Enhanced Bone Regeneration Using Demineralized Dentin Matrix: A Comparative Study in Alveolar Bone Repair

Abstract

Objectives: Alveolar bone resorption following tooth extraction presents significant challenges for implant-supported rehabilitations. Demineralised dentin matrix (DDM) has emerged as a promising scaffold for bone tissue regeneration. This study evaluates the bone-regenerating potential of varying degrees of dentin demineralisation.

Materials and methods: Thirty-two male white New Zealand rabbits underwent extraction of the left mandibular anterior tooth and were assigned to 4 groups: undemineralised dentin matrix (UDDM), partially demineralised dentin matrix (PDDM), completely demineralised dentin matrix (CDDM), and a control group with no treatment. At 4 and 8 weeks post extraction, cone-beam computed tomography (CBCT) was used to assess alveolar bone height and width. Histological analyses using H&E and Masson trichrome stains evaluated new bone formation, and immunohistochemistry detected osteopontin expression.

Results: CBCT imaging revealed progressive increases in alveolar bone height and width across all groups over time. Histological analysis showed new bone formation in all groups, with the PDDM group demonstrating closer integration of newly formed bone trabeculae compared with the others. IHC results showed higher osteopontin expression in the PDDM group, highlighting its superior bone-inductive potential.

Conclusion: Among the tested materials, PDDM exhibited the most effective bone induction and tissue regeneration capabilities, outperforming CDDM and UDDM in promoting alveolar bone repair. These findings position PDDM as a valuable scaffold for enhancing bone tissue regeneration in clinical applications.

Clinical relevance: The use of PDDM in tooth extraction sockets significantly promotes efficient and reliable bone regeneration, making it a valuable option for clinical applications in implant dentistry.

Keywords: Alveolar ridge augmentation; Bone regeneration; Cone-beam computed tomography; Demineralised dentin matrix; Immunohistochemistry.

Fig. 1

Photographs showing the lower left incisor socket (A), filling the socket with DDM (B), and the overlying soft tissues sutured in layers (C).

Fig. 2

CBCT micrograph showing schematic measurements of ABW and ABH.

Fig. 3

Representative histologic images of H&E (A, D, G, J), Masson’s trichrome (B, E, H, K), and osteopontin immune staining (C, F, I, L) at 4 weeks post treatment. In the control group, the defects are seen to be filled mainly with fatty tissue (A-C). The UDDM group shows dentin particles (*) with fibrous tissue surrounding (D-F) with no newly formed bone. The PDDM group shows smaller (resorbed) dentin particles (*) with osteoid bone surrounding the particles (arrowhead) and dense fibrous connective tissue filling the defect area (G-I). In the CDDM group, dentin particles started to resorb (*) surrounded by osteoid tissue (arrowhead) with irregularly arranged fibrous tissue around them (J-L). Scale bar: 100 μm.

Fig. 4

Representative histologic images of H&E (A, D, G, J), Masson’s trichrome (B, E, H, K), and osteopontin immune staining (C, F, I, L) at 8 weeks post treatment. In the control group, the defect area is filled mainly with granulation tissue (A-C). The UDDM group shows dentin particles (*) with well-aligned surrounding fibrous tissue (D-F) with no newly formed bone. The PDDM group shows smaller dentin particles (*) with newly formed bone trabeculae surrounding them (arrowhead) (G-I). In the CDDM group, the markedly resorbed dentin particles (*) are surrounded by relatively thin newly formed bone trabeculae with dense fibrous tissue with abundant vasculature (arrow) (J-L). Scale bar: 100 μm.

Fig. 5

Histomorphometric analysis of MT (A) and OPN (B) shows significantly higher expression in the PDDM group compared to other groups at both 4 and 8 weeks (P < .01 and *P < .001, respectively, indicate statistically significant differences).