Material and methods : Alveolar ridge preservation with autologous particulated dentin—a case series [1]
Four patients between 36 and 65 years of age are presented in this case series. There was no financial compensation. All four patients suffered from a trauma, causing damage to one or two teeth of the anterior maxilla. The frontal tooth/teeth has/had to be extracted. The pulp of the extracted teeth of three patients and the root canal filling of one patient had to be removed. All patients were informed on the operative procedure and possible risks and signed an informed consent. Treatment options were discussed.
After mouth rinsing with a chlorhexidine solution (Chlorhexamed® FORTE 0.2%, GlaxoSmithKline Consumer Healthcare GmbH & Co.KG, Bühl, Germany), local anaesthesia (4% Ubistesin® with 1: 200,000 adrenaline, 3M Espe AG, Seefeld, Germany) was applied. The tooth extraction was performed carefully using a special extraction-system (Benex II extraction-system, Helmut Zepf medical technology GmbH, Seitigen-Oberflacht, Germany) in order to preserve bone and soft tissue (Figs. 1 and 2).
The clinical and radiographic examination showed healthy periodontal structures; the buccal wall was intact without fenestration with a minimal thickness of 1 mm; the discrepancy between the buccal height of the socket and the palatal height was not more than 3 mm; and the socket was within the bony envelope in all four cases.
The root surface was carefully cleaned from periodontal tissue. The pulp was removed, using a root canal instrument (K-file, Dema Dent AG, Bassersdorf, Switzerland). Layers of enamel and cementum were removed, using a rotating instrument (Diamond polisher, Rodent AG, Montlingen, Switzerland) (Figs. 3 and 4).
Subsequently, the remaining dentin was cut into pieces (Bone rongeur forceps, Carl Martin BmbH, Solingen, Germany). These pieces of dentin were grinded using a bone mill (USTOMED INSTRUMENTE, Ulrich Storz GmbH & Co., Tuttingen, Germany) in order to achieve a particle size between 0.25 and 2 mm (Figs. 5 and 6).
The autologous, particulated dentin was mixed with autogenous blood from the operating site (Fig. 7) and carefully inserted into the alveolar socket under controlled pressure to the level of the palatal/vestibular bone plate (Fig. 8).
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