Autograft of human tooth and demineralized dentin matrices for bone augmentation

Abstract

In our previous clinical study, autogenous demineralized dentin matrices (DDM) prepared from the functional vital tooth (#4E) of 12-year-old male were grafted into the bone defect, using newly developed mill and device, and then received to the host without troubles. In this study, we transplanted human tooth and dentin adjusted previously to the atrophied upper jaw. 35-year-old female presented with missing tooth (#23–#24). First, a non-functional vital tooth (#38, #41, #35) were extracted and cryopreserved immediately. One year after extraction, the tooth were crushed by newly developed auto-crush mill using ZrO2 vessel and ZrO2 blade for 1 minute. The crushed granules were demineralized completely in 2% HNO3 solution, rinsed in cold distilled water and lyophilized (granule size: 0.5–2.0 mm). The bacteria-free of the DDM were confirmed by the bacteriological examination before use. We extracted the contralateral premolar (#14) for transplantation and performed the immediate root canal filling by using newly developed tooth fixing device while protecting periodontal ligament cell. The cavity for transplantation was formed by spiral and step drills. The contralateral premolar (#14) was transplanted into the modified socket (#24) and the DDM were loaded onto the places of the atrophied upper jaw. A dental X-ray photography and a CT scan of the implanted site were taken after transplantation. There were no postoperative complications at 13 months after transplantation and bone augmentation were observed by CT analysis at 4 months after transplantation. This case indicates that the preserved autogenous DDM can be used as collagenous biomaterials with osteoinductive potency.