Demineralized Dentin Matrix for Dental and Alveolar Bone Tissues Regeneration: An Innovative Scope Review

Abstract

Background: Dentin is a permeable tubular composite and complex structure, and in weight, it is composed of 20% organic matrix, 10% water, and 70% hydroxyapatite crystalline matrix. Demineralization of dentin with gradient concentrations of ethylene diamine tetraacetic acid, 0.6 N hydrochloric acid, or 2% nitric acid removes a major part of the crystalline apatite and maintains a majority of collagen type I and non-collagenous proteins, which creates an osteoinductive scaffold containing numerous matrix elements and growth factors. Therefore, demineralized dentin should be considered as an excellent naturally-derived bioactive material to enhance dental and alveolar bone tissues regeneration. Method: The PubMed and Midline databases were searched in October 2021 for the relevant articles on treated dentin matrix (TDM)/demineralized dentin matrix (DDM) and their potential roles in tissue regeneration. Results: Several studies with different study designs evaluating the effect of TDM/DDM on dental and bone tissues regeneration were found. TDM/DDM was obtained from human or animal sources and processed in different forms (particles, liquid extract, hydrogel, and paste) and different shapes (sheets, slices, disc-shaped, root-shaped, and barrier membranes), with variable sizes measured in micrometers or millimeters, demineralized with different protocols regarding the concentration of demineralizing agents and exposure time, and then sterilized and preserved with different techniques. In the act of biomimetic acellular material, TDM/DDM was used for the regeneration of the dentin-pulp complex through direct pulp capping technique, and it was found to possess the ability to activate the odontogenic differentiation of stem cells resident in the pulp tissues and induce reparative dentin formation. TDM/DDM was also considered for alveolar ridge and maxillary sinus floor augmentations, socket preservation, furcation perforation repair, guided bone, and bioroot regenerations as well as bone and cartilage healing. Conclusion: To our knowledge, there are no standard procedures to adopt a specific form for a specific purpose; therefore, future studies are required to come up with a well-characterized TDM/DDM for each specific application. Likely as decellularized dermal matrix and prospectively, if the TDM/DDM is supplied in proper consistency, forms, and in different sizes with good biological properties, it can be used efficiently instead of some widely-used regenerative biomaterials.

Dentin Particulate for Bone Regeneration: An In Vitro Study

“…These changes can affect gene expression, proteins, and lipids (e.g., phosphorylation events), can prompt protein degradation, intracellular translocation events, and the release of secreted factors, and can even alter a cell’s shape and size, among other effects. The challenge posed by these research findings is to identify which of these events are needed for mechanotransduction to occur and which events have few functional consequences for this process [ 63 , 64 , 65 ]. DP induces a mechanoinduction that takes effect on the stem cells’ commitment, stimulating both the osteogenic pathway (by means of WNT signaling, with the expression of miRNA26-27-32-586-885 and SMAD4) and odontogenic phenotyping (thanks to miRNA 200, miRNA 218, CREB and SMAD1).…”

Treated Dentin Matrix in Tissue Regeneration: Recent Advances

“…Dentin composes the major bulk of tooth hard tissue and serves the functions of protecting dental pulp and supporting enamel. It contains 70% mineral phase; 18% collagen; 2% non-collagenous proteins (NCPs), such as dentin matrix protein-1 (DMP-1), dentin sialoprotein (DSP) and dentinphosphoproteins (DPP); and 10% water [ 35 , 36 ]. The dentin matrix possesses abundant growth factors [ 33 ], such as basic fibroblast growth factor, insulin-like growth factor, transforming growth factor β and bone morphogenetic proteins [ 35 ], and resembles the bone matrix [ 26 ].…”

“…It contains 70% mineral phase; 18% collagen; 2% non-collagenous proteins (NCPs), such as dentin matrix protein-1 (DMP-1), dentin sialoprotein (DSP) and dentinphosphoproteins (DPP); and 10% water [ 35 , 36 ]. The dentin matrix possesses abundant growth factors [ 33 ], such as basic fibroblast growth factor, insulin-like growth factor, transforming growth factor β and bone morphogenetic proteins [ 35 ], and resembles the bone matrix [ 26 ]. In carious circumstances of demineralization, bacteria-produced acid would resolve hydroxylapatite of the dentin matrix, resulting in a loss of highly mineralized particles and degradation of the collagen matrix.…”

“…Moreover, this structure supports the nutrient and metabolic waste exchange in the tissue regeneration micro-environment. A root-shaped TDM usually applies to bio-root construction with a 10 mm length and 1 mm thickness, whereas particle-shaped TDM for hydrogel or paste fabrication has a diameter ranging from less than 40 μm to 2 mm [ 35 ]. Furthermore, with the prolonging of demineralization time, a treated dentin matrix showed nanoscale fissures among opened dentinal tubules [ 31 ], which is also favorable for carrying drug molecules that are to be released later.…”

“…A dentin matrix contains abundant collagen proteins [ 37 ]; non-collagen proteins, such as osteopontin, osteocalcin, dentin matrix protein, dentin phosphoprotein and dentin sialoprotein [ 38 ]; and growth factors, such as basic fibroblast growth factor, insulin-like growth factor and transforming growth factor β [ 35 ]. It also contains bone morphogenetic proteins (BMPs) [ 39 ].…”