The effect of autologous demineralized dentin matrix on postoperative complications and wound healing following lower third molar surgery: A split-mouth randomized clinical trial

Abstract

Background/purpose: Autologous dentin materials are among the most promising bone substitutes for preventing osseous defects on the distal side of the lower second molar. This study aimed to investigate the effects of autologous demineralized dentin matrix on postoperative complications and wound healing after lower third molar surgery.

Materials and methods: Thirteen patients with bilateral symmetrical lower third molars participated in this split-mouth randomized clinical trial. After removal surgery, one socket of the lower third molar was grafted with dentin material (demineralized dentin matrix side), and a piece of collagen sponge was used for the tooth socket of the remaining side (control side). The upper third molar on the same lateral side was extracted immediately before lower third molar surgery and used to create a demineralized dentin matrix according to the manufacturer's protocol (KometaBio). After lower third molar surgery, pain, swelling, trismus, and Inflammatory Proliferative Remodeling Scale scores were used to evaluate postoperative complications and wound healing.

Results: Pain, swelling, and trismus of the demineralized dentin matrix and control sides were not significantly different at any assessment time (P > 0.05). The wound-healing scores of the demineralized dentin matrix side were better than those of the control side; however, the differences were only significant at 7th and 30th days (P < 0.05).

Conclusion: Grafting autologous demineralized dentin matrix into the tooth socket did not increase the postoperative complications after lower third molar surgery. However, wound healing on the graft side was comparatively better than that on the control side.

Clinicaltrialsgov identifier: NCT06073639, date 10 October, 2023. This is a retrospectively registered trial.

Keywords: Demineralized dentin; Graft; Inflammatory proliferative remodeling scale scores; Postoperative complications; Third molar surgery.

Figure 1

Measurement of facial dimensions (left) and maximal mouth opening (right). A, the labial orbital; B, the gonial angle; C, the tragus; D, the anguli oris.

Figure 2

Lower third molars socket after surgery. Left (DDM side): Demineralized dentin matrix was placed into the tooth socket, covered with collagen sponge, and finally sutured. Right (control side): Only collagen sponge was placed into the tooth socket.

Figure 3

Wound healing inflammatory proliferative remodeling scores of the control and DDM side on 3rd, 7th, and 30th days after L3M surgery. n = 13 for each group. DDM, demineralized dentin matrix; ns, not significant; ∗P < 0.05.