Alveolar Ridge Preservation Using Autologous Demineralized Tooth Matrix and Platelet-Rich Fibrin Versus Platelet-Rich Fibrin Alone: A Split-Mouth Randomized Controlled Clinical Trial

OBJECTIVE

To assess the potential of using autologous demineralized tooth matrix (aDTM) in combination with platelet-rich fibrin (PRF) membrane (aDTM/PRF) or PRF membrane alone (control) to preserve the ridge dimension and facilitate bone healing after tooth extraction.

MATERIALS AND METHODS

Forty premolar sockets were assigned to either the aDTM/PRF or control group. Horizontal and vertical ridge changes were evaluated at the baseline 2, 4, 6, and 8 weeks using cast-based and periapical radiographs.

RESULTS

aDTM was well tolerated in all sites without incidences of postoperative complication. The change in horizontal ridge width was significantly greater in the control compared with the aDTM/PRF group. The overall vertical marginal bone resorption on the mesial, distal, and central site in the aDTM/PRF group was not statistically different from the control group. During the first 6 weeks, the bone healing density in the aDTM/PRF group was significantly higher than that of the control group, then it converged at week 8.

CONCLUSION

Application of aDTM with PRF membrane is useful for ridge preservation by reducing the horizontal ridge collapse and promoting bone healing as shown clinically and radiographically.

Treatment of Furcation Involvement Using Autogenous Tooth Graft With 1-Year Follow-Up: A Case Series

INTRODUCTION

The objective of this study was to clinically evaluate an autogenous tooth graft (ATG) as a novel bone graft material in the treatment of Class II furcation defects. ATG is prepared at chairside from a freshly extracted tooth to be used immediately for bone regeneration. It has an advantage over the autogenous and other bone graft materials as it is non-immunogenic, inexpensive, easily available, and lacks donor-site morbidity.

CASE PRESENTATION

This study was conducted on three middle-aged (35 to 55 years) male patients, who had at least one mandibular molar with Class II furcation involvement (a total of 5 sites) and one tooth that required extraction because of poor prognosis and was not endodontically treated. At 9 and 12 months, the mean reductions in horizontal probing depth were (1.40 ± 0.57 mm) and (1.52 ± 0.59 mm), respectively, and the mean gains in linear bone-fill were (3.90 ± 0.15 mm) and (5.33 ± 0.10 mm), respectively.

CONCLUSIONS

Within the limitation of this study, ATG exhibited ideal properties for alveolar bone regeneration. In addition, this study outlines the chairside method to prepare a graft and highlights the improvement in clinical and radiographic parameters at 9 and 12 months.

Bone grafts using autogenous tooth blocks: a case series

OBJECTIVE

A case study was conducted to examine the clinical results and histologic healing of bone grafts performed using an autogenous tooth block (AutoBT block), which was developed recently and proprietary.

STUDY DESIGN

Guided bone regeneration, extraction socket graft, sinus bone graft, and ridge augmentation were performed using autogenous tooth block graft material in 12 patients from March 2009 to June 2010. The clinical outcomes of each case were examined, and tissue specimens were collected from 1 case 2.5 months after the bone graft for histopathological analysis.

RESULTS

All of the cases had successful bone graft results. One patient developed wound dehiscence after surgery, although favorable secondary healing was achieved. One implant resulted in osseointegration failure. A histopathologic examination was performed after 2.5 months and showed excellent bone healing due to osteoconduction. The AutoBT block was incorporated into the upper soft tissue, aponeurosis, and lower recipient bone.

CONCLUSION

There were no notable complications associated with the bone transplant materials. The AutoBT block is clinically useful for a variety of bone grafts.

A prospective study on the effectiveness of newly developed autogenous tooth bone graft material for sinus bone graft procedure

PURPOSE

The purpose of this prospective study was to evaluate the effectiveness of newly developed autogenous tooth bone graft material (AutoBT)application for sinus bone graft procedure.

MATERIALS AND METHODS

The patients with less than 5.0 mm of residual bone height in maxillary posterior area were enrolled. For the sinus bone graft procedure, Bio-Oss was grafted in control group and AutoBT powder was grafted in experimental group. Clinical and radiographic examination were done for the comparison of grafted materials in sinus cavity between groups. At 4 months after sinus bone graft procedure, biopsy specimens were analyzed by microcomputed tomography and histomorphometric examination for the evaluation of healing state of bone graft site.

RESULTS

In CT evaluation, there was no difference in bone density, bone height and sinus membrane thickness between groups. In microCT analysis, there was no difference in total bone volume, new bone volume, bone mineral density of new bone between groups. There was significant difference trabecular thickness (0.07 µm in Bio-Oss group Vs. 0.08 µm in AutoBT group) (P=.006). In histomorphometric analysis, there was no difference in new bone formation, residual graft material, bone marrow space between groups. There was significant difference osteoid thickness (8.35 µm in Bio-Oss group Vs. 13.12 µm in AutoBT group) (P=.025).

CONCLUSION

AutoBT could be considered a viable alternative to the autogenous bone or other bone graft materials in sinus bone graft procedure.

Osteogenic ability according to the decalcified modality of auto-tooth bone grafts in peri-implant defects in dogs

PURPOSE

The purpose of this study was to evaluate the bone generation capacity of the autotransplantation material with clinical and histological analyses after controlled acid treatment conditions.

MATERIAL AND METHODS

Bony defects were formed in the femur. Then, autotransplantation material was grafted after hydroxyapatite-coated implant placement. Experimental groups were classified according to the acid treatment method: 2% H2SO4 (group 1), 2% HCl (group 2), 2% HNO3 (group 3), or 2% ethylenediaminetetraacetic acid (EDTA) (group 4).

RESULTS

The new bone formation area and bone-implant contact (BIC) of the autotransplantation materials were measured after 8 weeks. The new bone formation area in experimental groups 2, 3, and 4 were greater than that in the control group (no graft) and in experimental group 1 at 8 weeks, and the BIC of experimental group 4 was greater than that in the control group and in experimental group 1; these differences showed statistical significance (P < 0.05).

CONCLUSION

Auto-tooth bone treated with EDTA resulted in more effective bone formation in dogs' femurs than bone treated with other solutions.

Clinical evaluation of ridge augmentation using autogenous tooth bone graft material: case series study

Objectives

Interest in bone graft material has increased with regard to restoration in cases of bone defect around the implant. Autogenous tooth bone graft material was developed and commercialized in 2008. In this study, we evaluated the results of vertical and horizontal ridge augmentation with autogenous tooth bone graft material.

Materials and Methods

This study targeted patients who had vertical or horizontal ridge augmentation using AutoBT from March 2009 to April 2010. We evaluated the age and gender of the subject patients, implant stability, adjunctive surgery, additional bone graft material and barrier membrane, post-operative complication, implant survival rate, and crestal bone loss.

Results

We performed vertical and horizontal ridge augmentation using powder- or block-type autogenous tooth bone graft material, and implant placement was performed on nine patients (male: 7, female: 2). The average age of patients was 49.88±12.98 years, and the post-operative follow-up period was 35±5.31 months. Post-operative complications included wound dehiscence (one case), hematoma (one case), and implant osseointegration failure (one case; survival rate: 96%); however, there were no complications related to bone graft material, such as infection. Average marginal bone loss after one-year loading was 0.12±0.19 mm. Therefore, excellent clinical results can be said to have been obtained.

Conclusion

Excellent clinical results can be said to have been obtained with vertical and horizontal ridge augmentation using autogenous tooth bone graft material.

Tooth-derived bone graft material

With successful extraction of growth factors and bone morphogenic proteins (BMPs) from mammalian teeth, many researchers have supported development of a bone substitute using tooth-derived substances. Some studies have also expanded the potential use of teeth as a carrier for growth factors and stem cells. A broad overview of the published findings with regard to tooth-derived regenerative tissue engineering technique is outlined. Considering more than 100 published papers, our team has developed the protocols and techniques for processing of bone graft material using extracted teeth. Based on current studies and studies that will be needed in the future, we can anticipate development of scaffolds, homogenous and xenogenous tooth bone grafts, and dental restorative materials using extracted teeth.