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Minetti E, Palermo A, Berardini M. Comparison of Different Techniques in Post-Extractive Socket Regeneration Using Autologous Tooth Graft: Histological and Clinical Outcomes. Eur J Dent 2024; 18:477-484. [PMID: 37729934 PMCID: PMC11132773 DOI: 10.1055/s-0043-1772251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/22/2023] Open
Abstract
OBJECTIVE Post-extractive socket grafting techniques reduce alveolar ridge dimensional changes. Numerous graft materials have been suggested and a growing interest in tooth material has been observed as a valuable alternative to synthetic biomaterials or xenografts. Furthermore, different clinical procedures have been proposed for the wound closure of the post-extractive site. This study aims to compare histological and clinical outcomes of two different surgical techniques to seal the post-extractive site with the use of autologous demineralized extracted tooth as graft material. MATERIALS AND METHODS Sixteen post-extractive socket without buccal and/or palatal bone walls, in sixteen healthy patients, were grafted with the autologous tooth material treated by the new Tooth Transformer device (Tooth Transformer, Milan, Italy). Alveolar socket preservation procedures were performed without flap elevation. Patients were randomly subdivided into two equal groups according to the site closure technique. In group A, the pedunculate tissue was used, while in group B ice cone technique. A bone samples were collected in each site after 4 months for histological analysis. RESULTS No significant clinical differences among the different sealing techniques were observed. In both groups, the site was filled by new bone formation after 4 months of healing. The histological analysis revealed 46.1 ± 8.07% of bone volume, 9.2 ± 9.46% of residual graft, and 35.2 ± 12.36% of vital bone in group A, while group B shows 41.22 ± 5.88% of bone volume, 7.94 ± 7.54% of residual graft, and 31.7 ± 7.52% new bone. No statistical differences were detected (p > 0.05). CONCLUSION Further studies with a large number of patients, and different observation periods will be needed to confirm the results of this pilot study; however, the interesting data obtained have shown how these techniques, mixed with the autologous dentin derived graft material, seem to promote bone regeneration and reduce physiological bone resorption during alveolar socket preservation treatments.
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Affiliation(s)
- Elio Minetti
- Department of Biomedical, Surgical, Dental Science, University of Milan, Milan, Italy
| | - Andrea Palermo
- College of Medicine and Dentistry, University of Birmingham, Birmingham, United Kingdom
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Khurshid Z, Adanir N, Ratnayake J, Dias G, Cooper PR. Demineralized dentin matrix for bone regeneration in dentistry: A critical update. Saudi Dent J 2024; 36:443-450. [PMID: 38525180 PMCID: PMC10960104 DOI: 10.1016/j.sdentj.2023.11.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 11/26/2023] [Accepted: 11/26/2023] [Indexed: 03/26/2024] Open
Abstract
Over the last few decades, several new materials and techniques have been developed for bone regeneration. Scaffolds based on demineralized dentin matrix (DDM) present an attractive option due to their availability and several animal and human studies have been conducted to ascertain their utility in regenerative dentistry. The aim of this review was to summarize the recent studies conducted on DDM and used for bone grafts. PubMed, Web of Science, and Scopus were used to search for studies published within the last 10 years. The keywords and terms used were: "demineralized dentine matrix", "bone grafting", "bone augmentation" and "guided tissue regeneration" in various combinations. Original studies (in vitro, animal and human) and systematic reviews were included in the literature search. The literature search initially identified 23 studies (16 animal studies and 7 clinical reports. Most studies included in this review indicate that DDM has demonstrated promising results in a variety of dental and regenerative medicine applications. Further studies are required to completely comprehend its characteristics and prospective applications. Future studies should also focus on optimizing the processing protocols for the production of DDM-based scaffolds.
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Affiliation(s)
- Zohaib Khurshid
- Department of Prosthodontics and Dental Implantology, College of Dentistry, King Faisal University, Al-Ahsa 31982, Saudi Arabia
- Department of Oral Science, Faculty of Dentistry, University of Otago, 310 Great King Street, Dunedin 9016, New Zealand
| | - Necdet Adanir
- Department of Restorative Dentistry, College of Dentistry, King Faisal University, Al Ahsa 31982, Saudi Arabia
| | - Jithendra Ratnayake
- Department of Oral Science, Faculty of Dentistry, University of Otago, 310 Great King Street, Dunedin 9016, New Zealand
| | - George Dias
- Department of Anatomy, University of Otago, 310 Great King Street, Dunedin 9016, New Zealand
| | - Paul R. Cooper
- Department of Oral Science, Faculty of Dentistry, University of Otago, 310 Great King Street, Dunedin 9016, New Zealand
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Zhou WH, Li YF. A bi-layered asymmetric membrane loaded with demineralized dentin matrix for guided bone regeneration. J Mech Behav Biomed Mater 2024; 149:106230. [PMID: 37976993 DOI: 10.1016/j.jmbbm.2023.106230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Revised: 11/02/2023] [Accepted: 11/07/2023] [Indexed: 11/19/2023]
Abstract
OBJECTIVES Guided bone regeneration (GBR) is a well-established method for repairing hard tissue deficiency in reconstructive dentistry. The aim of this study was to investigate the barrier function, osteogenic activity and immunomodulatory ability of a novel bi-layered asymmetric membrane loaded with demineralized dentin matrix (DDM). METHODS DDM particles were harvested from healthy, caries-free permanent teeth. Electrospinning technique was utilized to prepare bi-layered DDM-loaded poly(lactic-co-glycolic acid) (PLGA)/poly(lactic acid) (PLA) membranes (abbreviated as DPP bilayer membranes). We analyzed the membranes' surface properties, cytocompatibility and barrier function, and evaluated their osteogenic activity in vitro. In addition, its effects on the osteogenic immune microenvironment were also investigated. RESULTS Synthetic DPP bilayer membranes presented suitable surface characteristics and satisfactory cytocompatibility. Transwell assays showed significant fewer migrated cells by the DPP bilayer membranes compared with blank control, with or without in vitro degradation (all P < 0.001). In vitro experiments indicated that our product elevated messenger ribonucleic acid (mRNA) expression levels of osteogenic genes alkaline phosphatase (ALP), osteopontin (OPN), osteocalcin (OCN) and runt-related transcription factor 2 (Runx2). Among all groups, 20% DPP bilayer membrane displayed highest ALP activity (P < 0.001). Furthermore, DPP bilayer membranes enhanced the mRNA expression of M2 macrophage markers and increased the proportion of CD206+ M2 macrophages by 100% (20% DPP: P < 0.001; 30% DPP: P < 0.001; 40% DPP: P < 0.05), thus exerting an inflammation suppressive effect. CONCLUSIONS DPP bilayer membranes exhibited notable biological safety and osteogenic activity in vitro, and have potential as a prospective candidate for GBR approach in the future.
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Affiliation(s)
- Wan-Hang Zhou
- Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, 510080, China
| | - Yan-Fei Li
- Department of Stomatology, The Eighth Affiliated Hospital, Sun Yat-Sen University, Shenzhen, 518033, China.
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Yang F, Ruan Y, Bai X, Li Q, Tang X, Chen J, Chen Y, Wang L. Alveolar ridge preservation in sockets with severe periodontal destruction using autogenous partially demineralized dentin matrix: A randomized controlled clinical trial. Clin Implant Dent Relat Res 2023; 25:1019-1032. [PMID: 37455372 DOI: 10.1111/cid.13247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 06/13/2023] [Accepted: 06/29/2023] [Indexed: 07/18/2023]
Abstract
BACKGROUND The preservation and reconstruction of alveolar ridge volume in extraction sockets of molars affected by severe periodontitis is a critical challenge that requires clinical attention. PURPOSE This randomized controlled clinical trial was designed to evaluate the efficiency of autogenous partially demineralized dentin matrix (APDDM) for alveolar ridge preservation (ARP) in severely periodontally compromised sockets compared to spontaneous healing (SH) on radiographic and histomorphometric outcomes. MATERIALS AND METHODS Thirty-two patients with 32 periodontally compromised molars were randomized into either the test group, which received ARP using APDDM covered with a collagen sponge, or the control group, which underwent SH. Linear and volumetric changes were assessed using superimposed cone-beam computed tomography (CBCT) acquired pre-extraction and after a 4-month healing time. Histomorphometric evaluation was performed on trephine cores harvested during implant placement. RESULTS All sites healed uneventfully. The ridge width at 1 mm apical to the bone crest increased by 5.03, 4.50, and 5.20 mm in the mesial, middle, distal area in the APDDM group, while decreasing by -1.98, -2.19, and -1.98 mm in the SH group, respectively (p < 0.05). The height increase of the central bone was significantly higher in the APDDM group than in the SH group (p < 0.05). The height decrease of the buccal (mesial, middle, distal) bone plate was lower in the APDDM group than in the SH group (p < 0.05). After a 4-month healing time, bone volume increased by 37.07% in the APDDM group and by only 2.33% in the SH group (p < 0.05). Histomorphometric analysis revealed that APDDM particles were surrounded by newly formed bone, with partially absorbed residual APDDM materials observed. New bone, APDDM remnants, and connective tissue occupied 39.67 ± 8.28%, 23.66 ± 9.22%, and 36.67 ± 17.05% of the areas in the APDDM group, respectively. CONCLUSIONS ARP using APDDM was effective, resulting in a significant increase in both linear and volumetric changes in severely periodontally compromised extraction sockets compared to SH. These findings suggest that APDDM may serve as a promising new clinical option for the reconstruction of alveolar ridge dimensions.
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Affiliation(s)
- Fan Yang
- Center for Plastic & Reconstructive Surgery, Department of Stomatology, Zhejiang Provincial People's Hospital (Affiliated People's Hospital), Hangzhou Medical College, Hangzhou, Zhejiang, China
| | - Yan Ruan
- Department of Oral and Maxillofacial Surgery/Pathology, Amsterdam UMC and Academic Center for Dentistry Amsterdam (ACTA), Amsterdam Movement Science (AMS), Vrije Universiteit Amsterdam (VU), Amsterdam, Netherlands
| | - Xiaolei Bai
- Center for Plastic & Reconstructive Surgery, Department of Stomatology, Zhejiang Provincial People's Hospital (Affiliated People's Hospital), Hangzhou Medical College, Hangzhou, Zhejiang, China
| | - Qi Li
- Department of Stomatology, Bengbu Medical College, Bengbu, China
| | - Xiaodong Tang
- Department of Stomatology, Tiantai Traditional Chinese Medicine Hospital, Taizhou, Zhejiang, China
| | - Jianping Chen
- Center for Plastic & Reconstructive Surgery, Department of Stomatology, Zhejiang Provincial People's Hospital (Affiliated People's Hospital), Hangzhou Medical College, Hangzhou, Zhejiang, China
| | - Yunfang Chen
- Center for Plastic & Reconstructive Surgery, Department of Stomatology, Zhejiang Provincial People's Hospital (Affiliated People's Hospital), Hangzhou Medical College, Hangzhou, Zhejiang, China
| | - Linhong Wang
- Center for Plastic & Reconstructive Surgery, Department of Stomatology, Zhejiang Provincial People's Hospital (Affiliated People's Hospital), Hangzhou Medical College, Hangzhou, Zhejiang, China
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Minetti E, Palermo A, Savadori P, Patano A, Inchingolo AD, Rapone B, Malcangi G, Inchingolo F, Dipalma G, Tartaglia FC, Inchingolo AM. Socket Preservation Using Dentin Mixed with Xenograft Materials: A Pilot Study. MATERIALS (BASEL, SWITZERLAND) 2023; 16:4945. [PMID: 37512221 PMCID: PMC10382043 DOI: 10.3390/ma16144945] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 07/08/2023] [Accepted: 07/10/2023] [Indexed: 07/30/2023]
Abstract
BACKGROUND The use of human dentin matrix could serve as an alternative to autologous, allogenic, and xenogeneic bone grafts due to its osteoinductive characteristics. The limitations of its use is tooth availability and that it is often necessary to mix it with a biomaterial. AIM The aim of this study was to analyze a mix of two different graft materials with different reabsorption ranges when the dentin graft material was not sufficient for full socket preservation. METHODS Seven socket preservation surgeries were carried out employing a mixed graft material containing 50% dentin and 50% xenograft. After four months of recovery, the implants were positioned. At the time of the prosthesis placement and implant surgery, bone samples were collected. RESULTS The histologic analysis revealed no inflammatory or infective reaction against the seven biopsies. The histomorphometric graft analysis revealed an amount of New Bone of 29.03 ± 6.57% after 4 months and 34.11 ± 5.02% after 8 months. CONCLUSIONS The two graft materials had a different volume reabsorption rate: 71% after 4 months and 90% after 8 months for dentin, and 6% after 4 months and 26% after 8 months for the xenograft. The space created by the dentin reabsorption increased the quantity of new bone.
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Affiliation(s)
- Elio Minetti
- Department of Biomedical, Surgical, and Dental Science, University of Milan, 20122 Milan, Italy
| | - Andrea Palermo
- College of Medicine and Dentistry, Birmingham B4 6BN, UK
| | - Paolo Savadori
- Department of Biomedical, Surgical, and Dental Science, University of Milan, 20122 Milan, Italy
- Fondazione Ca'Granda IRCCS Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Assunta Patano
- Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", 70121 Bari, Italy
| | | | - Biagio Rapone
- Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", 70121 Bari, Italy
| | - Giuseppina Malcangi
- Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", 70121 Bari, Italy
| | - Francesco Inchingolo
- Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", 70121 Bari, Italy
| | - Gianna Dipalma
- Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", 70121 Bari, Italy
| | - Francesco Carlo Tartaglia
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20072 Pieve Emanuele, Italy
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Human dentin materials for minimally invasive bone regeneration: Animal studies and clinical cases. J Oral Biosci 2023; 65:13-18. [PMID: 36336319 DOI: 10.1016/j.job.2022.10.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 10/28/2022] [Accepted: 10/31/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVES Bone, platelet concentrate, and tooth-derived dentin/cementum have been used as autologous materials in regenerative medicine Dentin materials were first recycled in 2002 for bone regeneration in humans, although bone autografts were noted in the 19th century, and auto-platelet concentrates were developed in 1998. Dentin/cementum-based material therapy has been applied as an innovative technique for minimally invasive bone surgery, while bone autografts are associated with donor site morbidity. METHODS In October 2021, PubMed, Google Scholar, Scopus, and the Cochrane Library databases from 1980 to 2020 were screened. RESULTS The demineralized dentin/cementum matrix (DDM) had better performance in bone induction and bone regeneration than mineralized dentin. CONCLUSIONS Unlike cell culture therapy, DDM is a matrix-based therapy that includes growth factors. A matrix-based system is a realistic and acceptable treatment, even in developing countries. The aim of this review was to summarize the evidence related to both animal studies and human clinical cases using human dentin materials with a patch of cementum, especially DDM.
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Inchingolo AM, Patano A, Di Pede C, Inchingolo AD, Palmieri G, de Ruvo E, Campanelli M, Buongiorno S, Carpentiere V, Piras F, Settanni V, Viapiano F, Hazballa D, Rapone B, Mancini A, Di Venere D, Inchingolo F, Fatone MC, Palermo A, Minetti E, Lorusso F, Scarano A, Sauro S, Tartaglia GM, Bordea IR, Dipalma G, Malcangi G. Autologous Tooth Graft: Innovative Biomaterial for Bone Regeneration. Tooth Transformer® and the Role of Microbiota in Regenerative Dentistry. A Systematic Review. J Funct Biomater 2023; 14:jfb14030132. [PMID: 36976056 PMCID: PMC10058341 DOI: 10.3390/jfb14030132] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Revised: 02/24/2023] [Accepted: 02/25/2023] [Indexed: 03/05/2023] Open
Abstract
Different biomaterials, from synthetic products to autologous or heterologous grafts, have been suggested for the preservation and regeneration of bone. The aim of this study is to evaluate the effectiveness of autologous tooth as a grafting material and examine the properties of this material and its interactions with bone metabolism. PubMed, Scopus, Cochrane Library, and Web of Science were searched to find articles addressing our topic published from 1 January 2012 up to 22 November 2022, and a total of 1516 studies were identified. Eighteen papers in all were considered in this review for qualitative analysis. Demineralized dentin can be used as a graft material, since it shows high cell compatibility and promotes rapid bone regeneration by striking an ideal balance between bone resorption and production; it also has several benefits, such as quick recovery times, high-quality newly formed bone, low costs, no risk of disease transmission, the ability to be performed as an outpatient procedure, and no donor-related postoperative complications. Demineralization is a crucial step in the tooth treatment process, which includes cleaning, grinding, and demineralization. Since the presence of hydroxyapatite crystals prevents the release of growth factors, demineralization is essential for effective regenerative surgery. Even though the relationship between the bone system and dysbiosis has not yet been fully explored, this study highlights an association between bone and gut microbes. The creation of additional scientific studies to build upon and enhance the findings of this study should be a future objective of scientific research.
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Affiliation(s)
| | - Assunta Patano
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy
| | - Chiara Di Pede
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy
| | | | - Giulia Palmieri
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy
| | - Elisabetta de Ruvo
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy
| | - Merigrazia Campanelli
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy
| | - Silvio Buongiorno
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy
| | - Vincenzo Carpentiere
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy
| | - Fabio Piras
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy
| | - Vito Settanni
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy
| | - Fabio Viapiano
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy
| | - Denisa Hazballa
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy
| | - Biagio Rapone
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy
| | - Antonio Mancini
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy
| | - Daniela Di Venere
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy
| | - Francesco Inchingolo
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy
- Correspondence: (F.I.); (M.C.F.); Tel.: +39-331-211-1104 (F.I.); +39-3479914635 (M.C.F.)
| | - Maria Celeste Fatone
- PTA Trani-ASL BT, Viale Padre Pio, 76125 Trani, Italy
- Correspondence: (F.I.); (M.C.F.); Tel.: +39-331-211-1104 (F.I.); +39-3479914635 (M.C.F.)
| | - Andrea Palermo
- College of Medicine and Dentistry Birmingham, University of Birmingham, Birmingham B4 6BN, UK
| | - Elio Minetti
- Department of Biomedical, Surgical, and Dental Science, Università Degli Studi di Milano, 20122 Milan, Italy
| | - Felice Lorusso
- Department of Innovative Technologies in Medicine and Dentistry, University of Chieti-Pescara, 66100 Chieti, Italy
| | - Antonio Scarano
- Department of Innovative Technologies in Medicine and Dentistry, University of Chieti-Pescara, 66100 Chieti, Italy
| | - Salvatore Sauro
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy
- Dental Biomaterials and Minimally Invasive Dentistry, Department of Dentistry, Cardenal Herrera-CEU University, CEU Universities, C/Santiago Ramón y Cajal, s/n., Alfara del Patriarca, 46115 Valencia, Spain
| | - Gianluca Martino Tartaglia
- Department of Biomedical, Surgical and Dental Sciences, School of Dentistry, University of Milan, 20100 Milan, Italy
- UOC Maxillo-Facial Surgery and Dentistry Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Ioana Roxana Bordea
- Department of Oral Rehabilitation, Faculty of Dentistry, Iuliu Hațieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
| | - Gianna Dipalma
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy
| | - Giuseppina Malcangi
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy
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Kajita T, Nogami S, Matsui K, Kataoka Y, Kurobane T, Koyama S, Takahashi T, Yamauchi K. Reconstruction of the alveolar cleft using a custom-made titanium mesh tray and particulate cancellous bone and marrow in an elderly patient with cleft lip and palate: A case report. JOURNAL OF ORAL AND MAXILLOFACIAL SURGERY, MEDICINE, AND PATHOLOGY 2023. [DOI: 10.1016/j.ajoms.2023.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
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Matsuzawa Y, Okubo N, Tanaka S, Kashiwazaki H, Kitagawa Y, Ohiro Y, Mikoya T, Akazawa T, Murata M. Primary Teeth-Derived Demineralized Dentin Matrix Autograft for Unilateral Maxillary Alveolar Cleft during Mixed Dentition. J Funct Biomater 2022; 13:jfb13030153. [PMID: 36135589 PMCID: PMC9506084 DOI: 10.3390/jfb13030153] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 09/13/2022] [Accepted: 09/14/2022] [Indexed: 12/21/2022] Open
Abstract
This clinical report describes the immediate autograft of primary (milk) teeth-derived demineralized dentin matrix (DDM) granules for a 6-year-old boy with unilateral alveolar cleft. First, four primary teeth were extracted, crushed in an electric mill for 1 min, and the crushed granules were demineralized in 2% HNO3 solution for 20 min. Simultaneously, the nasal mucoperiosteum was pushed upwards above the apices of the permanent central incisor adjacent to the cleft. The nasal and palatal openings were closed by suturing the mucoperiosteum on both sides of the cleft with absorbable threads. The wet DDM granules were grafted into the managed cleft triangle space, and a labial flap was repositioned. The radiographic images at 6 months showed the continuous hard tissues in the cleft area and DDM granules onto lateral incisor (22) and impacted canine (23). The 3D-CT views at 2 years showed impacted tooth (22) blocked by primary canine and the replacement of DDM granules by bone near teeth (22,23). At 4 years, tooth crown (22) was situated just under the mucous membrane, and teeth (22,23) erupted spontaneously until 6 years without a maxillary expansion and a tow guidance of canine. The DDM granules contributed to bone formation without the inhibition of spontaneous tooth eruption. We concluded that autogenous primary teeth DDM graft should become a minimally invasive procedure without bone harvesting and morbidities for unilateral alveolar cleft.
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Affiliation(s)
- Yusuke Matsuzawa
- Department of Oral and Maxillofacial Surgery, Graduate School of Dental Medicine, Hokkaido University, Sapporo 060-8586, Japan
- Division of Oral and Maxillofacial Surgery, Keiyukai Sapporo Hospital, Sapporo 003-0026, Japan
| | - Naoto Okubo
- Laboratory of Molecular and Cellular Medicine, Faculty of Pharmaceutical Sciences, Hokkaido University, Sapporo 060-8586, Japan
| | - Soichi Tanaka
- Department of Oral and Maxillofacial Surgery, Graduate School of Dental Medicine, Hokkaido University, Sapporo 060-8586, Japan
| | - Haruhiko Kashiwazaki
- Division of Maxillofacial Diagnostic and Surgical Sciences, Faculty of Dental Science, Kyushu University, Fukuoka 812-8582, Japan
| | - Yoshimasa Kitagawa
- Department of Oral Diagnosis and Medicine, Graduate School of Dental Medicine, Hokkaido University, Sapporo 060-8586, Japan
| | - Yoichi Ohiro
- Department of Oral and Maxillofacial Surgery, Graduate School of Dental Medicine, Hokkaido University, Sapporo 060-8586, Japan
| | - Tadashi Mikoya
- Department of Oral and Maxillofacial Surgery, Graduate School of Dental Medicine, Hokkaido University, Sapporo 060-8586, Japan
| | - Toshiyuki Akazawa
- Industrial Technology and Environment Research Development, Hokkaido Research Organization, Sapporo 060-0819, Japan
| | - Masaru Murata
- Division of Oral Regenerative Medicine, School of Dentistry, Health Sciences University of Hokkaido, Tobetsu 061-0293, Japan
- Correspondence:
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Minetti E, Gianfreda F, Palermo A, Bollero P. Autogenous Dentin Particulate Graft for Alveolar Ridge Augmentation with and without Use of Collagen Membrane: Preliminary Histological Analysis on Humans. MATERIALS 2022; 15:ma15124319. [PMID: 35744378 PMCID: PMC9230765 DOI: 10.3390/ma15124319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 06/16/2022] [Accepted: 06/17/2022] [Indexed: 11/17/2022]
Abstract
(1) Background: The phenomenon of ankylosis of the dental elements has led clinicians to think that properly treated dentin and cement may be a potential graft for alveolar ridge augmentation. Currently, there are no studies in the literature able to histomorphometrically compare the healing patterns of an autogenous dentin particulate graft with the association, or not, of resorbable membranes. The aim of this pilot study is to histologically compare bone after an alveolar ridge augmentation using an autogenous dentin particulate graft with and without a resorbable collagen membrane. (2) Methods: this clinical trial enrolled six patients with defects requiring bone augmentation. Two procedures were performed in all six adult human patients in order to perform a study–control study: in Group 1, a ridge augmentation procedure with an autogenous dentin particulate graft and a resorbable collagen membrane was performed, and, in Group 2, an alveolar ridge preservation without a membrane was performed at the same time (T0). At 4 months, a biopsy of the bone tissues was performed using a 4 mm trephine bur in order to perform a histomorphometric analysis. (3) Results: The histomorphometric analysis demonstrated that Group 1 presented 45% of bone volume, 38% of vital bone, and 7% of residual graft. On the contrary, membrane-free regenerative procedures demonstrated 37% of bone volume, 9% of vital bone, and 27% of non-resorbed graft. In all cases, the regenerated bone allowed the insertion of implants with a standard platform, and no early failures were recorded. (4) Conclusions: Autogenous dentin particulate grafts seem to work best when paired with a membrane.
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Affiliation(s)
- Elio Minetti
- Department of Biomedical, Surgical, and Dental Science, University of Milan, 20122 Milan, Italy;
| | - Francesco Gianfreda
- Department of Industrial Engineering, University of Rome “Tor Vergata”, 00133 Rome, Italy
- Correspondence:
| | - Andrea Palermo
- College of Medicine and Dentistry, Birmingham B4 6BN, UK;
| | - Patrizio Bollero
- Department of System Medicine, University of Rome “Tor Vergata”, 00133 Rome, Italy;
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Murata M, Kabir MA, Hirose Y, Ochi M, Okubo N, Akazawa T, Kashiwazaki H. Histological Evidences of Autograft of Dentin/Cementum Granules into Unhealed Socket at 5 Months after Tooth Extraction for Implant Placement. J Funct Biomater 2022; 13:jfb13020066. [PMID: 35735921 PMCID: PMC9224646 DOI: 10.3390/jfb13020066] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 05/17/2022] [Accepted: 05/23/2022] [Indexed: 01/27/2023] Open
Abstract
The aim of this clinical case study was to observe biopsy tissues at 5 months after an autograft of a partially demineralized dentin/cementum matrix (pDDM) into a tooth-extracted socket exhibiting healing failure. A 66-year-old female presented with healing failure in the cavity for 2 months after the extraction (#36). Initial X-ray photos showed a clear remainder of lamina dura (#36), a residual root (#37), and a horizontal impaction (#38). The vital tooth (#38) was selected for pDDM. The third molar crushed by electric mill was decalcified in 1.0 L of 2.0% HNO3 for 20 min and rinsed in cold distilled water. The pDDM granules (size: 0.5–2.0 mm) were grafted immediately into the treated socket. X-ray views just after pDDM graft showed radio-opaque granules. At 5 months after pDDM graft, the surface of regenerated bone was harmonized with the mandibular line, and bone-like radio-opacity was found in the graft region. The biopsy tissue (diameter: 3.0 mm) at 5 months after pDDM graft showed that mature bone was interconnected with the remaining pDDM. The novel histological evidence highlighted that newly formed bone was connected directly with both dentin-area and cementum-area matrix of pDDM. We concluded that pDDM contributed to the regeneration of bone in the unhealed socket, and this regeneration prepared the socket for implant placement. Autogenous pDDM could be immediately recycled as an innovative biomaterial for local bone regeneration.
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Affiliation(s)
- Masaru Murata
- Division of Regenerative Medicine, School of Dentistry, Health Sciences University of Hokkaido, Tobetsu 061-0293, Japan
- Correspondence: (M.M.); (M.A.K.)
| | - Md Arafat Kabir
- Division of Regenerative Medicine, School of Dentistry, Health Sciences University of Hokkaido, Tobetsu 061-0293, Japan
- Correspondence: (M.M.); (M.A.K.)
| | - Yukito Hirose
- Division of Fixed Prosthodontics and Oral Implantology, School of Dentistry, Health Sciences University of Hokkaido, Tobetsu 061-0293, Japan; (Y.H.); (M.O.)
| | - Morio Ochi
- Division of Fixed Prosthodontics and Oral Implantology, School of Dentistry, Health Sciences University of Hokkaido, Tobetsu 061-0293, Japan; (Y.H.); (M.O.)
| | - Naoto Okubo
- Laboratory of Molecular and Cellular Medicine, Faculty of Pharmaceutical Sciences, Hokkaido University, Sapporo 060-0812, Japan;
| | - Toshiyuki Akazawa
- Industrial Technology and Environment Research Development, Hokkaido Research Organization, Sapporo 060-0819, Japan;
| | - Haruhiko Kashiwazaki
- Division of Maxillofacial Diagnostic and Surgical Sciences, Faculty of Dental Science, Kyushu University, Fukuoka 812-8582, Japan;
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Demineralized Dentin Matrix for Dental and Alveolar Bone Tissues Regeneration: An Innovative Scope Review. Tissue Eng Regen Med 2022; 19:687-701. [PMID: 35429315 PMCID: PMC9294090 DOI: 10.1007/s13770-022-00438-4] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Revised: 01/08/2022] [Accepted: 01/25/2022] [Indexed: 12/17/2022] Open
Abstract
Background: Dentin is a permeable tubular composite and complex structure, and in weight, it is composed of 20% organic matrix, 10% water, and 70% hydroxyapatite crystalline matrix. Demineralization of dentin with gradient concentrations of ethylene diamine tetraacetic acid, 0.6 N hydrochloric acid, or 2% nitric acid removes a major part of the crystalline apatite and maintains a majority of collagen type I and non-collagenous proteins, which creates an osteoinductive scaffold containing numerous matrix elements and growth factors. Therefore, demineralized dentin should be considered as an excellent naturally-derived bioactive material to enhance dental and alveolar bone tissues regeneration. Method: The PubMed and Midline databases were searched in October 2021 for the relevant articles on treated dentin matrix (TDM)/demineralized dentin matrix (DDM) and their potential roles in tissue regeneration. Results: Several studies with different study designs evaluating the effect of TDM/DDM on dental and bone tissues regeneration were found. TDM/DDM was obtained from human or animal sources and processed in different forms (particles, liquid extract, hydrogel, and paste) and different shapes (sheets, slices, disc-shaped, root-shaped, and barrier membranes), with variable sizes measured in micrometers or millimeters, demineralized with different protocols regarding the concentration of demineralizing agents and exposure time, and then sterilized and preserved with different techniques. In the act of biomimetic acellular material, TDM/DDM was used for the regeneration of the dentin-pulp complex through direct pulp capping technique, and it was found to possess the ability to activate the odontogenic differentiation of stem cells resident in the pulp tissues and induce reparative dentin formation. TDM/DDM was also considered for alveolar ridge and maxillary sinus floor augmentations, socket preservation, furcation perforation repair, guided bone, and bioroot regenerations as well as bone and cartilage healing. Conclusion: To our knowledge, there are no standard procedures to adopt a specific form for a specific purpose; therefore, future studies are required to come up with a well-characterized TDM/DDM for each specific application. Likely as decellularized dermal matrix and prospectively, if the TDM/DDM is supplied in proper consistency, forms, and in different sizes with good biological properties, it can be used efficiently instead of some widely-used regenerative biomaterials. Supplementary Information The online version contains supplementary material available at 10.1007/s13770-022-00438-4.
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Li Y, Zhou W, Li P, Luo Q, Li A, Zhang X. Comparison of the Osteogenic Effectiveness of an Autogenous Demineralized Dentin Matrix and Bio-Oss® in Bone Augmentation: A Systematic Review and Meta-analysis. Br J Oral Maxillofac Surg 2022; 60:868-876. [DOI: 10.1016/j.bjoms.2022.03.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 03/21/2022] [Indexed: 10/18/2022]
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Inchingolo F, Hazballa D, Inchingolo AD, Malcangi G, Marinelli G, Mancini A, Maggiore ME, Bordea IR, Scarano A, Farronato M, Tartaglia GM, Lorusso F, Inchingolo AM, Dipalma G. Innovative Concepts and Recent Breakthrough for Engineered Graft and Constructs for Bone Regeneration: A Literature Systematic Review. MATERIALS 2022; 15:ma15031120. [PMID: 35161065 PMCID: PMC8839672 DOI: 10.3390/ma15031120] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 01/26/2022] [Accepted: 01/27/2022] [Indexed: 02/06/2023]
Abstract
Background: For decades, regenerative medicine and dentistry have been improved with new therapies and innovative clinical protocols. The aim of the present investigation was to evaluate through a critical review the recent innovations in the field of bone regeneration with a focus on the healing potentials and clinical protocols of bone substitutes combined with engineered constructs, growth factors and photobiomodulation applications. Methods: A Boolean systematic search was conducted by PubMed/Medline, PubMed/Central, Web of Science and Google scholar databases according to the PRISMA guidelines. Results: After the initial screening, a total of 304 papers were considered eligible for the qualitative synthesis. The articles included were categorized according to the main topics: alloplastic bone substitutes, autologous teeth derived substitutes, xenografts, platelet-derived concentrates, laser therapy, microbiota and bone metabolism and mesenchymal cells construct. Conclusions: The effectiveness of the present investigation showed that the use of biocompatible and bio-resorbable bone substitutes are related to the high-predictability of the bone regeneration protocols, while the oral microbiota and systemic health of the patient produce a clinical advantage for the long-term success of the regeneration procedures and implant-supported restorations. The use of growth factors is able to reduce the co-morbidity of the regenerative procedure ameliorating the post-operative healing phase. The LLLT is an adjuvant protocol to improve the soft and hard tissues response for bone regeneration treatment protocols.
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Affiliation(s)
- Francesco Inchingolo
- Department of Interdisciplinary Medicine, University of Medicine Aldo Moro, 70124 Bari, Italy; (D.H.); (A.D.I.); (G.M.); (G.M.); (A.M.); (M.E.M.); (A.M.I.)
- Correspondence: (F.I.); (F.L.); (G.D.); Tel.: +39-3312111104 (F.I.); +39-3282132586 (F.L.); +39-3396989939 (G.D.)
| | - Denisa Hazballa
- Department of Interdisciplinary Medicine, University of Medicine Aldo Moro, 70124 Bari, Italy; (D.H.); (A.D.I.); (G.M.); (G.M.); (A.M.); (M.E.M.); (A.M.I.)
- Kongresi Elbasanit, Rruga: Aqif Pasha, 3001 Elbasan, Albania
| | - Alessio Danilo Inchingolo
- Department of Interdisciplinary Medicine, University of Medicine Aldo Moro, 70124 Bari, Italy; (D.H.); (A.D.I.); (G.M.); (G.M.); (A.M.); (M.E.M.); (A.M.I.)
| | - Giuseppina Malcangi
- Department of Interdisciplinary Medicine, University of Medicine Aldo Moro, 70124 Bari, Italy; (D.H.); (A.D.I.); (G.M.); (G.M.); (A.M.); (M.E.M.); (A.M.I.)
| | - Grazia Marinelli
- Department of Interdisciplinary Medicine, University of Medicine Aldo Moro, 70124 Bari, Italy; (D.H.); (A.D.I.); (G.M.); (G.M.); (A.M.); (M.E.M.); (A.M.I.)
| | - Antonio Mancini
- Department of Interdisciplinary Medicine, University of Medicine Aldo Moro, 70124 Bari, Italy; (D.H.); (A.D.I.); (G.M.); (G.M.); (A.M.); (M.E.M.); (A.M.I.)
| | - Maria Elena Maggiore
- Department of Interdisciplinary Medicine, University of Medicine Aldo Moro, 70124 Bari, Italy; (D.H.); (A.D.I.); (G.M.); (G.M.); (A.M.); (M.E.M.); (A.M.I.)
| | - Ioana Roxana Bordea
- Department of Oral Rehabilitation, Faculty of Dentistry, Iuliu Hațieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania;
| | - Antonio Scarano
- Department of Innovative Technologies in Medicine and Dentistry, University of Chieti-Pescara, 66100 Chieti, Italy;
| | - Marco Farronato
- UOC Maxillo-Facial Surgery and Dentistry, Department of Biomedical, Surgical and Dental Sciences, School of Dentistry, Fondazione IRCCS Ca Granda, Ospedale Maggiore Policlinico, University of Milan, 20100 Milan, Italy; (M.F.); (G.M.T.)
| | - Gianluca Martino Tartaglia
- UOC Maxillo-Facial Surgery and Dentistry, Department of Biomedical, Surgical and Dental Sciences, School of Dentistry, Fondazione IRCCS Ca Granda, Ospedale Maggiore Policlinico, University of Milan, 20100 Milan, Italy; (M.F.); (G.M.T.)
| | - Felice Lorusso
- Department of Innovative Technologies in Medicine and Dentistry, University of Chieti-Pescara, 66100 Chieti, Italy;
- Correspondence: (F.I.); (F.L.); (G.D.); Tel.: +39-3312111104 (F.I.); +39-3282132586 (F.L.); +39-3396989939 (G.D.)
| | - Angelo Michele Inchingolo
- Department of Interdisciplinary Medicine, University of Medicine Aldo Moro, 70124 Bari, Italy; (D.H.); (A.D.I.); (G.M.); (G.M.); (A.M.); (M.E.M.); (A.M.I.)
| | - Gianna Dipalma
- Department of Interdisciplinary Medicine, University of Medicine Aldo Moro, 70124 Bari, Italy; (D.H.); (A.D.I.); (G.M.); (G.M.); (A.M.); (M.E.M.); (A.M.I.)
- Correspondence: (F.I.); (F.L.); (G.D.); Tel.: +39-3312111104 (F.I.); +39-3282132586 (F.L.); +39-3396989939 (G.D.)
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Zhang S, Li X, Qi Y, Ma X, Qiao S, Cai H, Zhao BC, Jiang HB, Lee ES. Comparison of Autogenous Tooth Materials and Other Bone Grafts. Tissue Eng Regen Med 2021; 18:327-341. [PMID: 33929713 PMCID: PMC8169722 DOI: 10.1007/s13770-021-00333-4] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 01/25/2021] [Accepted: 01/31/2021] [Indexed: 10/21/2022] Open
Abstract
Autogenous odontogenic materials are a new, highly biocompatible option for jaw restoration. The inorganic component of autogenous teeth acts as a scaffold to maintain the volume and enable donor cell attachment and proliferation; the organic component contains various growth factors that promote bone reconstruction and repair. The composition of dentin is similar to that of bone, which can be a rationale for promoting bone reconstruction. Recent advances have been made in the field of autogenous odontogenic materials, and studies have confirmed their safety and feasibility after successful clinical application. Autogenous odontogenic materials have unique characteristics compared with other bone-repair materials, such as the conventional autogenous, allogeneic, xenogeneic, and alloplastic bone substitutes. To encourage further research into odontogenic bone grafts, we compared the composition, osteogenesis, and development of autogenous odontogenic materials with those of other bone grafts. In conclusion, odontogenic bone grafts should be classified as a novel bone substitute.
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Affiliation(s)
- Shuxin Zhang
- Stomatological Materials Laboratory, School of Stomatology, Shandong First Medical University, Tai’an, 271016 Shandong China
| | - Xuehan Li
- Stomatological Materials Laboratory, School of Stomatology, Shandong First Medical University, Tai’an, 271016 Shandong China
| | - Yanxin Qi
- Stomatological Materials Laboratory, School of Stomatology, Shandong First Medical University, Tai’an, 271016 Shandong China
| | - Xiaoqian Ma
- Stomatological Materials Laboratory, School of Stomatology, Shandong First Medical University, Tai’an, 271016 Shandong China
| | - Shuzhan Qiao
- Stomatological Materials Laboratory, School of Stomatology, Shandong First Medical University, Tai’an, 271016 Shandong China
| | - HongXin Cai
- Stomatological Materials Laboratory, School of Stomatology, Shandong First Medical University, Tai’an, 271016 Shandong China
| | - Bing Cheng Zhao
- Stomatological Materials Laboratory, School of Stomatology, Shandong First Medical University, Tai’an, 271016 Shandong China
| | - Heng Bo Jiang
- Stomatological Materials Laboratory, School of Stomatology, Shandong First Medical University, Tai’an, 271016 Shandong China
| | - Eui-Seok Lee
- Department of Oral and Maxillofacial Surgery, Graduate School of Clinical Dentistry, Korea University, Seoul, 02841 Republic of Korea
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Outcome of Different Processing Methods on Mechanical and Physicochemical Properties of Human Dentin as a Potential Natural Scaffold. REGENERATIVE ENGINEERING AND TRANSLATIONAL MEDICINE 2020. [DOI: 10.1007/s40883-020-00185-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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17
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Rutkowski JL. Global Perspectives for Implant Dentistry. J ORAL IMPLANTOL 2020; 46:173. [PMID: 32582922 DOI: 10.1563/aaid-joi-d-20-editorial.4603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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