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Bone tissue regeneration is a critical aspect of dental surgery, given the common occurrence of bone resorption leading to alveolar bone defects. The aim of this paper was to conduct a systematic review to provide a comprehensive summary of the evidence regarding the regenerative properties of dentin biomaterial. This systematic review was conducted through comprehensive searches in the PubMed, Scopus, and Web of Science databases, as well as an extensive exploration of the gray literature sources, including WorldCat, The New York Academy of Medicine Library, and Trip Database, following the established PRISMA protocol. Keywords such as tooth, dentin, grinder, and autograft guided the search, with a focus on a standardized procedure involving dentin grinders within laboratory, experimental, and clinical settings. Initially, a pool of 1942 articles was identified with 452 duplicates removed. An additional 1474 articles were excluded for not aligning with the predefined topics, and three more were excluded due to the unavailability of the full text. Ultimately, 13 articles met the strict inclusion criteria and were included in the review. The chemical composition of the dentin particles was similar to natural bone in terms of oxygen, carbon, calcium, phosphorus, sodium, and magnesium content, as well as in terms of the Ca/P ratio. In addition, the dentin also contained amide I and amide II structures, as well as aliphatic and hydroxyl functional groups. The chemically treated dentin was free of microorganisms. The dentin had characteristic tubules that opened after chemical treatment. At the cellular level, dentin released bone morphogenetic protein 2, induced significant cell growth, and stimulated the reorganization of the fibroblast cytoskeleton. Most clinical studies have focused on alveolar bone regeneration. After the transplantation of demineralized dentin particles, studies have observed new bone formation, a reduction in residual bone, and an increase in connective tissue. Clinical reports consistently indicate uncomplicated healing and recovery post-transplantation. However, there is a notable gap in the evidence concerning complication rates, patient-reported outcomes, and the presence of pro-inflammatory factors. In conclusion, dentin biomaterial emerges as a versatile bone substitute, demonstrating high biocompatibility and ease of acquisition. The preservation of its internal structure containing organic matter and growth factors enhances its potential for effective bone regeneration. Particularly, in dental surgery, dentin-derived materials present a promising alternative to traditional autologous bone autografts, offering the potential to reduce patient morbidity and treatment costs.

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OBJECTIVES: To assess and compare the clinical, radiological, and histological outcomes of socket seal surgery between two protocols: deproteinized demineralized tooth matrix (dpDTM) and freeze-dried bone allograft (FDBA) each covered with a free gingival graft. MATERIALS AND METHODS: Twenty extraction sockets in the anterior or premolar region were randomly allocated to either the dpDTM or FDBA protocol (n = 10 per group). Measurements of the alveolar ridge changes were obtained using an intraoral scanner and cone-beam computed tomography at 3 months post-operation. Three-month post surgery, the dental implant was installed (n = 5 per group), bone biopsies were obtained for histomorphometrical and micro-computed tomography analyses. Implant stability quotients (ISQs) were determined and compared at 3 months post-implant. RESULTS: Lower significant reductions in buccal alveolar ridge height and hard tissue volume were observed in dpDTM group compared to FDBA group at 3 months (0.25 ± 0.35 mm vs. 1.60 ± 0.66 mm [p = .000] and 9.64 ± 15.39% mm3 vs. 31.45 ± 18.11% mm3 [p = .010], respectively). At the same time, lower soft tissue volume reduction was detected in the dpDTM group compared to FDBA group (4.21 ± 5.25% mm3 vs. 5.25 ± 5.79% mm3). No statistically significant difference in the percentage of mineralized tissue formation was found between dpDTM group (53.39 ± 11.16%) and FDBA group (49.90 ± 3.27%). Even though the ISQ in the dpDTM group showed a higher value than the FDBA group at 3 months post-implant, the results were without statistical significance. CONCLUSIONS: Alveolar ridge preservation using dpDTM is an efficacious procedure for providing the conditions for the development of functional and esthetic implants.

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PURPOSE: This study aimed to analyze and compare three-dimensional volumetric bone changes and stability of simultaneously placed dental implants following sinus augmentation using deproteinized human demineralized tooth matrix (dpDTM) and deproteinized bovine bone mineral (DBBM). METHODS: Twenty-four patients who required lateral maxillary sinus floor augmentation with simultaneous dental implant placement were randomly assigned to receive either dpDTM (n = 12) or DBBM (n = 12). Cone-beam computed tomography and resonance frequency analysis of implant stability were conducted immediately after surgery and 6 months postoperatively. Changes in the graft sinus floor and graft height volumes in the sagittal and coronal views, along with the implant stability quotient (ISQ), were analyzed and compared. RESULTS: Volumetric graft alteration was comparable between dpDTM (120.33 ± 77.48 mm3) and DBBM (108.51 ± 65.15 mm3) (p = 0.690). Reduction in the average graft height was also comparable: dpDTM group ranged from - 0.59 to - 0.93 mm and the DBBM group ranged from - 0.55 to - 0.82 mm (p > 0.05) at most examined levels. However, greater reduction in the mesial-graft height occurred in the dpDTM group (- 1.08 ± 0.70 mm vs. -0.58 ± 0.39 mm, p = 0.04). The ISQ values increased similarly in both groups to reach 70 at 6 months. CONCLUSION: dpDTM demonstrated comparable stability in graft volume and height during the healing process compared to DBBM and could serve as a viable alternative to DBBM for sinus floor augmentation with simultaneous implant placement.

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The purpose of this research was to assess the effectiveness of an innovative medical device capable of extracting tooth graft materials directly from the patient's own teeth. Twenty consecutive tooth grafting procedures were conducted, with an average follow-up period of 18 months. METHODS: Twenty patients requiring tooth extraction underwent socket preservation utilizing the extracted tooth as the grafting material. RESULTS: After a 4-month healing period, the defects were significantly filled with newly formed hard tissue. Subsequently, bone biopsies were performed during dental implant placement to evaluate histological outcomes. The tissue exhibited a similar density to medium-density bone, displaying a homogeneous and uniform appearance without any visible signs of inflammation. The post-operative healing phase was free from infective complications or indications of graft particles within the regenerated bone structure. The histomorphometric analyses revealed the following results: bone total volume, BV% 52.6 ± 13.09, vital bone VB% 40.39 ± 15.86, residual graft % 12.20 ± 12.34. CONCLUSION: The study demonstrated positive bony healing in guided regenerative surgery procedures using autologous tooth grafts. However, further research with an extended follow-up period is necessary to thoroughly assess the potential of demineralized dentin autografts.

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AIM: The aim of the present study was to investigate the histological differences between samples processed by different devices and to confirm safe clinical application of different dentin matrix obtained from three devices: BonMaker, Tooth Transformer, and Smart Dentin Grinder in regeneration of maxillary defects. RESEARCH DESIGN: The study involved 39 patients with two-wall or three-wall defects who underwent bone augmentation procedures in the maxilla using dentin matrix grafts from the BonMaker, Tooth Transformer, and Smart Dentin Grinder devices. Histological examination was conducted on samples obtained from patients who received each device. In this article, histological samples have been selected and are presented. RESULTS: In all patients, bone defects were successfully augmented with ground dentin matrix. The histological examination revealed no inflammation and a good connection between the bone and dentin matrix and clinically all patients were qualified for implant placement. CONCLUSIONS: After comparing the BonMaker, Tooth Transformer, and Smart Dentin Grinder devices in our practice, we concluded that all these systems have the potential for obtaining regenerative material from the patient's teeth.

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BACKGROUND: The use of human dentin matrix could serve as an alternative to autologous, allogenic, and xenogeneic bone grafts due to its osteoinductive characteristics. The limitations of its use is tooth availability and that it is often necessary to mix it with a biomaterial. AIM: The aim of this study was to analyze a mix of two different graft materials with different reabsorption ranges when the dentin graft material was not sufficient for full socket preservation. METHODS: Seven socket preservation surgeries were carried out employing a mixed graft material containing 50% dentin and 50% xenograft. After four months of recovery, the implants were positioned. At the time of the prosthesis placement and implant surgery, bone samples were collected. RESULTS: The histologic analysis revealed no inflammatory or infective reaction against the seven biopsies. The histomorphometric graft analysis revealed an amount of New Bone of 29.03 ± 6.57% after 4 months and 34.11 ± 5.02% after 8 months. CONCLUSIONS: The two graft materials had a different volume reabsorption rate: 71% after 4 months and 90% after 8 months for dentin, and 6% after 4 months and 26% after 8 months for the xenograft. The space created by the dentin reabsorption increased the quantity of new bone.

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Background: The periodontal regeneration is the most challenging process which involves regeneration of both hard and soft tissues. There are various biomaterials available for this purpose. Tooth graft can be used as a regenerative material in the field of periodontics and implantology. The tooth graft with 70% demineralization is considered to be a better option for periodontal regeneration. Different methods are employed for demineralization of tooth using various acids. Materials and Methods: This study was designed as an in vitro study. Totally 60 teeth were collected and categorized into four groups. Groups I, II, and III teeth were demineralized in 2% nitric acid, 0.6 M hydrochloric acid, and 17% ethylenediaminetetraacetic acid (EDTA), respectively. The Group IV teeth were left undemineralized. The elements present in the various tooth graft groups after demineralization were analyzed by EDX-720 XRF Instrument. Results: The EDTA demineralized tooth graft has higher level of Calcium, Strontium, and Zinc content compared to other tooth graft groups and it was statistically significant with P = 0.001. Conclusion: The EDTA demineralized tooth graft can serve as better graft than 2% nitric acid and 0.6M hydrochloric acid demineralized and undemineralized tooth grafts.

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BACKGROUND: The use of the human dentin matrix could serve as an alternative to autologous, allogenic, and xenogeneic bone grafts. Since 1967, when the osteoinductive characteristics of autogenous demineralized dentin matrix were revealed, autologous tooth grafts have been advocated. The tooth is very similar to the bone and contains many growth factors. The purpose of the present study is to evaluate the similarities and differences between the three samples (dentin, demineralized dentin, and alveolar cortical bone) with the aim of demonstrating that the demineralized dentin can be considered in regenerative surgery as an alternative to the autologous bone. METHODS: This in vitro study analyzed the biochemical characterizations of 11 dentin granules (Group A), 11 demineralized using the Tooth Transformer (Group B), and dentin granules and 11 cortical bone granules (Group C) using scanning electron microscopy (SEM) and energy dispersive spectroscopy (EDS) to evaluate mineral content. Atomic percentages of C (carbon), O (oxygen), Ca (calcium), and P (phosphorus) were individually analyzed and compared by the statistical t-test. RESULTS: The significant p-value (p < 0.05) between group A and group C indicated that these two groups were not significantly similar, while the non-significant result (p > 0.05) obtained between group B and group C indicated that these two groups are similar. CONCLUSIONS: The findings support that the hypothesis that the demineralization process can lead to the dentin being remarkably similar to the natural bone in terms of their surface chemical composition. The demineralized dentin can therefore be considered an alternative to the autologous bone in regenerative surgery.

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Different biomaterials, from synthetic products to autologous or heterologous grafts, have been suggested for the preservation and regeneration of bone. The aim of this study is to evaluate the effectiveness of autologous tooth as a grafting material and examine the properties of this material and its interactions with bone metabolism. PubMed, Scopus, Cochrane Library, and Web of Science were searched to find articles addressing our topic published from 1 January 2012 up to 22 November 2022, and a total of 1516 studies were identified. Eighteen papers in all were considered in this review for qualitative analysis. Demineralized dentin can be used as a graft material, since it shows high cell compatibility and promotes rapid bone regeneration by striking an ideal balance between bone resorption and production; it also has several benefits, such as quick recovery times, high-quality newly formed bone, low costs, no risk of disease transmission, the ability to be performed as an outpatient procedure, and no donor-related postoperative complications. Demineralization is a crucial step in the tooth treatment process, which includes cleaning, grinding, and demineralization. Since the presence of hydroxyapatite crystals prevents the release of growth factors, demineralization is essential for effective regenerative surgery. Even though the relationship between the bone system and dysbiosis has not yet been fully explored, this study highlights an association between bone and gut microbes. The creation of additional scientific studies to build upon and enhance the findings of this study should be a future objective of scientific research.

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AIM: The aim of the present study was to propose the clinical efficacy of the different dentin matrix obtained from three devices (BonMaker, Tooth Transformer, and Smart Dentin Grinder) and to show their morphological, physical, and biochemical characteristics using scanning electron microscopy (SEM), energy-dispersive X-ray (EDX) spectroscopy, and Raman spectroscopy. RESEARCH DESIGN AND METHODS: The study included 70 patients who underwent bone augmentation using the BonMaker, Tooth Transformer, and Smart Dentin Grinder devices. In addition, 84 implants were placed. Furthermore, four samples, one for each device and one non-demineralized control, were analyzed with scanning electron microscopy (SEM), energy-dispersive X-ray analysis, and Raman spectroscopy. RESULTS: In all patients, augmentation of bone defects with ground dentin matrix was successful, and implants showed correct osseointegration. The morphological organization, the chemical composition, and the presence of organic molecules in the dentin samples processed by the three different devices were demonstrated using SEM, energy-dispersive X-ray analysis, and Raman spectroscopy. CONCLUSIONS: Comparing BonMaker, Tooth Transformer, and Smart Dentin Grinder devices in our practice, we concluded that these systems, even with different structural and chemical differences of the dentin granules, have a comparable potential for obtaining regenerative material from the patient's own teeth.

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AIM: This study aims to compare the effect of demineralized xenogeneic tooth graft in its two forms, particulate and block, with bovine xenograft in the healing of a rabbit tibial bone defect model. MATERIALS AND METHODS: Two monocortical bony defects were made in the right tibias of 36 rabbits, and were divided into four groups. Group I defects were left empty, while group II, III, and IV were filled with bovine xenograft, demineralized particulate tooth graft, and demineralized perforated block tooth graft, respectively for evaluation of the bone healing process. Three rabbits from each group were euthanized at 2, 4, and 6 weeks after surgery. The bone specimens were processed and stained with hematoxylin and eosin (H&E) and osteopontin (OPN) immunohistochemical staining. The results were subjected to image analysis and quantitative evaluation. RESULTS: Demineralized particulate tooth graft showed the best bone healing capacity compared to all other groups at all time points tested, as it showed a large amount of the formed bone, rapid closure of the defect with a significant increase in OPN expression, and the least amount of the residual grafted particles. CONCLUSION: In comparison to bovine xenograft and demineralized dentin block graft, the demineralized particulate tooth grafting material is a promising bone grafting substitute as it proved to be osteoconductive, biocompatible, and bioresorbable. CLINICAL SIGNIFICANCE: Demineralized tooth grafting material can aid in the regeneration of large bone defects, leading to improvement in the filling of the bone defects which can help in oral and maxillofacial reconstruction.

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ABSTRACT: The present study investigated the healing response of 12 fresh post-extraction alveolous grafted with particulate autologous teeth to achieve preservation of the post-extraction alveolar ridge. The objective is to elucidate the osteoconductive and osteoinductive properties of the autologous dental graft used as a bone substitute in the alveolar ridge preservation technique. Five patients were included, with at least one hopeless tooth and in need of extraction and preservatio n of the ridge, to receive in the same place a dental implant in prosthetic replacement. In the first surgical stage, dental extractions and preservation of the alveolar ridge were performed, using the teeth extracted and processed with an automatic system as bone substitutes. In the second surgical stage, an incisional bone biopsy was performed in each grafted site, the bone beds were recapitulated in a drilling protocol that allowed the placement of the dental implant, and the harvested bone specimens were prepared for analysis. The histological results of the bone biopsies in all cases showed remnant particles of the dental graft, made up of dentin, partially resorbed, with irregular superficial edges and in close contact with newly forme d bone in transition to mature lamellar bone, in which well differentiated osteocytes were observed. The immunohistochemical results showed a moderate positive expression of osteopontin at the edges of the integrated teeth particles, inside the peritubular dentin space and at the osteodental contact interfaces. In conclusion, the evidence from the study shows that the autologous dental graft is a biocompatible bone substitute, that provides an osteoconductive scaffold that promotes bone cell adhesion and migration for local osteogenesis and that it is associated with moderate in situ expression of osteopontin, which showed a high affinity with mineralized dental tissue, suggesting osteoinductive properties in situ.

RESUMEN: El presente estudio investigó el resultado cicatrizal de 12 alvéolos frescos postextracción injertados con dientes autólogos particulados para lograr la preservación del reborde alveolar postextracción. El objetivo es dilucidar las propiedades osteoconductivas y osteoinductivas del injerto dental autólogo utilizado como sustituto óseo en la técnica de preservación de reborde. Se incluyeron 5 pacientes, con al menos un diente sin esperanza y con necesidad de extracción y preservación del reborde, para recibir en el mismo sitio un implante dental en sustitución protésica. En la primera etapa quirúrgica, se realizaron las extracciones dentales y la preservación del reborde alveolar, utilizando como sustituto óseo los dientes extraídos y procesados con un sistema automático. En la segunda etapa quirúrgica, se realizó una biopsia ósea incisional en cada sitio injertado, los lechos óseos fueron recapitulados en un protocolo de fresado que permitió la colocación del implante dental y los especímenes óseos recolectados fueron preparados para su análisis. Los resultados histológicos de las biopsias óseas en todos los casos mostraron partículas remanentes del injerto dental, conformadas por dentina, parcialmente reabsorbidas, con margenes superficiales irregulares y en estrecho contacto con depósitos de hueso de reciente formación en transición hacia hueso laminar maduro, en el cual se observaron osteocitos bien diferenciados. Los resultados inmunohistoquímicos mostraron una expresión positiva moderada de osteopontina en los bordes de las partículas del injerto dental integrado, al interior del espacio peritubular dentinario y en las interfases de contacto osteodental. En conclusión, la evidencia del estudio muestra que el injerto dental autólogo es un sustituto óseo biocompatible, que provee un andamio osteoconductivo promotor de la adhesión y migración de las células óseas para la osteogénesis local y que está asociado a la expresión modera in situ de osteopontina, la cual mostro una alta afinidad con el tejido dental mineralizado, sugiriendo propiedades osteoinductivas in situ.

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BACKGROUND: Alveolar bone loss can occur as a result of aggressive maneuvering due to iatrogenic trauma during teeth extraction or due to normal post-extraction socket healing. Tooth if used as a whole grafting material then successful osteoconductive remodeling can be expected because low-crystalline apatite is the main minerals in bone tissue. A study was conducted in the department of oral and maxillofacial surgery focused on the potential for osteoconduction, osteoinduction, and osteogenesis by growth factors in the tooth and related histogenesis between the tooth and bone. Radiographic evaluation of alveolar ridge preservation was performed using a 3D imaging technique as well as histologically using Autogenous fresh mineralized tooth graft prepared at the chairside. RESULTS: A total of 30 patients were included in the study. The data was subjected to statistical analysis and the comparison of quantitative data was done using paired t-test. CONCLUSION: The outcome of this study suggests that chair side autogenous tooth graft can be used for socket survival, sinus and ridge augmentation as it is less time consuming, easy to prepare, with lower bone resorption speed, osteoinduction, osteoconduction, osteogenetic properties, and excellent primary implant stability.

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Reconstruction of the alveolar cleft is very important for providing both aesthetic as well as functional benefits to the patients with cleft lip and palate. The autogenous iliac crest is the most widely used bone graft in SABG procedures. There are very few published studies in the literature where tooth as an autogenous graft is used in dentoalveolar defects. Through the medium of this article, we present a novel idea of the tooth as a graft in a 20-year-old male patient with bilateral cleft alveolus. Grafting of the bilateral cleft alveolus was done by using an autogenous graft from the teeth which were indicated for extraction. The patient was monitored at 1-week, 1-month, and 6-month intervals postoperatively. On the Bergland scale, the bone graft of Type I was seen on the right side as the interdental bone level was normal and Type II was seen on the left side as the interdental bone level was greater than three-quarters of normal height. The result of this report proves that autogenous tooth graft is equally effective as compared to the other options available today. The postoperative complications are also minimal with no donor site morbidity.

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The aim of this study was to evaluate the effect of autogenous tooth bone graft (ATBG) combined with platelet-rich fibrin (PRF) on bone healing in rabbit peri-implant osseous defects. Eighteen New Zealand rabbits were divided into 3 groups. Bone defects were prepared in each rabbit, and then an implant cavity was created in the defects. Dental implants were placed, and the peri-implant bone defects were treated with the following 3 methods: no graft material was applied in the control group, bone defects were treated with ATBG in the ATBG group, and bone defects were treated with ATBG combined with PRF in the ATBG+PRF group. After 28 days, the rabbits were sacrificed, and the dental implants with surrounding bone were removed. New bone formation and the percentage of bone-to-implant contact (BIC) were determined with histomorphometric evaluations. New bone formation was significantly higher in the ATBG+PRF group than the control and ATBG groups (P < .05). In addition, BIC was significantly higher in the ATBG+PRF group than in the control and ATBG groups (P < .05). The combination of ATBG with PRF contributed to bone healing in rabbits with peri-implant bone defects.

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BACKGROUND: The histological and histomorphometrical results were evaluated between vital whole and non-vital endodontically treated teeth used as autologous grafts in post-extractive socket preservation procedures. METHODS: Twenty-eight patients (average age 51.79 ± 5.97 years) with post-extractive defects were enrolled in five dentistry centers. All patients were divided into two groups: with whole teeth (Group 1) and teeth with endodontical root canal therapy (Group 2). The extracted teeth were processed with the Tooth Transformer device to obtain a demineralized and granulated graft material used with a resorbable collagen membrane for socket preservation. After four months, 32 bone biopsies were obtained for histological, histomorphometric, and statistical analysis. RESULTS: During the bone healing period, no infection signs were observed. Nineteen biopsies in group 1 and 13 biopsies in group 2 were detected. The histological analysis showed neither inflammatory nor infective reaction in both groups. Autologous grafts surrounded by new bone were observed in all samples and, at high magnification, partially resorbed dentin and enamel structures were detected. No gutta-percha or cement was identified. Small non-statistically significant differences between the groups, in total bone volume (BV), autologous graft residual, and vital bone percentage were detected. CONCLUSIONS: The study showed that the TT Transformer grafts were capable of producing new vital bone in socket preservation procedures. The histomorphometric results showed no statistical differences comparing whole and endodontically treated teeth in bone regeneration. Further studies will be carried out in order to understand the advantages of the autologous graft materials obtained from the tooth compared with the current biomaterials in bone regeneration treatments.

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Alveolar ridge deficiency hampers placement of dental implants in functionally optimal position. This warrants hard-tissue augmentation using bone grafts. Lately, the use of autogenous tooth bone graft material is gaining a momentum. However, tedious and time-consuming chair-side preparation limits its use. Allograft using human extracted teeth can be a better alternative to tackle these practical issues. Hence, we prepared "Whole Human Tooth Allograft (whole tooth allograft [WTA])" following standard protocols of tissue bank at Tata Memorial Hospital, Mumbai, India. The efficacy of WTA was evaluated in a 43-year-old patient who reported with Seibert Class-III alveolar ridge deficiency in the right maxillary canine region. Three-dimensional changes were evaluated on clinical and radiographic parameters at baseline and at 4-month follow-up. A clinicoradiographic comparative analysis of height and width measurements revealed a successful three-dimensional alveolar ridge augmentation. The finding of the present case report underscores clinical safety and good bone-forming potential of WTA.

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The aim of the study was to evaluate the chemical composition of crushed, extracted human teeth and the quantity of biomaterial that can be obtained from this process. A total of 100 human teeth, extracted due to trauma, decay, or periodontal disease, were analyzed. After extraction, all the teeth were classified, measured, and weighed on a microscale. The human teeth were crushed immediately using the Smart Dentin Grinder machine (KometaBio Inc., Cresskill, NJ, USA), a device specially designed for this procedure. The human tooth particles obtained were of 300⁻1200 microns, obtained by sieving through a special sorting filter, which divided the material into two compartments. The crushed teeth were weighed on a microscale, and scanning electron microscopy (SEM) evaluation was performed. After processing, 0.25 gr of human teeth produced 1.0 cc of biomaterial. Significant differences in tooth weight were found between the first and second upper molars compared with the lower molars. The chemical composition of the particulate was clearly similar to natural bone. Scanning electron microscopy⁻energy dispersive X-ray (SEM⁻EDX) analysis of the tooth particles obtained mean results of Ca% 23.42 0.34 and P% 9.51 0.11. Pore size distribution curves expressed the interparticle pore range as one small peak at 0.0053 µm. This result is in accordance with helium gas pycnometer findings; the augmented porosity corresponded to interparticle spaces and only 2.533% corresponded to intraparticle porosity. Autogenous tooth particulate biomaterial made from human extracted teeth may be considered a potential material for bone regeneration due to its chemical composition and the quantity obtained. After grinding the teeth, the resulting material increases in quantity by up to three times its original volume, such that two extracted mandibular lateral incisors teeth will provide a sufficient amount of material to fill four empty mandibular alveoli. The tooth particles present intra and extra pores up to 44.48% after pycnometer evaluation in order to increase the blood supply and support slow resorption of the grafted material, which supports healing and replacement resorption to achieve lamellar bone. After SEM⁻EDX evaluation, it appears that calcium and phosphates are still present within the collagen components even after the particle cleaning procedures that are conducted before use.

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The aim of this study is to compare the histological results after socket preservation between dentin mixed with xenograft and dentin alone in tooth graft procedure. Six patients were included in this prospective case series study and treated in three clinical centers using standardized clinical procedures. This clinical trial enrolled patients with three walls post-extractive defects requiring the restoration of bone dimension and shape in mandibular zone. The patients were divided in two groups: extracted teeth alone (first group) and extracted teeth mixed with equal quantity of xenograft (second group). The extracted tooth was cleaned and processed by a recently introduced automated device, that allows fragmentation and partial demineralization of the tooth matrix and used as graft material. The graft obtained in this way, was inserted at the time of the extraction. A covering membrane was used to protect the graft. Implants were placed after 4 months of healing. Bone biopsies of the all grafted sites were taken at the time of implant surgery, for histological analysis. Descriptive statistics was used to synthesize the results, using mean values and standard deviations. Six patients (5 women, mean age at surgery 50.3±12.1 years) were treated and after 4 months of healing both groups, grafts height appeared stable. No signs of infection were present. Bone biopsy were taken in all grafted sites (3 with group one and 3 with group two). The histologic analysis revealed no inflammatory or infective reaction against both groups. The histomorphometry results between the two groups are different. The first group show an amount of new bone greater than the second group (+85.29%) and minor quantity of residual graft (-83.59%). The dentin alone shows a larger amount of new bone.

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