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Clinical and radiographic evaluation of natural bovine bone with hyaluronic acid on osseointegration of immediate implants: a randomized clinical study.

Created on 07 Aug 2026

Authors

Mohamed Wageh Foad, Ahmad Mohamad El Rawdy, Mohamed Said Hamed

Published in

Scientific reports. Volume 16. Issue 1. Aug 06, 2026. Epub Aug 06, 2026.

Abstract

Hyaluronic acid (HA) is a natural component of the extracellular matrix (ECM) and has gained wide application in bone regeneration, particularly in maxillofacial and dental research. HA derivatives and HA-incorporated composite scaffolds demonstrate strong potential in enhancing osteogenesis and mineralization. The aim of this work was to evaluate clinical and radiographic effects of natural bovine bone with HA on immediate implants. Sixteen immediate implants were placed in medically free patients with non-restorable single-rooted maxillary anterior or premolar teeth; Patients were randomly allocated into two groups: Group 1 (Control): Implants placed in 8 fresh extraction sockets. Group 2 (Study): Implants placed in 8 fresh extraction sockets followed by grafting with a natural bovine bone material with HA. Implant stability quotient (ISQ) was measured at the time of implant surgery and 4 months postoperatively. Bone density and buccal bone width were measured immediately and 6 months postoperatively using Cone Beam CT. After 4 months, the study group showed higher ISQs values than the control group (72.25 ± 2.66 vs. 64.88 ± 1.36, p < 0.001). Bone density was significantly higher in the study group at 6 months (1163.38 ± 112.64 HU vs. 1034.13 ± 71.19 HU, p = 0.016). A significant reduction in buccal bone width was observed at 6-month follow-up in both groups. The reduction was more pronounced in the control group (15.99%; p < 0.001) than in the study group (3.88%; p = 0.014). No statistically significant differences were detected between the groups at either the immediate postoperative assessment or the 6-month follow-up. The use of natural bovine bone with hyaluronic acid after immediate implant placement enhances early implant stability, increases peri-implant bone density, and contributes to preservation of buccal bone dimensions, thereby supporting improved osseointegration.Trial registration: Current controlled trials NCT07199725 "Retrospectively registered" (registration date 02/09/2025).

PMID:
42562852
Bibliographic data and abstract were imported from PubMed on 07 Aug 2026.

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