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.

PurposeThis retrospective study compares the amount of bone resorption around implants between an autogenous tooth bone graft (AutoBT) and a synthetic bone graft after a bone-added crestally approached sinus lift with simultaneous implant placements.MethodsIn all, 37 patients participated in this study. Seventeen patients were grouped as group I and underwent an AutoBT-added sinus lift using the crestal approach. The remaining 20 patients were grouped as group II and underwent synthetic bone grafting. Both groups received the implant placements simultaneously. Of the 37 participating patients, only 22 patients were included in the final results: Eleven patients of group I and 11 patients of group II. Before the surgery, the distance from the alveolar crest to the sinus floor was measured using panoramic radiography. After the surgery, the distance was measured again from the neck of the implant thread to the most superior border of the added graft materials. Then, the amount of sinus lift was calculated by comparing the two panoramic radiographs. After a year, a panoramic radiograph was taken to calculate the resorption of the bone graft material from the radiograph that was taken after the surgery. The significance of the resorption amount between the two types of graft materials was statistically analyzed.ResultsThe bone height was increased to an average of 4.89 mm in group I and 6.22 mm in group II. The analysis of panoramic radiographs 1 year after the surgery showed an average bone resorption of 0.76 mm and 0.53 mm, respectively. However, the degree of lifting (P=0.460) and the amount of bone-grafted material resorption (P=0.570) showed no statistically significant difference.ConclusionsBased on this limited study, AutoBT can be considered a good alternative bone graft to a synthetic bone graft in a bone-added sinus lift, when extraction is necessary prior to the surgery.Graphical Abstract

This study uses scanning acoustic microscopy (SAM) ultrasonic profilometry to determine acceptable vs. failed tissue engineered oral mucosa. Specifically, ex vivo-produced oral mucosal equivalents (EVPOMEs) under normal or thermally stressed culture conditions were scanned with the SAM operator blinded to the culture conditions. As seeded cells proliferate, they fill in and smooth out the surface irregularities; they then stratify and produce a keratinized protective upper layer. Some of these transformations could alter backscatter of ultrasonic signals and in the case of the thermally stressed cells, produce backscatter similar to an unseeded device. If non-invasive ultrasonic monitoring could be developed, then tissue cultivation could be adjusted to measure biological variations in the stratified surface. To create an EVPOME device, oral mucosa keratinocytes were seeded onto acellular cadaveric dermis. Two sets of EVPO-MEs were cultured: one at physiological temperature 37 °C and the other at 43 °C. The specimens were imaged with SAM consisting of a single-element transducer: 61 MHz center frequency, 32 MHz bandwidth, 1.52 f#. Profilometry for the stressed and unseeded specimens showed higher surface irregularities compared to unstressed specimens. Elevated thermal stress retards cellular differentiation, increasing root mean square values; these results show that SAM can potentially monitor cell/tissue development.

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