Application of autogenous dentinal block to increase alveolar bone volume: a clinical case

Introduction. Materials based on extracted teeth in various studies have been radiographically and histologically proven to be effective in osteoplastic operations. These materials can be used in the form of crushed dentin matrix, a fragment of the tooth’s root and an autogenous dentin block. The purpose of this clinical case was to evaluate the effectiveness of using an autogenous dentin block to increase the alveolar process of the jaws in the preimplantation period.

Description of a clinical case. Patient F., 30 years old, applied to the clinic of the Clinical Center of Maxillofacial, Plastic Surgery and Dentistry Russian University of Medicine with a complaint of a missing tooth in the frontal region of the lower jaw. At the time of treatment, the patient was already undergoing orthodontic treatment in another medical institution in Moscow. The patient underwent a clinical and radiological examination together with a prosthodontst. A diagnosis of «partial secondary adentia», «atrophy of the alveolar ridge in the frontal part of the lower jaw» and «dystopia of teeth 1.8, 2.8, 3.8, 4.8» was established. A comprehensive treatment plan has been drawn up. At the first stage, the patient underwent extraction of teeth 1.8, 2.8, 3.8, 4.8 for orthodontic indications with simultaneous bone grafting of the alveolar ridge in the area of the missing tooth 3.1. At the second stage, the patient underwent a trephine biopsy in the area of augmentation and installation of a dental implant in the area of missing tooth 3.1. The third stage was rational prosthodontic treatment on a dental implant in the department of prosthodontics.

Results. The present study showed that autogenous dentinal block can serve as an alternative material for alveolar ridge augmentation.

1. Jung R.E., Naenni N., Ruales-Carrera E., Busher D., Thoma D.S. Short and Ultra-short implants. Forum Implantologicum. 2021; 17(1): 3443. DOI: 10.3290/iti.fi.45625.

2. Dubova L.V., Manin O.I., Romanenko M.V. Selection of optimal structural materials for the manufacture of dentures supported by effective implants from Straumann, depending on the pH values of the mouth. Current issues in dentistry: Collection of scientific papers of the All-Russian scientific and practical conference dedicated to the founder of the Department of Orthopedic Dentistry of KSMU, Professor Isaac Mikhailovich Oksman. 2020: 150-153 (In Russ.).

3. Kulakov A.A., Badalyan V.A., Kasparov A.S. Increasing the volume of the alveolar process in the anterior part of the upper jaw using a membrane based on titanium thread. Clinical dentistry. 2020; 93(1): 5458 (In Russ.). http://doi. org/10.37988/1811-153X_2020_1_54.

4. Khoury F., Antoun H., Missika P. Bone augmentation in oral implantology. London: Quitessence publ. 2007: 435

5. Drobyshev A.Yu., Kiselev A.A., Melikov E.A., Snigerev S.A. The use of compression-distraction method in patients with complex defects of the upper and lower jaws in order to prepare for dental implantation. Stomatologiya. 2013; 92(3): 48–51 (In Russ.)

6. Gorgis R., Qazo L., Bruun N.H., Starch-Jensen T. Lateral Alveolar Ridge Augmentation with an Autogenous Bone Block Graft Alone with or without Barrier Membrane Coverage: a Systematic Review and Meta-Analysis. J Oral Maxillofac Res. 2021;12(3):e1. doi: 10.5037/jomr.2021.12301.

7. Sakkas A., Wilde F., Heufelder M., Winter K., Schramm A. Autogenous bone grafts in oral implantology-is it still a «gold standard»? A consecutive review of 279 patients with 456 clinical procedures. Int J Implant Dent. 2017;3(1):23. doi: 10.1186/s40729-017-0084-4.

8. Gultekin A. B., Bedeloglu E., Kose T.E., Mijiritsky E. Comparison of Bone Resorption Rates after Intraoral Block Bone and Guided Bone Regeneration Augmentation for the Reconstruction of Horizontally Deficient Maxillary Alveolar Ridges. Biomed Res Int. 2016; 2: 19. DOI: 10.1155/2016/4987437.

9. Binderman I., Hallel G., Nardy C. A novel procedure to process extracted teeth for immediate grafting of autogenous dentin. J Interdisciplinary Medicine and Dental Science. 2014; 2(154): 6-11. doi: 10.4172/2376-032X.1000154.

10. Minetti E., Corbellaa S., Taschieri S., Canullo L. Tooth as graft material: Histologic study. Clin. Implant Dent. Relat. Res. 2022; 24(4): 488496. DOI: 10.1111/cid.13097.

11. Pohl S., Binderman I., Tomac J. Maintenance of Alveolar Ridge Dimensions Utilizing an Extracted Tooth Dentin Particulate Autograft and Platelet-Rich fibrin: A Retrospective Radiographic Cone-Beam Computed Tomography Study. Materials. 2020; 13(5): 1083. doi: 10.3390/ma13051083.

12. Li Y., Zhou W., Li P., Luo Q., Li A., Zhang X. Comparison of the osteogenic effectiveness of an autogenous demineralised dentin matrix and Bio-Oss® in bone augmentation: a systematic review and meta-analysis. Br J Oral Maxillofac Surg. 2022; 60(7): 868876. doi: 10.1016/j.bjoms.2022.03.009.

13. Um U. W., Kim Y.K., Mitsugi M. Demineralized dentin matrix scaffolds for alveolar bone engineering. J. Indian Prosthodont Soc. 2017; 17(2): 120127. DOI: 10.4103/jips.jips_62_17.

14. Schwarz F., Hazar D., Becker K., Sader R., Becker J. Efficacy of autogenous tooth roots for lateral alveolar ridge augmentation and stage d implant placement. A prospective controlled clinical study. J Clin Periodontol. 2018; 45(8): 9961004. DOI: 10.1111/jcpe.12977.

15. Becker K., Jandik K., Stauber M., Mihatovic I., Drescher D., Schwarz F. Microstructural volumetric analysis of lateral ridge augmentation using differently conditioned tooth roots. Clin. Oral. Investig. 2019; 23(7): 110. DOI: 10.1007/s00784-018-2723-4.

16. Schwarz F., Mihatovic I., Popal-Jensen I., Parvini P., Sader R. Influence of autoclavation on the efficacy of extracted tooth roots used for vertical alveolar ridge augmentation. J. Clin. Periodontol. 2019; 46(4): 502509. DOI: 10.1111/jcpe.13090.

17. Parvini P., Schliephake C., Al-Maawi S., Schwarz K., Sader R., Ghanaati S., Schwarz F. Histomorphometrical assessment of vertical alveolar ridge augmentation using extracted tooth roots in the canine. Clin Oral Investig. 2020; 24(1): 317323. doi: 10.1007/s00784-019-02960-7. DOI: 10.1007/s00784-019-02960-7.

18. Redko N.A., Drobyshev A.Yu., Lezhnev D.A. Preservation of the tooth socket in the preimplantation period: assessment of the effectiveness of the use of osteoplastic materials using cone-beam computer data. Kuban Scientific Medical Bulletin. 2019; 6: 7079 (In Russ.). https://doi.org/10.25207/1608-6228-2019-26-6-70-79.

19. Le T.H., Drobyshev A.Yu., Redko N.A., Tsarev V.N., Podporin M.S. The effectiveness of using antiseptic agents for the treatment of autogenous dentin blocks. Russian dental journal. 2023; 27(3): 219–228. https://doi.org/10.17816/dent321610.

20. Korsch M. Tooth shell technique: A proof of concept with the use of autogenous dentin block grafts. Aust Dent J. 2021; 66(2): 159-168. doi: 10.1111/adj.12814.

21. Drobyshev A.Yu., Le T.H., Redko N.A. A method for lateral enlargement of the alveolar ridge of the jaw. Patent for the invention of RU 2804989 C1 09.10.2023 (In Russ.)

22. Le T.H., Drobyshev A.Yu., Redko N.A. Zairatyants O.V., Plekhanova E.N. Preservation of alveolar bone volume using a fragment of an anterior tooth after its extraction: a dangerous case. Clinical dentistry. 2023; 26 (4): 102–107. DOI: 10.37988/1811-153X_2023_4_102 (In Russ.)