Discussion : Alveolar ridge preservation with autologous particulated dentin—a case series [1]
The aim of this case series is to demonstrate the efficacy and safety of this novel augmentative procedure for ridge preservation prior to implant therapy. This shall serve as a basis for a prospective study.
In all four cases, patients showed a stable volume of soft and hard tissues after the augmentation with AutoPD and good osseointegration of titanium implants, having been placed in this augmented socket.
The application of autologous bone and xenogeneic biomaterials for alveolar bone augmentation following tooth extraction has been intensively studied. This so called ridge preservation aims at the prevention of bone atrophy. From a biological point of view, autologous bone is still considered to be the optimal augmentation material due to its osteogenic, osteoinductive and osteoconductive properties [1, 34]. However, especially in small defects, possible donor-site morbidity, limited graft volume availability and additional length of operation for harvesting autologous bone led to the increasing usage of xenogeneic biomaterials such as demineralized bovine bone substitute (DBBS—Bio-Oss©). These kind of non-resorbable biomaterials have great potential in maintaining the dimension of the contour of the ridge by serving as a framework for new bone formation [7]. Although DBBS shows great osteoconductive potential and has been proven to be as effective as autologous bone alone or in combination with autologous bone, it has a slow and incomplete resorption rate [4, 14, 22, 24].
In addition, the use of DBBS increases treatment cost and may be incompatible to some patients. Regarding these factors of influence, it is of interest to test alternative bone substitute materials.
In traumatology, many studies showed that replanted teeth with a devitalized periodontal tissue will ankylose and dentin will be replaced by bone [1, 3].
It is well known that dentin and bone have a similar organic and inorganic structure [21]. Recent studies have focused on dentin as a potential bone substitute in different models of alveolar defects. It could be shown that dentin, being used either as a block graft or in particulated form, is involved in bone remodelling, expressing osteoconductive and even osteoinductive properties [3, 5, 9, 26, 29, 30]. In vivo studies in mice showed that dentin scaffolds performed similar with regard to the inflammatory response and neovascularization compared to isogenic bone [9]. Both materials induced an acute short-term inflammatory response with increased leukocyte-endothelial cell interaction, a process often observed after the implantation of biomaterials [19, 27]. Additionally, in vitro studies showed that protein extracts from dentin affect proliferation and differentiation of osteoprogenitor cells. Results suggested that TGFβ and perhaps other factors in dentin can regulate cell behaviour and, therefore, can influence development, remodelling and regeneration of mineralized tissues [33].
Serial posts:
- Background : Alveolar ridge preservation with autologous particulated dentin—a case series
- Material and methods : Alveolar ridge preservation with autologous particulated dentin—a case series [1]
- Material and methods : Alveolar ridge preservation with autologous particulated dentin—a case series [2]
- Case presentation : Alveolar ridge preservation with autologous particulated dentin—a case series
- Results : Alveolar ridge preservation with autologous particulated dentin—a case series
- Discussion : Alveolar ridge preservation with autologous particulated dentin—a case series [1]
- Discussion : Alveolar ridge preservation with autologous particulated dentin—a case series [2]
- Conclusion : Alveolar ridge preservation with autologous particulated dentin—a case series
- References : Alveolar ridge preservation with autologous particulated dentin—a case series [1]
- References : Alveolar ridge preservation with autologous particulated dentin—a case series [2]
- References : Alveolar ridge preservation with autologous particulated dentin—a case series [3]
- References : Alveolar ridge preservation with autologous particulated dentin—a case series [4]
- Acknowledgements : Alveolar ridge preservation with autologous particulated dentin—a case series
- Author information : Alveolar ridge preservation with autologous particulated dentin—a case series
- Rights and permissions : Alveolar ridge preservation with autologous particulated dentin—a case series
- About this article : Alveolar ridge preservation with autologous particulated dentin—a case series
- Fig. 1. Extraction with the benex system : Alveolar ridge preservation with autologous partic
- Fig. 2. The remaining root of tooth 11 : Alveolar ridge preservation with autologous partic
- Fig. 3. Removal of the pulp : Alveolar ridge preservation with autologous partic
- Fig. 4. Removal of enamel and the cementum : Alveolar ridge preservation with autologous partic
- Fig. 5. Autologous dentin in a bone mill : Alveolar ridge preservation with autologous partic
- Fig. 6. Autologous dentin with the desired particle size : Alveolar ridge preservation with autologous partic
- Fig. 7. Autologous, particulated dentin mixed with blood from the operating site : Alveolar ridge preservation with autologous partic
- Fig. 8. Autologous, particulated dentin in the alveolar socket : Alveolar ridge preservation with autologous partic
- Fig. 9. Soft tissue punch : Alveolar ridge preservation with autologous partic
- Fig. 10. Soft tissue graft placed on the recipient site : Alveolar ridge preservation with autologous partic
- Fig. 11. Sagittal view : Alveolar ridge preservation with autologous partic
- Fig. 12. Axial view : Alveolar ridge preservation with autologous partic
- Fig. 13. a, b Clinical situation prior to implant placement : Alveolar ridge preservation with autologous partic
- Fig. 14. Single tooth X-ray immediately after the augmentation using autogenous dentin : Alveolar ridge preservation with autologous partic
- Fig. 15. Single tooth X-ray, showing a constant bone level 7 months after implant placement : Alveolar ridge preservation with autologous partic
- Fig. 16. Single tooth X-ray, 1 year post-implantation, showing the finalized crown : Alveolar ridge preservation with autologous partic
- Fig. 17. Histology of dentin augmentation. aAsterisk denotes incorporated dentin particle, surrounded by vital woven bone. Triangle shows reactive process in the bone marrow lacunae with osteoblast rimming. No signs of necrosis or infection (H&E stain, ×100 magnification). b Larger magnification at ×200. c EvG (Elastica van Gieson) stain, ×200 : Alveolar ridge preservation with autologous partic
- Fig. 18. Finalized prosthetic restoration after 1 year : Alveolar ridge preservation with autologous partic
- Fig. 19. Colour-coded superimposition of intraoral scans before extraction and after definitive prosthetic restoration : Alveolar ridge preservation with autologous partic
- Fig. 20. Colour-coded superimposition of intraoral scans before extraction and after definitive prosthetic restoration : Alveolar ridge preservation with autologous partic