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Investigation of Bone Augmentation using an Autologous Tooth as the Bone-graft Material: Application in a Hydroxyapatite-coating Implant


Authors:

Toshihiro Nakatsuka, DDS, PhD – Med. Corp. Maitreya, Keikodo Oral & Dental Clinic

Abstract:

Purpose of the Study: Generally, autologous, xenogenic, and artificial bone grafts are used to fill bone defects during implant placement. I have recently used an autologous tooth as the bone-graft material (My Teeth Bone: MTB; Tooth Osteoplant graft: Top graft), which was crushed and processed from the patient’s own tooth. In this study, I report cases of an autologous tooth bone graft, which was applied to a hydroxyapatite-coating implant (HA implant) and showed favorable results.

Methods: Preparation of an autologous tooth bone graft: Soft tissues adhering to the autologous tooth extracted from a patient were removed as much as possible. The autologous tooth was washed thoroughly with saline and crushed using a crusher to 250–1000 μm. The crushed tooth was immersed into a 0.6-M hydrochloric acid solution and demineralized using a dedicated machine (Top Graft MaterializerTM, GeoMedi, Fukuoka, Japan) in vacuum while leaving the growth factors. Subsequently, the demineralized tooth was washed and finished into a bone substitute (MTB/Top Graft). MTB/Top Graft was filled in the bone defects at the time of HA-coating implant (AQB TM, ADVANCE, Tokyo, Japan) placement. We investigated a total of 32 cases (18 men and 14 women; 13 in the anterior region, 8 in the premolar region, and 11 in the molar region of the jaws) from November 2016 to February 2019.

Results: The results showed that the treatment period was shortened in all cases treated with MTB/ Top Graft. To date, the postoperative course in all the cases have been uneventful, with no bone resorption or infection.

Conclusion: The MTB/Top Graft appears to have a highly osteoconductive potential, as it is a bone graft processed from the autologous tooth (the patient’s own tooth). Similarly, good results were seen in cases using MTB/Top Graft during Dennis P Tarnow's ice cream cone technique (USA) and Homa Zadeh's vestibular incision subperiosteal tunnel access method for bone augmentation (South Korea). Bone formation must be promoted because of the synergistic effect between this material and a HA-coated implant, which is an osteoconductive material. Comparative studies on this material applied to other types of implant materials are needed. The sample size was small, and clinical data were statistically insufficient. Further studies on more patients are needed for widespread clinical use.

Articles: 1. Sarala C, Chauhan M, Sandhya PS, Dharmendra CH, Mitra N. Autogenous tooth bone graft: Ingenious bone regeneration material. Indian J Dent Sci. 2018; 10: 56−59. 2. Kim ES. Autogenous fresh demineralized tooth graft prepared at chair side for dental implant. Maxillofac Plast Reconstr Surg. 2015; 37: 8. 3. Kim YK, Pang KM, Yun PY, Leem DH, Um IW. Long-term follow-up of autogenous tooth bone graft blocks with dental implants. Clin Case Rep. 2017; 5: 108−118.

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