We present some clinical cases of autogenous tooth graft - a modern method in which the extracted teeth are processed into a demineralised dentin matrix (DDM) and are then immediately transplanted into the post-extraction sockets or bone defects. We included patients with jaw lesions due to chronic inflammatory conditions, cystic formations, or peri-implantitis. After removing the pathological processes and tissues, we performed curettage with an Er-YAG laser and treated the bone structures in the borderline area. Then auto-tooth bone (ATB) graft material was applied. The clinical results showed favourable wound healing and good bone integration of implants. Radiological studies showed stimulation and acceleration of bone regeneration with alveolar crest resorption of graft material of no more than 10%. Histological examination found new bone formation which was induced by the osteo-inductive material. On the basis of the clinical outcomes and the favourable healing process with a very good bone integration of the DDM, we can recommend this method as an option for bone defect reconstruction. The satisfactory quantity (up to 3 grams per molar) and quality of the demineralised dentin matrix determine a relatively low cost of bone grafting.

The placement of dental screw implants typically involves the use of rotary techniques and drills to create a bone bed. This study explores the potential benefits of combining this method with an Er:YAG laser. Split osteotomies were performed on 10 jaws of euthanized domestic pigs (Sus scrofa domestica), with 12 mandibular implant osteotomies in each jaw, divided into 4 groups. In order to make a comprehensive assessment of the effect of Er:YAG lasers, histomorphological techniques were used to measure the reduction in amorphous layer thickness after Er:YAG laser treatment, both with and without the placement of dental screw implants from different manufacturers. Following bone decalcification and staining, the thickness of the amorphous layer was measured in four groups: Group A—osteotomy performed without Er:YAG laser treatment—had amorphous layer thicknesses ranging from 21.813 to 222.13 µm; Group B—osteotomy performed with Er:YAG laser treatment—had amorphous layer thicknesses ranging from 6.08 to 64.64 µm; Group C—an implant placed in the bone without laser treatment—had amorphous layer thicknesses of 5.90 to 54.52 µm; and Group D—an implant placed after bone treatment with Er:YAG laser—had amorphous layer thicknesses of 1.29 to 7.98 µm. The examination and photomicrodocumentation was performed using a LEICA DM1000 LED microscope (Germany) and LAS V 4.8 software (Leica Application Suite V4, Leica Microsystems, Germany). When comparing group A to group B and group C to D, statistically significant differences were indicated (p-value = 0.000, p < 0.05). The study demonstrates the synergistic effects and the possibility of integrating lasers into the conventional implantation protocol. By applying our own method of biomodification, the smear layer formed during rotary osteotomy can be reduced using Er:YAG lasers. This reduction leads to a narrower peri-implant space and improved bone-to-implant contact, facilitating accelerated osseointegration.

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