Dentine grafts in socket preservation: An overview

Abstract

During management of carious teeth, root stumps, fractured roots and unsalvageable teeth, extractions become inescapable. Healing post-extraction is characterized by changes that results in bone formation in the socket internally and changes related to width and height of alveolar ridge externally. The maintenance of height and width of alveolar bone or regeneration of alveolar bone is necessary to provide good support to the prosthesis, conservation of adjacent tooth structure and also for superior and satisfactory aesthetic outcome. A broadly documented approach is the preservation of bone walls by use of bone substitute (bone graft) in the extraction socket, where guided-bone regeneration may be required. Different varieties of bone grafts like autogenous bone grafts, allografts, alloplasts and xenograft may be used. Various factors like donor site morbidity, restricted availability and cost are the limitations of various bone substitutes. A new autogenous bone substitute that is being studied is the extract of patient’s own extracted tooth without need for a secondary bone harvesting site. Tooth-derived mineralized dentin matrix exhibits composition similar to the bone and is a viable option for alveolar bone augmentation immediately after dental extraction. The aim of this review is to analyze the role and efficacy of dentine grafts in preservation of post-extraction sockets. Autogenous dentine graft when used in socket preservation procedures showed many benefits for both patients and the clinicians by excluding donor site morbidity, limited availability and associated cost issues with a better quality of newly substituted bone and minimal amount of residual graft. Future controlled trials are suggested to monitor various tissue changes along with histological studies to provide substantial evidence of its regenerative potential.