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Abstract
This umbrella review aims to evaluate systematic/meta-analysis studies containing clinical evidence on tooth grafts as bone substitutes in the oral and maxillofacial regions. Using language restrictions and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, an electronic database search of PubMed, MEDLINE, Embase, Cochrane library, and Google Scholar was conducted, featuring published studies up until August 2022. All systematic/meta-analysis review articles relating to tooth graft materials were matched against the inclusion criteria. Two qualified researchers independently assessed the studies' inclusion or exclusion criteria and risk of bias, and a third investigator assisted in resolving ambiguities. A total of 81 systematic/meta-analysis studies, comprising 21 animal-controlled trials, 23 randomized controlled human trials, 23 prospective studies, and 14 retrospective studies, were selected for this study. A small risk of bias was observed in systematic studies/meta-analyses. In addition, the clinical evidence from the analysis of these studies revealed a low incidence of side effects. According to the current review, two systematic reviews indicated that autogenous bone grafting of prepared teeth might be as effective as other bone grafting materials. Four studies also mentioned autologous grafts as potential alternatives to autologous grafts, autogenous demineralized dentin (ADDM), engineered grafts, root blocks, and dental matrix. On the other hand, three systematic studies stated that more long-term research is needed to confirm their findings. Finally, given the importance of standardization and homogeneity of studies for clinical cases, it is advised to be used cautiously due to the risks of transplant rejection.
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Affiliation(s)
- Sara Hashemi
- Dental Students Research Committee, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | | | - Amirhossein Fathi
- Dental Prosthodontics Department, Dental Materials Research Center, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | | | - Ramin Atash
- Department of Prosthodontics, School of Dentistry, Faculty of Medicine, Université Libre de Bruxelles, Brussels, Belgium
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Minetti E, Dipalma G, Palermo A, Patano A, Inchingolo AD, Inchingolo AM, Inchingolo F. Biomolecular Mechanisms and Case Series Study of Socket Preservation with Tooth Grafts. J Clin Med 2023; 12:5611. [PMID: 37685678 PMCID: PMC10489098 DOI: 10.3390/jcm12175611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 08/25/2023] [Accepted: 08/26/2023] [Indexed: 09/10/2023] Open
Abstract
The purpose of this research was to assess the effectiveness of an innovative medical device capable of extracting tooth graft materials directly from the patient's own teeth. Twenty consecutive tooth grafting procedures were conducted, with an average follow-up period of 18 months. METHODS Twenty patients requiring tooth extraction underwent socket preservation utilizing the extracted tooth as the grafting material. RESULTS After a 4-month healing period, the defects were significantly filled with newly formed hard tissue. Subsequently, bone biopsies were performed during dental implant placement to evaluate histological outcomes. The tissue exhibited a similar density to medium-density bone, displaying a homogeneous and uniform appearance without any visible signs of inflammation. The post-operative healing phase was free from infective complications or indications of graft particles within the regenerated bone structure. The histomorphometric analyses revealed the following results: bone total volume, BV% 52.6 ± 13.09, vital bone VB% 40.39 ± 15.86, residual graft % 12.20 ± 12.34. CONCLUSION The study demonstrated positive bony healing in guided regenerative surgery procedures using autologous tooth grafts. However, further research with an extended follow-up period is necessary to thoroughly assess the potential of demineralized dentin autografts.
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Affiliation(s)
- Elio Minetti
- Department of Biomedical, Surgical, Dental Science, University of Milan, 20161 Milan, Italy;
| | - Gianna Dipalma
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (G.D.); (A.P.); (A.D.I.)
| | - Andrea Palermo
- College of Medicine and Dentistry, Birmingham B4 6BN, UK; (A.P.); (F.I.)
| | - Assunta Patano
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (G.D.); (A.P.); (A.D.I.)
| | - Alessio Danilo Inchingolo
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (G.D.); (A.P.); (A.D.I.)
| | - Angelo Michele Inchingolo
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (G.D.); (A.P.); (A.D.I.)
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Saravanan MA, Devi RR, Nalini HE. Elemental analysis of various demineralized tooth graft by EDX-720 XRF: An in vitro study. J Indian Soc Periodontol 2023; 27:189-194. [PMID: 37152455 PMCID: PMC10159093 DOI: 10.4103/jisp.jisp_109_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 12/10/2022] [Accepted: 01/06/2023] [Indexed: 05/09/2023] Open
Abstract
Background The periodontal regeneration is the most challenging process which involves regeneration of both hard and soft tissues. There are various biomaterials available for this purpose. Tooth graft can be used as a regenerative material in the field of periodontics and implantology. The tooth graft with 70% demineralization is considered to be a better option for periodontal regeneration. Different methods are employed for demineralization of tooth using various acids. Materials and Methods This study was designed as an in vitro study. Totally 60 teeth were collected and categorized into four groups. Groups I, II, and III teeth were demineralized in 2% nitric acid, 0.6 M hydrochloric acid, and 17% ethylenediaminetetraacetic acid (EDTA), respectively. The Group IV teeth were left undemineralized. The elements present in the various tooth graft groups after demineralization were analyzed by EDX-720 XRF Instrument. Results The EDTA demineralized tooth graft has higher level of Calcium, Strontium, and Zinc content compared to other tooth graft groups and it was statistically significant with P = 0.001. Conclusion The EDTA demineralized tooth graft can serve as better graft than 2% nitric acid and 0.6M hydrochloric acid demineralized and undemineralized tooth grafts.
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Affiliation(s)
| | - R. Renuka Devi
- KSR Institute of Dental Science and Research, Tiruchengode, Tamil Nadu, India
| | - H. Esther Nalini
- KSR Institute of Dental Science and Research, Tiruchengode, Tamil Nadu, India
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Kızıldağ A, Tasdemir U, Arabacı T, Kızıldağ CA, Albayrak M, Şahin B. Effects of Autogenous Tooth Bone Graft and Platelet-Rich Fibrin in Peri-Implant Defects: An Experimental Study in an Animal Model. J ORAL IMPLANTOL 2020; 46:221-226. [PMID: 32582918 DOI: 10.1563/aaid-joi-d-19-00038] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The aim of this study was to evaluate the effect of autogenous tooth bone graft (ATBG) combined with platelet-rich fibrin (PRF) on bone healing in rabbit peri-implant osseous defects. Eighteen New Zealand rabbits were divided into 3 groups. Bone defects were prepared in each rabbit, and then an implant cavity was created in the defects. Dental implants were placed, and the peri-implant bone defects were treated with the following 3 methods: no graft material was applied in the control group, bone defects were treated with ATBG in the ATBG group, and bone defects were treated with ATBG combined with PRF in the ATBG+PRF group. After 28 days, the rabbits were sacrificed, and the dental implants with surrounding bone were removed. New bone formation and the percentage of bone-to-implant contact (BIC) were determined with histomorphometric evaluations. New bone formation was significantly higher in the ATBG+PRF group than the control and ATBG groups (P < .05). In addition, BIC was significantly higher in the ATBG+PRF group than in the control and ATBG groups (P < .05). The combination of ATBG with PRF contributed to bone healing in rabbits with peri-implant bone defects.
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Affiliation(s)
- Alper Kızıldağ
- Department of Periodontology, Faculty of Dentistry, Pamukkale University, Denizli, Turkey
| | - Ufuk Tasdemir
- Department of Maxillofacial Surgery, Faculty of Dentistry, Pamukkale University, Denizli, Turkey
| | - Taner Arabacı
- Department of Periodontology, Faculty of Dentistry, Atatürk University, Erzurum, Turkey
| | - Canan Aksu Kızıldağ
- Department of Orthodontics, Faculty of Dentistry, Pamukkale University, Denizli, Turkey
| | - Mevlüt Albayrak
- Medical Laboratory Department, Health Services Vocational Training School, Atatürk University, Erzurum, Turkey
| | - Barbaros Şahin
- Experimental Surgery Application and Research Center, Pamukkale University, Denizli, Turkey
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Minetti E, Palermo A, Savadori P, Barlattani A, Franco R, Michele M, Gianfreda F, Bollero P. Autologous tooth graft: a histological comparison between dentin mixed with xenograft and dentin alone grafts in socket preservation. J BIOL REG HOMEOS AG 2019; 33:189-197. [PMID: 32338473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The aim of this study is to compare the histological results after socket preservation between dentin mixed with xenograft and dentin alone in tooth graft procedure. Six patients were included in this prospective case series study and treated in three clinical centers using standardized clinical procedures. This clinical trial enrolled patients with three walls post-extractive defects requiring the restoration of bone dimension and shape in mandibular zone. The patients were divided in two groups: extracted teeth alone (first group) and extracted teeth mixed with equal quantity of xenograft (second group). The extracted tooth was cleaned and processed by a recently introduced automated device, that allows fragmentation and partial demineralization of the tooth matrix and used as graft material. The graft obtained in this way, was inserted at the time of the extraction. A covering membrane was used to protect the graft. Implants were placed after 4 months of healing. Bone biopsies of the all grafted sites were taken at the time of implant surgery, for histological analysis. Descriptive statistics was used to synthesize the results, using mean values and standard deviations. Six patients (5 women, mean age at surgery 50.3±12.1 years) were treated and after 4 months of healing both groups, grafts height appeared stable. No signs of infection were present. Bone biopsy were taken in all grafted sites (3 with group one and 3 with group two). The histologic analysis revealed no inflammatory or infective reaction against both groups. The histomorphometry results between the two groups are different. The first group show an amount of new bone greater than the second group (+85.29%) and minor quantity of residual graft (-83.59%). The dentin alone shows a larger amount of new bone.
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Affiliation(s)
- E Minetti
- University of Bari "Aldo Moro", Italy, Private Practice, Milan, Italy
| | - A Palermo
- University of Bari "Aldo Moro", Italy, Associate Professor College of Medicine and Dentistry Birmingham, England, Private Practice, Lecce, Italy
| | - P Savadori
- IRCCS Istituto Ortopedico Galeazzi, 20161 Milan, Italy
| | - A Barlattani
- Department of Clinical Sciences and Translational Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - R Franco
- Department of Biomedicine and Prevention, School of Applied Medical-Surgical Sciences, University of Rome Tor Vergata, Rome, Italy
| | - M Michele
- Department of Clinical Sciences and Translational Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - F Gianfreda
- Department of Clinical Sciences and Translational Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - P Bollero
- Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy
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Calvo-Guirado JL, Ballester-Montilla A, N De Aza P, Fernández-Domínguez M, Alexandre Gehrke S, Cegarra-Del Pino P, Mahesh L, Pelegrine AA, Aragoneses JM, Maté-Sánchez de Val J. Particulated, Extracted Human Teeth Characterization by SEM⁻EDX Evaluation as a Biomaterial for Socket Preservation: An in vitro Study. Materials (Basel) 2019; 12:E380. [PMID: 30691075 DOI: 10.3390/ma12030380] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Revised: 01/22/2019] [Accepted: 01/23/2019] [Indexed: 01/30/2023]
Abstract
The aim of the study was to evaluate the chemical composition of crushed, extracted human teeth and the quantity of biomaterial that can be obtained from this process. A total of 100 human teeth, extracted due to trauma, decay, or periodontal disease, were analyzed. After extraction, all the teeth were classified, measured, and weighed on a microscale. The human teeth were crushed immediately using the Smart Dentin Grinder machine (KometaBio Inc., Cresskill, NJ, USA), a device specially designed for this procedure. The human tooth particles obtained were of 300⁻1200 microns, obtained by sieving through a special sorting filter, which divided the material into two compartments. The crushed teeth were weighed on a microscale, and scanning electron microscopy (SEM) evaluation was performed. After processing, 0.25 gr of human teeth produced 1.0 cc of biomaterial. Significant differences in tooth weight were found between the first and second upper molars compared with the lower molars. The chemical composition of the particulate was clearly similar to natural bone. Scanning electron microscopy⁻energy dispersive X-ray (SEM⁻EDX) analysis of the tooth particles obtained mean results of Ca% 23.42 0.34 and P% 9.51 0.11. Pore size distribution curves expressed the interparticle pore range as one small peak at 0.0053 µm. This result is in accordance with helium gas pycnometer findings; the augmented porosity corresponded to interparticle spaces and only 2.533% corresponded to intraparticle porosity. Autogenous tooth particulate biomaterial made from human extracted teeth may be considered a potential material for bone regeneration due to its chemical composition and the quantity obtained. After grinding the teeth, the resulting material increases in quantity by up to three times its original volume, such that two extracted mandibular lateral incisors teeth will provide a sufficient amount of material to fill four empty mandibular alveoli. The tooth particles present intra and extra pores up to 44.48% after pycnometer evaluation in order to increase the blood supply and support slow resorption of the grafted material, which supports healing and replacement resorption to achieve lamellar bone. After SEM⁻EDX evaluation, it appears that calcium and phosphates are still present within the collagen components even after the particle cleaning procedures that are conducted before use.
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