Sticky bone in regenerative dentistry: a paradigm shift in graft stability or a promising technique still under scrutiny?

Background: Sticky bone is an emerging regenerative material in dentistry that combines autologous injectable platelet-rich fibrin with particulate bone grafts to form a cohesive, moldable, and biologically active mass. It addresses limitations of conventional bone grafting by integrating biologic and mechanical benefits into a single material, enhancing the predictability of dental regenerative procedures. Its clinical advantages include adaptability to defect sites, reduced graft migration, and sustained release of growth factors to accelerate healing. Objectives: This review evaluates the applications, efficacy, and limitations of sticky bone in implantology and periodontics, focusing on its role in ridge augmentation, socket preservation, sinus lifts, and management of periodontal defects. It also synthesizes evidence on its biologic mechanisms, handling properties, and clinical outcomes. Methods: A comprehensive literature search was conducted across databases (PubMed/MEDLINE, Scopus, Web of Science) to identify studies on sticky bone's composition, clinical techniques, and outcomes. Keywords such as sticky bone, Injectable PRF, Mineralized Plasmatic Matrix, Concentrated Growth Factors, and bone graft were employed in the search. Results: Evidence from the reviewed literature indicates that sticky bone significantly improves graft stability and handling properties, preventing particle migration and scattering. Its fibrin scaffold supports sustained release of growth factors, which enhances angiogenesis, cell proliferation, and osteogenesis. Clinically, it has been successfully applied in horizontal ridge augmentation, sinus lift procedures (even with small membrane perforations), socket preservation, and the repair of periodontal and alveolar cleft defects, demonstrating enhanced bone density, superior soft tissue healing, and reduced postoperative discomfort. Conclusions: Sticky bone offers a biologically enriched, easy-to-handle grafting material that enhances healing and graft stability in dental procedures. Its fibrin scaffold supports tissue integration and vascularization, while particulate grafts provide osteoconductive frameworks. Current evidence underscores its value in modern regenerative dentistry, though further long-term studies are needed to standardize protocols and optimize outcomes.