Nonetheless, its inherent brittleness and porosity necessitate modifications to enhance its mechanical and functional properties. Ionic doping has emerged as a transformative strategy to improve the properties of HA by integrating ions such as strontium (Sr²⁺), magnesium (Mg²⁺), and zinc (Zn²⁺). These dopants influence HA’s crystal structure, morphology, and solubility, resulting in enhanced bioactivity, accelerated bone mineralization, and improved mechanical properties, such as increased fracture resistance and wear durability. Additionally, antimicrobial properties can be achieved through the inclusion of silver ions (Ag⁺), reducing the risk of peri-implant infections. This review focuses on the effects of ionic doping on the structure and functionality of hydroxyapatite, emphasizing advancements in tailoring its properties to clinical needs. By consolidating two decades of research, this study highlights how ionic doping bridges the gap between synthetic biomaterials and native bone, unlocking new potential in regenerative medicine and orthopedic applications.

Proper horizontal and vertical thickness of the gingival connective tissue has been proven to be one of the success criteria in dental implant and reconstructive surgery. When thin tissue is found, gingiva augmentation methods can be used to increase the quality and volume of the tissue. Many methods have been described, among them pedicle soft-tissue flaps or autogenic tissue grafts. As an alternative to patients’ own tissue, xenogenic materials can be used for grafting. The fundamental issue is to choose a material that will ensure the maximum therapeutic effect, while also minimizing the negative influence on the patient’s health. The aim of this study was to compare gingival augmentation procedures using a palatal connective tissue graft (CTG) and an xenogenic soft-tissue substitute, Geistlich Mucograft (xenogeneic collagen matrix; CMX), and assess whether the timing of the graft surgery influences the clinical outcomes. The original study was a randomized control trial with a total of 75 implants placed. The patients received the soft-tissue thickening 3 months before the implant placement or 3 months after the implant placement (depending on the group). A connective tissue graft (CTG) or Geistlich Mucograft were used (depending on the group). For both the CTG and Geistlich Mucograft, better clinical outcomes were observed for maintaining the alveolar bone level and the thickness of the attached gingiva compared to the control group with no gingival augmentation. The Geistlich Mucograft showed good clinical performance in comparison to the control. Soft-tissue augmentation with the CTG before the implant placement was found to be most efficient method in terms of a stable increase of the tissue thickness since, throughout the entire observation period, the greatest increase of 1.035 mm (SD = 0.73 mm) in thickness was observed. Statistically important differences in the tissue thickness baseline compared after 5 years were observed for groups G1 vs. G2b (no augmentation vs. CTG before), G1 vs. G3b (no augmentation vs. CTG after) and for groups G2b vs. G3a (CTG before vs. CMX after).

Guided bone regeneration (GBR) is a well-documented and widely-used dental surgical procedure for the treatment of various types of alveolar bone defects. The aim of the study was to evaluate the long-term effectiveness of the GBR procedure in correcting small peri-implant bone dehiscence using the xenogeneic deproteinized bovine bone mineral material and a xenogeneic native bilayer collagen membrane. The present study was designed as a retrospective study. Seventy-five bone-level tapered two-piece dental implants Conelog^®, Camlog (Biotechnologies AG, Switzerland) were divided into two groups G1—no bone augmentation (no GBR)—44 implants and G2—bone augmentation (GBR)—31 implants. For both groups, the closed healing protocol with a primary wound closure was used. The incidence of peri-implantits was evaluated, the quantitative assessment of soft tissue thickness was performed using the ultrasound (USG) device, quantitative assessment of marginal bone loss (MBL) was done. The prevalence of peri-implantitis was 5.3%, with a three-fold increase in peri-implantitis comparing the groups without and with bone augmentation (G1 = 2.27%, G2 = 9.7%). The average keratinized gingiva thickness was 1.87 mm and did not differ significantly between groups. No statistically significant differences in MBL between G1 and G2 were found. When dividing patients by gender, no statistically significant differences were observed. When dividing patients by age groups, statistically significant differences were observed between the youngest and oldest groups of patients. Within the limitations of this study, it can be concluded that the use of xenogeneic bone and a xenogeneic collagen membrane in a GBR procedure can be recommended to correct small peri-implant bone dehiscence.