Alveolar Socket Preservation with Different Autologous Graft Materials: Preliminary Results of a Multicenter Pilot Study in Human

Abstract

Background: The histological and histomorphometrical results were evaluated between vital whole and non-vital endodontically treated teeth used as autologous grafts in post-extractive socket preservation procedures. Methods: Twenty-eight patients (average age 51.79 ± 5.97 years) with post-extractive defects were enrolled in five dentistry centers. All patients were divided into two groups: with whole teeth (Group 1) and teeth with endodontical root canal therapy (Group 2). The extracted teeth were processed with the Tooth Transformer device to obtain a demineralized and granulated graft material used with a resorbable collagen membrane for socket preservation. After four months, 32 bone biopsies were obtained for histological, histomorphometric, and statistical analysis. Results: During the bone healing period, no infection signs were observed. Nineteen biopsies in group 1 and 13 biopsies in group 2 were detected. The histological analysis showed neither inflammatory nor infective reaction in both groups. Autologous grafts surrounded by new bone were observed in all samples and, at high magnification, partially resorbed dentin and enamel structures were detected. No gutta-percha or cement was identified. Small non-statistically significant differences between the groups, in total bone volume (BV), autologous graft residual, and vital bone percentage were detected. Conclusions: The study showed that the TT Transformer grafts were capable of producing new vital bone in socket preservation procedures. The histomorphometric results showed no statistical differences comparing whole and endodontically treated teeth in bone regeneration. Further studies will be carried out in order to understand the advantages of the autologous graft materials obtained from the tooth compared with the current biomaterials in bone regeneration treatments.

Autogenous Dentin Graft in Bone Defects after Lower Third Molar Extraction: A Split-Mouth Clinical Trial

“…Regarding the preparation of autogenous dentin for grafting, the present trial used the LTM without removing the enamel, following other authors such as Kabir et al [20] or Minetti et al [33] who conducted a clinical trial of alveolar preservation using dentin and enamel. Others such as Valdec et al [17] removed the enamel, pulp and cementum, while Pohl et al [34] removed the enamel from the crown and Del Canto et al [18] and Schwarz et al [35] used only the roots, having removed the radicular cementum.…”

Allogeneic Dentin Graft: A Review on Its Osteoinductivity and Antigenicity

“…They reported that bone formation was higher with Auto-DDM than with the negative control (empty) and polytetrafluoroethylene membrane. Since then, studies on the regenerative potential of Auto-DDM blocks, including clinical studies involving humans, for guided bone regeneration (GBR), socket preservation (SP), and sinus augmentation have been reported [ 13 , 14 , 15 , 16 , 17 , 18 ].…”

Autologous Materials in Regenerative Dentistry: Harvested Bone, Platelet Concentrates and Dentin Derivates

“…If a more stable scaffold is required, to facilitate the placement of a fixture after the extraction, e.g., the mineralised dentine would be a better choice [ 36 ]. If instead, the defect to be regenerated is periodontal, or to gain alveolar ridge in width and height, the demineralised dentine [ 41 ] would be the ideal choice. Indeed, demineralised dentine matrix, preserving the collagen fibres, containing high levels of growth factors, biglycans and collagen fibres promotes the formation of new bone tissue [ 42 ].…”

“…The main procedures reported by the few randomised controlled trials in literature are resumed in Table 2 , using dentine derivates as socket preservation, guided bone regeneration and sinus augmentation [ 41 , 43 , 44 , 45 , 46 , 47 ]…”