Abstract
ObjectivesCell-free DNA (cfDNA) harboring mutations has been found in patients with diseases. Experimental studies have shown that cfDNA can be transmitted, leading to transformations in the host. In the present study, we evaluated whether bone allograft material contains cfDNA and whether this foreign cfDNA can be released into the patient’s blood circulation.Materials and methodsPlasma samples were collected preoperatively and postoperatively on the same day, at 5 weeks, and 4 months from 25 women who received bone allograft material (test group) from male donors and from 10 women who were treated with autologous graft (control group, only pre- and postoperative samples were collected). DNA was quantified and characterized in bone material and plasma samples by quantitative PCR with primers specific for glyceraldehyde-3-phosphate dehydrogenase (GAPDH) and Y chromosome and gel electrophoresis. DNA in bone material was digested by different concentrations of DNase I.ResultsWe detected between 1 and 1.8 μg cfDNA fragments at a length around 601 base pairs (bp) and smaller in each 100 mg allograft. Treatment of the allograft with DNase I completely degraded the longer but not the shorter DNA 90-bp fragments. Y-DNA was not detected in the patients’ bloodstream at any time during the treatment and follow-up, but elevated levels of circulating cfDNA could be measured immediately postoperatively.ConclusionsOur results suggest that a transmission of DNA from allografts used for alveolar ridge reconstruction in humans is unlikely. The observed increase in circulating cfDNA in allograft and autograft patients immediately postoperatively may be elicited by the surgical procedure.Clinical relevanceThe results support the safety of allograft materials. The results suggest that human allograft materials seem not to release DNA into the blood since we did not measure Y-DNA with our technique.
Highlights
A reduced alveolar bone volume is a physiological consequence after tooth loss, commonly implying the need for augmentation procedures prior to dental implant treatment
We classified alveolar ridge defects according to the description published by Seibert in 1983 [30], who differentiated between three defect classes: buccolingual vertical, apicocoronal, and combined defects
Blood samples were collected from 25 women who received bone allograft material from male donors and from 10 women who were treated with autologous graft
Summary
A reduced alveolar bone volume is a physiological consequence after tooth loss, commonly implying the need for augmentation procedures prior to dental implant treatment. Autogenous bone grafts may show different disadvantages, such as increased operation time, donor site morbidity, post-operative discomfort, limitations in bone quantity and volume, unpredictable bone quality, and reduced volume stability, as well as a fast resorption rate It may be only effective under good recipient site conditions [2, 4,5,6,7,8]. In order to overcome this limitation on one hand and to avoid patient discomfort on the other hand, efforts were made to find suitable alternatives for bone replacement, when grafts are required for large intraoral defects [3] Among those materials, bone allografts are considered a very useful alternative because they provide similar properties like autogenous bone but are available in unlimited volume. Application of different techniques to control infection transmission, such as donor screening, repeated infectious disease testing, graft sterilization with ethylene oxide or radiation, and long-term tracking of the grafts, significantly decreases the disease transmission risks [3, 20]
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