Analysis Of Short-term Clinical Effect Of Autotooth-Bone-Grafts-Case Series Study

Objective:With the development of dental implantology and biological materials,implant restorations become the first choice for partially or totally edentulous.Researches have suggested that the dimensional change of an alveolar ridge is inevitable over time after tooth extraction.More than half of implant sites has insufficient available bone which have been recommended for the rehabilitation of resorbed alveolar ridges during implant placement or by stage.Currently,there are various bone graft materials includes autogenous bone,allograft,xenograft,and synthetic graft,all of these has their respective shortcomings that making limited clinical application.Autotooth-bone-graft material is an innovative bone graft material which its very similar components to bone.In addition,it has osteoinduction,osteoconduction,and creeping substitution capacities.The aim of this study was to observe the clinical effectiveness of autotooth-bone-graft prepared at the chairside for alveolar bone augmentation during dental implant surgery and socket preservation.Methods:Twenty-nine patients who received bone augmentation and socket preservation using autotooth-bone-graft from Dec.2014 to Feb.2016 were evaluated.A total of fifty implants were placed which received function loading at least six months.We clinically and radiologically evaluated cases in the day of surgery and termination of study.Meanwhile,the patients' satisfaction degree and dental implant success rates were recorded.The characteristics of autotooth-bone-graft were evaluated by scanning electron microscopy and raman spectroscopy.According to the different operations(GBR,sinus augmentation,socket preservation),we discussed the clinical efficacy of autotooth-bone-graft,respectively.The augmented bone stability was analysised by CBCT,and histological studies were conducted for socket preservation cases.We also observe whether those Factors of interest Will affect the clinical outcome including processing method/material status/mixed with Bio-Oss based on the CBCT.Results:1.SEM visualized DATB surfaces with widened dentinal tubules and the loose structure.As for NDATB,it shows more compact and small particles of dentin in its surface.2.The PO4-3?1 and amide I levels of NDATB were higher than those of DATB with no statistical significance.The Full-width half-maximal(FWHM)of PO4-3?1 of NDATB was 31.60±0.82 cm-1 whereas that of DATB was 20.65±2.58 cm-1 at a significantly difference.3.The total implant success rates is 98%.Among with all patients,24 patients were completely satisfied with the overall experience and clinical effects,4 patients were basically satisfied and 1 failed case was dissatisfied.4.As for investigating the influence factors on efficacy of autotooth-bone-graft used in GBR,a set of results can be obtained: the amounts and percents of graft resorption and marginal bone resorption of the NDATB group were lower than those of the DATB group,no statistically significant differences were found.There were no significant differences in aforementioned variables between caries,periodontitis,combined periodontic-caries lesions.and health teeth.The mean percents volume reduction after healing in the autotooth-bone-graft with Bio-Oss group(25.01±3.30%)were significantly lower than those of the autotooth-bone-graft group(39.82 ±11.58%).Although the marginal bone resorption showed no statistically significant differences.5.The mean volume of the grafts was reduced by 11% in maxillary sinus augmentation after 8 months of function loading,and the marginal bone resorption was 0.24 mm.6.the alveolar ridge contour within 4 months after socket grafting kept constant,but changed remarkably after function loading.Histological examination revealed there was no sign of chronic inflammation in grafted site.A large amounts of osteoblasts were found in DATB site,and the material had integrated strongly with the newly formed bone which has also remolded into lamellar bone.NDATB particles were enclosed in connective tissue and the osteoblasts,newly formed bone were also observed.Conclusions:Chairside preparation of autotooth-bone-graft after extraction can be a new alternative to the use of autogenous bone or other synthetic graft materials for reconstruction of alveolar bone defects or socket preservation due to it's favourable ossification.In clinically,using this with the Bio-Oss graft may show more resistant to resorption,which ensure a good long-term clinical outcomes.