Dentin-Derived-Barrier Membrane in Guided Bone Regeneration: A Case Report

Abstract

An autogenous, demineralized, dentin matrix is a well-known osteo-inductive bone substitute that is mostly composed of type I collagen and is widely used in implant dentistry. This single case report describes a successful outcome in guided bone regeneration and dental implantation with a novel human-derived collagen membrane. The authors fabricated a dentin-derived-barrier membrane from a block-type autogenous demineralized dentin matrix to overcome the mechanical instability of the collagen membrane. The dentin-derived-barrier acted as an osteo-inductive collagen membrane with mechanical and clot stabilities, and it replaced the osteo-genetic function of the periosteum. Further research involving large numbers of patients should be conducted to evaluate bone forming capacity in comparison with other collagen membranes.

Keywords: bone regeneration; collagen; demineralized dentin matrix; dental implant; dentistry; membrane.

Figure 1

Dentin-derived-barrier membrane (DDB). (A) DDB was fabricated from a 300 to 800 µm thick slice of autogenous tooth bone graft block with 0.2 to 0.3 mm diameter holes. (B) Scanning electronic microscopy (S-4700, Hitachi, Tokyo, Japan) of the DDB surface with exposed dentinal tubules (×1000 magnification).

Figure 2

Surgical procedure for guided bone regeneration using a dentin-derived-barrier membrane (DDB). (A) Implants (3.8 mm in diameter, 13 mm in length, Dio, Busan, Korea) were placed with good primary stability. There was a buccal wall defect about 4 mm around the implant. (B) The defect around the implant was filled with autogenous bone graft materials (AutoBT powder, Korea Tooth Bank, Seoul, Korea). (C) The DDB covered the whole defect. The DDB showed a color change after soaking with the patient’s own blood due to the major collagenous nature. (D) The DDB had completely disappeared and was homogeneously incorporated at the graft site by re-entry at 14 weeks for a prosthetic procedure.

Figure 3

Cone-beam computed tomography after guided bone regeneration using a dentin-derived-barrier membrane (DDB). (A) Coronal plane of cone-beam computed tomography immediately after implant placement with guided bone regeneration using a DDB. There was a radiolucent defect that was filled with auto-DDM and covered with a DDB. (B) At 4 years and 8 months, the cortical bone around the implant neck was fully repaired and supported by well-developed corticocancellous bone.