Objectives: This study aimed to compare the dentin block (D-group) harvested from impacted wisdom teeth with autogenous ramus bone block (A-group) for horizontal alveolar ridge augmentation. Materials and methods:Forty-two patients with anterior missing teeth and horizontal ridge defect were randomly assigned to two groups (n = 21 per group) to receive either dentin block group or autogenous bone block. Six months after the augmentation, dental implants were placed in all patients, and a core biopsy was performed for histological evaluation in addition to clinical and radiographic evaluation using cone beam computed tomography. The primary outcome was the mean overall clinical ridge width gain (CRWG) after 6 months of augmentation. Secondary outcomes were the overall radiographic ridge width gain (RRWG) after 6 months of augmentation and descriptive histological analysis with histomorphometric assessment of bone fraction %.Results: All sites healed uneventfully, and the mean overall CRWG 6 months after augmentation was 3.52 ± 0.56 mm and 2.24 ± 0.86 mm in the D and A groups, respectively, with statistically significant difference between them (P ≤ .001). The overall mean RRWG was 3.61 ± 0.61 mm and 3.41 ± 1.15 mm in D and A groups, respectively, without any statistically significant difference between them (p = .062). The histomorphometric analysis of the bone area fraction was 42.6% and 41.3% in D and A groups, respectively, without any statistically significant difference between the two values (p = .89, Student's t-test). Histological evaluation in the D-group revealed new bone formation, viable cells, and matrix formation on the dentin block periphery, in addition to well-organized woven bone that suggests dentin block remodeling and supports new bone deposition. Conclusion:The present clinical study revealed that dentin block may serve as an alternative graft to support horizontal alveolar ridge augmentation. Dentin blocks showed less resorption than autogenous bone blocks.
Introduction: Tooth roots proved in different studies clinically and radiographically to be an alternative to autogenous bone. However, the histological evaluation of the tooth block following ridge augmentation is still missing. The aim of this case report was to evaluate histologically and radiographically the effect of autogenous dentin block (DB) to restore a horizontal ridge deficiency at a single tooth gap. Case Presentation:A healthy 36-year-old female patient presented with a missing lower first molar (30), after clinical and radiographic examination, the site showed a class III defect horizontal atrophy. The procedure performed was the surgical removal of the wisdom tooth (32), shaping and fixation of a separated DB at the defect site using an osteosynthesis screw. A cone beam computed tomography was performed immediately and 6 month following the surgery. During implant placement, a core biopsy specimen was retrieved, stored and prepared for histological evaluation. The radiographic analysis showed a horizontal width gain of about 4 mm. The histologic assessment revealed cortical bone formation at the buccal and lingual aspects between the tooth and the bone. During implant placement, the core biopsy exhibited a slight separation upon removal from the grafted side, at 6 month following implant placement, the implant was successfully osteointegrated. Conclusion:DB was successfully used for horizontal alveolar ridge augmentation, thus allowing a prosthetically driven implant placement. More cases assessing implant survival and success are needed to confirm the results of this case report.
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