Are recent available blended collagen-calcium phosphate better than collagen alone or crystalline calcium phosphate? Radiotextural analysis of a 1-year clinical trial

Objectives The purpose of this study is to compare bone regeneration properties of recently available collagen-calcium phosphate (C-CP) blend as bone substitute (BS) material in oral surgery with calcium phosphate (CP) as well as collagen material (Collagen). Is C-CP better than the classic loose CP, or is it at least equally effective in the jawbone regeneration with the superiority of a coherent consistency? Materials and methods This study included 102 patients during 12-month follow-up. All patients underwent the following surgical procedures: sinus lift (52patients) and tooth extraction (50patients). Patients were divided into 3 groups which are as follows: experimental group with C-CP, CP and pure Collagen as control groups. Texture analysis was performed in intra-oral radiographs. Analyses were performed in the MaZda 4.6 software. Average 2444-pixel ROIs were established in the image of BS materials and normal trabecular bone for texture comparison to evaluate the jawbone regeneration process. Four features were calculated and investigated. Results Texture analyses revealed that all 4 features described the healing process well. Reference textural value of feature SumOfSqrs < 102.37 was soft tissue, DifEntr < 1.1 was not the bone, Entr < 2.62 was not a bone and LngREmph > 1.8 was soft tissue. For 12 months, bone regeneration was proved by 3 of 4 investigated features. Only Entr indicated to CP remnants in the ROI (p < 0.05). Conclusions This study proves that blended collagen-calcium phosphate as a BS material can bring satisfactory and predictable outcomes in jawbone regeneration.