Untreated Mineralized Dentin Graft Versus Xenograft Around Immediately Placed Dental Implants in the Mandibular Anterior Region: A Randomized Controlled Clinical Trial.

Abstract

The structural and compositional similarities between dentin and alveolar bone formed the basis for utilizing dentin for bone regeneration. Various authors recommended using treated mineralized, partially demineralized, and demineralized dentin grafts over xenografts because of their comparable clinical and radiographic results and lower costs. Therefore, the current study aimed at comparing the effect of untreated mineralized dentin grafts (UMDG) versus xenografts in vertical and horizontal augmentation around dental implants that were immediately placed in the mandibular anterior region. A total of 56 patients who required immediate dental implant placement in the lower anterior region were randomly allocated to group I (study), where ground dentin was washed with normal saline and placed around the dental implants, and to group II (control), where xenograft was used. The primary implant stability was measured at the time of implant placement. Secondary stability, plaque index (PI), bleeding index (BI), probing depth (PD), and keratinized mucosa width (KMW) were assessed at baseline (time of definitive abutment and temporary crown placement) and then at 3, 6, and 12 months. Pain and the number of analgesics consumed were assessed daily during the first postoperative week. Marginal bone loss (MBL) and radiodensity were assessed radiographically. There were no significant differences between both groups in terms of postoperative pain, the number of analgesic tablets consumed, peri-implant mucositis, or peri-implantitis. Both groups showed comparable results for the PI, BI, and BD. Moreover, there was no statistical difference between both groups with regard to primary implant stability and secondary stability at baseline and 12 months. Group I showed significantly lower secondary stability after loading at 3 and 6 months and significantly greater bone loss and lower bone density before exposure. KMW and MBL after exposure were significantly higher in group I at all time points. Although UMDG showed similar clinical results as xenografts, including primary and secondary implant stability, they had higher resorption rates than xenografts. Therefore, treatment of the dentin graft is required. Thus, the authors do not recommend using untreated mineralized dentin grafts.