## 4 Discussion  
Since bone grafts are used to augment the atrophic maxilla and mandible, volumetric changes on the grafted sites are frequently of interest. Nevertheless, there are few studies on bone volume changes at donor sites [6]. Bone deposition after harvesting has been reported in several studies [7; 23; 24]. [PERSON] et al. [24] reported that complete bone deposition could be detected after 9 months. Likewise, [PERSON] et al. [7] demonstrated the presence of a newly formed bone at the donor site after 8 months. However, these evaluations were performed using panoramic radiographs, which were inaccurate owing to their two-dimensional nature and image distortion. [PERSON] et al. [8] also demonstrated bone formation in mandibular symphysis defects using helical computed tomography (CT). The study \begin{table}
\begin{tabular}{c c c} \hline \hline
**Age** & 53.72 \(\pm\) 11.2 years \\ \hline
**Sex** & Female: 14; male: 18 \\ \hline
**Healing time** & 4.6 \(\pm\) 1.65 months \\ \hline \hline \end{tabular}
\end{table} 
Table 1: Patient demographic factors. \begin{table}
\begin{tabular}{c c c c} \hline \hline  & **Bone Volume Change (mm\({}^{3}\))** & \\ \hline
**Volume** & **Volume** & **Regenerated** & \(p\)**-Value** \\ \hline
**T1 \(-\) T0** & **T2 \(-\) T1** & **Bone** & \\ \hline  & & **(\%)** & \\ \hline Total & 703.18 \(\pm\) 410.31 & 459.87 \(\pm\) 307.95 & 34.87 \(\pm\) 17.11 & 0.001 [1] \\ \hline UA (upper anterior) & 121.15 \(\pm\) 106.36 & 87.49 \(\pm\) 74.91 & 28.6 \(\pm\) 19.56 & \\ \hline UP (upper posterior) & 220.198 \(\pm\) 166.22 & 136.53 \(\pm\) 125.49 & 40.37 \(\pm\) 21.47 & \\ \hline LA (lower anterior) & 273.07 \(\pm\) 173.13 & 179.54 \(\pm\) 122.86 & 33.37 \(\pm\) 20.26 & \\ \hline LP (lower posterior) & 170.22 \(\pm\) 130.88 & 122.83 \(\pm\) 113.40 & 38.36 \(\pm\) 22.91 & \\ \hline \hline \end{tabular} \({}^{(\mathrm{a)}}\) _t_-Test, \({}^{(\mathrm{c)}}\) ANOVA.  
\end{table} 
Table 2: Bone volume and pixel value changes. \begin{table}
\begin{tabular}{c c c c} \hline \hline  & **Pixel Value** & **Pixel Value Change (T1/T2)** & \(p\)**-Value** \\ \hline T0 & 0.33 \(\pm\) 0.05 & & \\ \hline T2 & 0.26 \(\pm\) 0.07 & & \\ \hline \hline \end{tabular} \({}^{(\mathrm{a)}}\) _t_-Test.  
\end{table} 
Table 3: Pixel value change. reported a second harvesting from the same area; nonetheless, the defect was grafted with bovine bone particles, and quantitative evaluations were not performed. More recent studies have attempted to perform quantitative evaluations. [PERSON] et al. [25] attempted to quantify the mandibular symphysis bone formation after bone block harvesting with CT evaluation at different time points. The initial period was 4-13 months after harvesting, whereas the final period was 24-72 months after harvesting. The bone repair rate was 63.8%. Measurements were obtained in two dimensions and were multiplied by the number of cuts. [PERSON] et al. [6] also performed CT evaluations of the bone formation in the mandibular ramus 6 months after bone harvesting. The registration was based on a tomographic guide containing steel balls, and volumetric measurements were obtained from CT images. Subsequently, a bone deposition of 76.1% was observed. In this study, approximately half of the bone was observed to regenerate, which seemed appropriate considering the 4 month duration of the follow-up period. The bone repair rate of this study is expected to be higher with longer observation periods. Bone defect healing is a complex process involving numerous cellular signaling pathways mediated by multiple factors, including hypoxia, inflammation, and mechanical loading [26]. Those factors trigger osteogenic cell proliferation, which is of great clinical interest in the regeneration of lost bone, particularly for body defects around dental elements and implants [27]. Currently, stem cells of different origins are proposed for more predictable regenerative procedures. Among those are pluripotent embryonic stem cells, undifferentiated multipotent mesenchymal stem cells, and induced pluripotent stem cells.