## 1 Introduction  
Bone defects are often associated with inadequate or absence of bone tissue in a body area where the area should be normal bone [1; 2]. Bone defects can occur due to various causes, such as traumatic injury, a congenital defect, or surgical intervention of infection or tumor resection [3; 4; 5; 6; 7; 8; 9; 10]. Moreover, bone defects also often occur in the jaw after tooth extraction, especially in the posterior maxillary region, because the bone in this region is bordered by the floor of the sinus and crest of the alveolar bone that causes height bone loss after tooth extraction [3; 5; 6; 7; 8; 11; 12; 13; 14; 15; 16; 17]. A lack of bone volume in the jaw makes dental implant placement impossible [7; 11; 12; 16; 17; 18; 19; 20; 21]. Currently, bone defects are still a difficult problem and become a concern for both orthopedics and oral surgeons because of the potential risk of complications [1; 2; 6; 10; 13; 15; 17; 22; 23; 24; 25]. One of the bone defect treatments is bone reconstruction with a bone graft that can regenerate bone and restore the function of the area affected by the defect [3; 4; 15; 19; 20; 26]. A bone graft is an implanted material that not only serves to promote bone healing but, also, to contour augmentation [13; 16]. Thus, this material should have osteoconduction, osteoinduction, osteogenic, and osseointegration properties [1; 3; 4; 8; 13; 16]. Furthermore, bone graft material should be easy and safe to use [1; 3; 4]. Although autologous bone graft is still the gold standard for bone reconstruction, however, some disadvantages have been reported to cause discomfort to the patient, and it will increase the treatment costs [1; 3; 7; 8; 9; 14; 16; 20; 24; 27]. Xenograft bone blocks have been reported to be good alternatives to autologous bone grafts that can increase the bone volume both horizontally and vertically via an on-lay or inlay grafting procedure [28; 29; 30; 31]. One study showed that a xenograft bone block increased the vertical bone volume in the inlay graft technique without the use of a fixation devices, which could lead to the risk of fracture in the bone segment [31]. However, the use of bone block xenografts potentially causes disease transmission or allergic reactions in the patient, requiring shape adjustment, the recipient area requires additional contouring, and the remaining space needs to be filled with bone particles [28; 29; 30; 31]. Another alternative to bone reconstruction that has been widely suggested is the use of synthetic bone substitutes [1; 4; 9; 15; 19; 22]. The use of calcium sulfate hemihydrate bioceramic has been widely used in medical applications such as bone grafts, repairing root perforations, root-end filling materials, drug carriers, and also, potential as three-dimensional printing materials for scaffold manufacture in bone tissue engineering due to its excellent properties, especially in osteoinduction [32; 33; 34; 35]. Other advantages of using calcium sulfate clinically include the usefulness for local hemostasis after dental extraction even in patients on anticoagulant therapy without stopping the therapy before surgery and, also, for local hemostasis in endodontic microsurgery [36; 37; 38; 39]. In previous studies, we used an innovative \(\alpha\)-calcium sulfate hemihydrate (\(\alpha\)-CSH) bioceramic as a bone graft substitute that is similar in nature to autologous bone grafts, and these studies also indicated that \(\alpha\)-CSH bioceramic is safe to use in clinical applications, since this material is a noniritant and has no risk of immunological rejection [40]. Our other previous study showed the potential safety of using \(\alpha\)-CSH bioceramic, since this material is microwave-synthesized high-purity \(\alpha\)-CSH without using any chemical reagents, and the cytotoxicity assay results demonstrated that this material does not affect the proliferation of L929 cells [41]. Moreover, that study clearly showed the formation of angiogenesis, which is important for osseointegration and the healing process [41].