Short‐term outcomes of staged lateral alveolar ridge augmentation using autogenous tooth roots. A prospective controlled clinical study

Abstract

Objectives To assess the short‐term clinical outcomes of lateral alveolar ridge augmentation using autogenous tooth roots (TR) and autogenous bone blocks (AB). Material and Methods A total of n = 23 patients (23 implants) were available for the analysis. Each subject was allocated to lateral ridge augmentation using either (a) healthy autogenous tooth roots (e.g., retained wisdom or impacted teeth; n = 13) or (b) cortical autogenous bone blocks harvested from the retromolar area (n = 10). Clinical parameters (e.g., bleeding on probing—BOP, probing pocket depth—PD, mucosal recession—MR, clinical attachment level—CAL) were recorded at (V8) and after 26 ± 4 weeks (V9) of implant loading. Results TR and AB groups were associated with comparable (p > 0.05) changes in mean BOP (−23.0 ± 34.3%; −11.75 ± 24.9%), PD (−0.03 ± 0.14 mm; −0.1 ± 0.29 mm), MR (0.0 ± 0.0 mm; 0.0 ± 0.0 mm) and CAL (−0.03 ± 0.14 mm; −0.1 ± 0.29 mm) values. The regression analysis failed to reveal any significant correlations between changes in BOP and PD values and the initial as well as the ridge width measured at 26 weeks. Conclusions TR and AB were associated with comparable clinical short‐term outcomes.

Cleaning Teeth Reduces the Inflammatory Response of Macrophages to Acid Dentine Lysate

“…In the clinical scenario, caries-free, partially or fully retained or impacted wisdom teeth without signs of local pathologies are used for auto transplantation. These teeth are not or only marginally contaminated with plaque, as canines, premolars and molars were also used for preparing block grafts [2,7]. Importantly, periodontally diseased tooth roots were applied for lateral alveolar ridge augmentation, at least in a canine model [6].…”

“…We could not standardize the level of plaque from the extracted pig teeth, thus not representing the clinical situation prior to a tooth extraction were preferentially clean teeth previously impacted in the jaw bone are used [2,7]. Future studies should include human ADL following the established protocols to rule out any possible contamination with endotoxins [2,7]. We also have not standardized the mechanical cleaning of extracted teeth with a toothbrush and toothpaste, however we try to do the cleaning for at least 15 min.…”

“…Autologous tooth roots have gained increasing attention for oral bone augmentation [1] and were systematically investigated for lateral augmentation in deficient extraction sockets [2] and ridges prior to implant placement [3]. This clinical concept is based on radiological analyses [4,5], case reports [6,7] and preclinical studies [8][9][10]. These studies support the clinical use of autologous tooth roots and particularly dentine as a graft material for bone augmentation.…”

“…The clinical principle is based on the similarities of dentine and bone; both being mineralized tissues, osteoconductive and subjected to bone remodeling during the course of graft consolidation. Thus, dentine in the same way as bone serves as a grafting material; however, in contrast to bone that is protected by the soft tissue, the tooth crown and potentially also parts of the root dentine are exposed to the oral cavity [2,7]. It can thus not be ruled out that at least a contaminating microbiome is co-transplanted with the teeth roots [11,12].…”

The Use of Autogenous Teeth for Alveolar Ridge Preservation: A Literature Review

“…One study performed lateral alveolar ridge augmentation comparing the use of autogenous tooth roots versus the use of autogenous bone blocks [62]. In this particular study, after 26 weeks of healing, the implants were placed with no significant difference between groups (p > 0.05) in terms of primary implant stability quotient [62].…”