Autogenous Dentin Particulate Graft for Alveolar Ridge Augmentation with and without Use of Collagen Membrane: Preliminary Histological Analysis on Humans

Abstract

(1) Background: The phenomenon of ankylosis of the dental elements has led clinicians to think that properly treated dentin and cement may be a potential graft for alveolar ridge augmentation. Currently, there are no studies in the literature able to histomorphometrically compare the healing patterns of an autogenous dentin particulate graft with the association, or not, of resorbable membranes. The aim of this pilot study is to histologically compare bone after an alveolar ridge augmentation using an autogenous dentin particulate graft with and without a resorbable collagen membrane. (2) Methods: this clinical trial enrolled six patients with defects requiring bone augmentation. Two procedures were performed in all six adult human patients in order to perform a study-control study: in Group 1, a ridge augmentation procedure with an autogenous dentin particulate graft and a resorbable collagen membrane was performed, and, in Group 2, an alveolar ridge preservation without a membrane was performed at the same time (T0). At 4 months, a biopsy of the bone tissues was performed using a 4 mm trephine bur in order to perform a histomorphometric analysis. (3) Results: The histomorphometric analysis demonstrated that Group 1 presented 45% of bone volume, 38% of vital bone, and 7% of residual graft. On the contrary, membrane-free regenerative procedures demonstrated 37% of bone volume, 9% of vital bone, and 27% of non-resorbed graft. In all cases, the regenerated bone allowed the insertion of implants with a standard platform, and no early failures were recorded. (4) Conclusions: Autogenous dentin particulate grafts seem to work best when paired with a membrane.

Keywords: alveolar ridge augmentation; autogenous dentin graft; bone graft histology; membrane; tooth transformer.

Figure 1

Radiographic investigation before surgery (A) and after the healing time (B) before implants.

Figure 2

Histology extracted from a site with membrane, with a circle for the bone and a star for the tooth graft. New bone was 41.67%, residual graft was 5.65%, and total calcificated tissue was 47.33%.

Figure 3

Histology extracted from Group 2 (dentin graft alone), With a circle for the bone and a star for the tooth graft. New bone was 4.12%, residual graft was 36.25%, and total calcified tissue was 43.49%.

Figure 4

Clinical images of a case of alveolar ridge preservation with the two adjacent procedure types: (A) X-ray before the surgery; (B) Situation before alveolar ridge augmentation; (C) It is possible to note the membrane presence in site 3.6. Dentin graft alone is present in the position of tooth 3.7; (D) After 4 months, two biopsies were made on sites 3.6 and 3.7; (E) Definitive prosthesis; (F) X-ray after 6 months of load.

Figure 5

Images of all cases. Cases (A–E), the groups 1 and 2 are in different mouth sites.