Evaluation of Autogenous Fresh Demineralized Tooth Graft Prepared at Chairside for Dental Implant (Clinical and Histological Study)

Abstract

INTRODUCTION:Although, the chemical composition of dentin is similar to bone, extracted teeth are still considered a clinical waste and therefore being discarded. 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. OBJECTIVES: To evaluate clinical, radiological and histological efficiency of autogenous fresh demineralized tooth (AFDT) graft prepared at the chairside for alveolar bone grafting in fresh extracted sockets for dental implant surgery MATERIALS AND METHODS: Ten patients requiring tooth extraction and alveolar bone regeneration for dental implant placement were included in the study. Within 45 minutes the extracted teeth were mechanicaly prepared, grinded, sieved, defatted, demineralized and sterilized. In the same setting, the graft material was used to reconstruct defects at the extraction. After 3 months of uninterrupted healing at time of implant placement bone samples were collected for histological analysis. CBCT were taken preoperative, 3months after grafting and 3 and 6 months after implant placement. RESULTS: Histologically the osteoconductive, Osteoinductive and Biodegradation of (AFDT) graft was evident. Clinically 100 % success rate of implants was achieved, with no adverse tissue reaction. CBCT have shown increase of bone density at the graft site and stability of marginal bone level around implants. CONCLUSIONS: (AFDT) graft should be considered as an option given its autogenous origin and favorable clinical, radiographical and histological outcomes when teeth extraction is necessary.

Comparison of Autogenous Fresh Demineralized Dentin and Beta-Tricalcium Phosphate in Immediate Implant Placement of Mandibular Molars (Randomized Clinical Controlled Trial)

“…The percentage increase in implant stability in the demineralized dentin graft group was statistically significantly higher than in the β-tri calcium phosphate group (p<.001). The percentage increase in the demineralized dentin graft group was more than 20%, which agrees with that reported by El-Said et al (15) , in their single-arm clinical trial, who reported a 15% increase in the mean OSSTELL score at six months postoperatively in comparison to the time of implant placement. Rawat et al ( 12), (16) reported that β-TCP appears unsuitable and not advantageous as a bone filler in immediate implant placement due to its slow bone formation and integration and inability to condense appropriately.…”

“…The percentage increase in bone density in the present study is more than 15% in the demineralized dentin graft group and about 7% in the β-TCP. El-Said et al (15) reported a 39% increase in mean bone density six months after implant placement compared to preoperative values. Radiographic examination showed that all implants were fully osseointegrated with no signs of bone resorption.…”

Evaluation of a Dual Socket Preservation Technique Followed by Delayed Dental Implant Placement (Controlled Clinical and Radiographic Study)

“…To save time, smart dentine grinders integrate the grinding and sieving procedures; nonetheless, they create calcified autogenous dentine grafts. However, they have the disadvantage of lacking the demineralization phase, which is required to expose the biological dentine matrix and growth factors that drive bone production, leading in a prolonged healing period for bone (22). Also, the usage of acetic acid and pareacetic acid has affected the bacterial effect development in the autogenus fresh demineralize tooth (AFDT) graft owing to its strong oxidizing activity, which oxidizes the exterior cell walls of microorganisms.…”

“…Also, the usage of acetic acid and pareacetic acid has affected the bacterial effect development in the autogenus fresh demineralize tooth (AFDT) graft owing to its strong oxidizing activity, which oxidizes the exterior cell walls of microorganisms. Proteins will be denatured, cell wall permeability will be compromised, and sulfhydral and sulphur linkages in proteins, enzymes, and other metabolites will be oxidized, causing microorganisms to quickly deactivate (22). In the presence of organic materials, peracetic acid at 200-500 ppm will inactivate grampositive and gram-negative bacteria, fungi, and yeasts in 5 minutes (22).…”

“…Proteins will be denatured, cell wall permeability will be compromised, and sulfhydral and sulphur linkages in proteins, enzymes, and other metabolites will be oxidized, causing microorganisms to quickly deactivate (22). In the presence of organic materials, peracetic acid at 200-500 ppm will inactivate grampositive and gram-negative bacteria, fungi, and yeasts in 5 minutes (22). In the present study, the autogenous graft of dentin, prepared from the palatal part of the extracted tooth, combined with socket shield technique gave very promising outcomes.…”