3. Discussion
PROLIFERATION
This study included 38 subjects, 17 (45%) male and 21 (55%) female. They were divided into two groups, the test group and the control group. The mean age of the respondents was 35.03 ± 9.16 years (females = 36.67 ± 6.39; males = 33.00 ± 11.61). Parallels can be drawn with human studies conducted by Čandrlić et al. [Quantitative and qualitative analysis of bone biopsy samples is used to evaluate regenerated augmentation areas, which is supported by many previous studies in addition to ours [In the literature, Bio-OssAccording to the literature on human studies using this form of xenograft six months after augmentation, an older study by Zitzmann et al. in 2001 [In addition to histomorphometric analysis, the interest of previous studies, such as this one, focused on the interactions between BSB and host tissues, such as the biological response of the tissue related to the origin of BSB, which is crucial for qualitative analysis. Notwithstanding the slow resorption demonstrated in many studies, the qualitative light microscopic analyses in other studies as well as this study strongly demonstrate that the sites treated with Bio-OssInjectable BCP (maxresorbFrom the currently available literature, Gauthier et al. [The main evidence of regenerative potential and formation of the new bone is found in the current literature on human studies using the injectable form of BCP, but it is quite limited. Histologic and histomorphometric analyses of bone biopsy samples taken four and six months after augmentation, in the studies by Papanchev et al. [Qualitative analysis was also used in this group to evaluate the pathohistological response of the host tissue to the BSB used. Alloplastic BSBs enhance growth and proliferation in vivo and stimulate osteoblasts to deposit mineralized extracellular matrix as a structural scaffold for osteogenic cell migration [Immunohistochemical analysis of the control and test groups was used to detect the transcription factor Osx and BMP-2 protein, which play a role in bone remodeling and the differentiation of mesenchymal cells. The immunohistochemical findings with expression level (Osx and BMP-2) were reviewed and evaluated semiquantitatively. Intensity level 3 (+++), i.e., strong staining indicating good osteoconductive properties of both BSBs, was detected in both groups. Representative samples from the control and test group and Osx immunohistochemical staining showed cells with Osx expression of intensity level 3 (+++) in pre-osteoblasts anchored to the margin of newly formed bone, indicating their transition into mature osteoblasts and osteocytes. In addition, trabecularization of the new bone was observed, indicating continuous remodeling. Osx has been shown to be involved in osteoblast differentiation, maturation, and activity; it regulates the expression of various markers, i.e., osteoblast proteins, the most important of which are osteopontin (OPN) and osteocalcin (OCN), etc., as indicated by the currently available literature. Previous studies have shown that Osx is an essential transcription factor in osteogenic differentiation [On the other hand, representative samples from the control and test groups and BMP-2 immunohistochemical staining showed cells with BMP-2 expression levels of 3 (+++), present mainly in the zones where differentiation of mesenchymal cells into pre-osteoblasts continued, indicating recovery, i.e., regeneration of the damaged tissue. According to the literature, BMP-2 is a protein that acts as a potent osteogenic factor and promoter of osteoblast differentiation, which was expressed in similar studies with this type of BSB, confirming the results obtained [