Human Dentin Autograft into Atrophied Jaw for Implant Placement

In 1967, a bone-inducing property was discovered in the intramuscular pockets of rabbit dentin. We confirmed the osteoinductive property of human demineralized dentin matrix (DDM) granules in the subcutaneous tissue of nude mice (male, 4 wks old). Until now, human pioneering trials (10 cases) with autogenous DDM have been proceeding successfully. Clinical studies have been approved by the Ethics Committee in the Health Sciences University of Hokkaido.

Objective: To report a human pioneering trial following the auto-transplantation of DDM for bone augmentation in an atrophied upper jaw.

Methods: Patient: A 58-year-old female presented with missing teeth (#12-#22). A clinical examination revealed an atrophied upper jaw. Her medical history was unremarkable. The autogenous DDM was obtained from a non-functional vital tooth (#17) and prepared by our newly developed crash machine. The DDM was confirmed by bacteriological examination to be bacteria-free.

Surgery: Split osteotomy and cortical perforations were performed in the atrophied jaw, and the autogenous DDM was transplanted to the treated bone. At 4 months post-surgery, 3 fixtures (Synchro Stepped Screw Type - diameter, 3.4 mm; length, 11 mm; FRIADENT) were implanted, with the FRIALIT-2 implant system, into the augmented bone while the patient was under local anesthesia. .

Results: The DDM granules were received by the host, and biological width (4-6 mm) was achieved. The DDM residues were partially observed during the implant placement. Bone biopsy revealed that the DDM were remodeled by bone at 4 months. This patient was successfully restored with dental implants after the DDM autograft.

Conclusion: Human DDM granules from vital teeth are collagenous matrices with osteoinductive potential, and the human dentin can be ‘recycled' as autogenous biomaterials for local bone engineering.

Study supported by METI, JST, and Hokkaido grants, Japan.