Maintenance of Alveolar Ridge Dimensions Utilizing an Extracted Tooth Dentin Particulate Autograft and Platelet-Rich fibrin: A Retrospective Radiographic Cone-Beam Computed Tomography Study

Abstract

This study utilized radiographic comparative analysis in order to evaluate dimensional ridge changes four months after tooth extraction and immediate grafting with mineralized dentin particulate autograft and chopped platelet-rich fibrin. Fifty-eight extraction sockets with up to 2 mm of missing buccal bone in the coronal aspect compared to the lingual bone were included. Graft material was covered with either a platelet-rich fibrin membrane or collagen sponge with no effort to achieve primary closure. The dimensional changes of the ridge were assessed on cone-beam computed tomography (CBCT) images acquired prior to extraction and four months later. The reduction in the buccal bone plate thickness 1 mm, 3 mm, and 5 mm below the buccal crest was −0.87 ± 0.84 mm, −0.60 ± 0.70 mm, and −0.41 ± 0.55 mm, respectively. The mean ridge width changes 1 mm, 3 mm, and 5 mm below the crest were −1.38 ± 1.24 mm, −0.82 ± 1.13 mm, and −0.43 ± 0.89 mm, respectively. The average mid-buccal bone height gain was +1.1%, while the mid-lingual height gain was 5.6%. A mineralized dentin autograft with platelet-rich fibrin is effective in preserving post-extraction alveolar ridge dimensions.

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.…”

The Use of Autogenous Teeth for Alveolar Ridge Preservation: A Literature Review

“…While some investigators have reported success when using DDM (or PDDM) [17,37,39,40,44,[48][49][50] others prefer using in its undemineralized form [38,[51][52][53][54][55][56][57].…”

“…In terms of UDD, a solid number of preclinical and clinical studies have been performed evaluating its efficacy [38,[51][52][53][54][55][56][57]68].…”

“…Equivalently to the studies mentioned before, these clinical studies applied a similar protocol when preparing UDD. Generally speaking, after the teeth extraction, removal of crowns, fillings of any nature, pulp tissues and periodontal ligament, the biomaterial was grinded in order to generate particles with a diameter varying from 300 to 1200 μm [38,51,[54][55][56][57]59]. In most of the studies, a basic alcohol cleanser consisting of 0.5 M of NaOH and 30%/20% alcohol as well as a sterile phosphate buffered saline were applied to the samples gathered [38,55,56].…”

“…When assessing the efficacy of the UDD in these studies, one aspect that is worthy of mention is that in some studies a combination of UDD was used either with platelet-rich fibrin [54] or with leukocyte-platelet-rich fibrin and fibrinogen [57], which can be seen as a drawback when analyzing this biomaterial due to lack of standardization as well as understanding the real influence of the UDD.…”