Autogenous demineralized dentin matrix from extracted tooth for the augmentation of alveolar bone defect: a prospective randomized clinical trial in comparison with anorganic bovine bone

Abstract

Objectives: The aim of this study was to prospectively evaluate the clinical efficacy and histological outcome of the autogenous tooth graft material (AutoBT) compared to that of anorganic bovine bone (Bio-Oss^® , Geistlich, Switzerland) in post-extraction alveolar bone augmentation.

Patients and methods: A total of 33 graft sites in 24 patients were included in this study. AutoBT was used in 21 sites of 15 patients and Bio-Oss^® was used in 12 sites of 9 patients for alveolar bone augmentation 2-4 weeks after dental extraction. Vertical dimension of grafted bone was measured both at the time of graft placement and at implant fixture placement after 6 months. Trephine cores were harvested for the histomorphometric evaluations during implant placement when feasible. The primary stability of implant fixture was also measured.

Results: Infection of graft material or graft bed was not observed and graft sites healed without any notable complications in both groups. The vertical dimensions of alveolar bone increased by 5.38 ± 2.65 mm in AutoBT group and 6.56 ± 3.54 mm in Bio-Oss^® group at 6 months post-extraction. Histomorphometrically, new bone formation of AutoBT-grafted site was 31.24 ± 13.87% while that of Bio-Oss^® was 35.00 ± 19.33%. The implant stability quotient (ISQ) of implants placed in AutoBT-grafted sites measured 72.80 ± 10.81 while those placed in Bio-Oss^® -grafted sites measured 70.0 ± 12.86. There were no statistically significant differences between measurements of the two groups.

Conclusion: Autogenous demineralized dentin matrix from extracted tooth grafted to extraction sockets for the augmentation of vertical dimension was as effective as augmentation using anorganic bovine bone. Both groups showed favorable wound healing, similar amount of implant stability, and histologically confirmed new bone formation. Thus, the results of this study suggest that autogenous tooth graft material is a viable option for alveolar bone augmentation following dental extraction.

Keywords: bone regeneration; bone substitutes; clinical research; clinical trials; guided tissue regeneration; histo-pathology; host mechanisms.