_Applied_  
_sciences_  
_Article_  
A Radiological Approach to Evaluate Bone Graft  
Integration in Reconstructive Surgeries  
**[PERSON] 1**, [PERSON] 2,*, [PERSON] 3**, [PERSON] 4@,  
**[PERSON] 4@, [PERSON] 1,5**, [PERSON] 6**, [PERSON] 4**, [PERSON] 1  
**and [PERSON] 1,2,7,*  
1 Industrie Biomedicine Insbri SA, Via Cantonale 67, 6805 Mezzovico-Vira, Switzerland; [EMAIL_ADDRESS] (C.F.G.); [EMAIL_ADDRESS] (L.P.); [EMAIL_ADDRESS] (A.C.)  
2 Department of Surgical Sciences, Orthopaedic Clinic-IRCCS A.O.U. San Martino, 16132 Genova, Italy  
3 Center for Research and Medical Studies, A.O.U. Citta della Salute e della Scienza, 10129 Torino, Italy; [EMAIL_ADDRESS]  
4 Radiologia Diagnostic Presidio CTO, Azienda Ospedaliero-Universitaria Citta della Salute e della Scienza di Torino, 10129 Torino, Italy; [EMAIL_ADDRESS] (A.T.); [EMAIL_ADDRESS] (O.R.); [EMAIL_ADDRESS] (A.B.)  
5 Department of Mechanical and Aerospace Engineering, Politecnico di Torino, Corso Duca degli Abruzzi 24, 10129 Torino, Italy  
6 Department of Traumatology and Rehabilitation, C.T.O. Hospital-A.O.U. Citta della Salute e della Scienza, 10129 Torino, Italy; [EMAIL_ADDRESS]  
7 Biomaterials Laboratory, Institute for Mechanical Engineering and Materials Technology, University of  
Applied Sciences and Arts of Southern Switzerland, Via Cantonale 2C, 6928 Manno, Switzerland  
* Correspondence: [EMAIL_ADDRESS] (R.F.); [PERSON]DDRESS] (G.P.); Tel.: +41-(091-930-6640 (G.P.))  
Received: 23 January 2019; Accepted: 1 April 2019; Published: 8 April 2019  
**Featured Application: This protocol allows tracking new bone formation after implantation of a xenohybrid bone graft (SmartBone@), without invasive histological samples.**  
**Abstract: (1) Background: Bone tissue engineering is a promising tool to develop new smart solutions for regeneration of complex bone districts, from orthopedic to oral and maxilla-facial fields. In this respect, a crucial characteristic for biomaterials is the ability to fully integrate within the patient body. In this work, we developed a novel radiological approach, in substitution to invasive histology, for evaluating the level of osteointegration and osteogenesis, in both qualitative and quantitative manners. (2) SmartBone@, a composite xeno-hybrid bone graft, was selected as the base material because of its remarkable effectiveness in clinical practice. Using pre- and post-surgery computed tomography (CT), we built 3D models that faithfully represented the patient's anatomy, with special attention to the bone defects. (3) Results: This way, it was possible to assess whether the new bone formation respected the natural geometry of the healthy bone. In all cases of the study (four dental, one maxilla-facial, and one orthopedic) we evaluated the presence of new bone formation and volumetric increase. (4) Conclusion: The newly established radiological protocol allowed the tracking of SmartBone@effective integration and bone regeneration. Moreover, the patient's anatomy was completely restored in the defect area and functionality completely rehabilitated without foreign body reaction or inflammation.**  
**Keywords: bone tissue regeneration; computed tomography; Xenografts**