A Novel Procedure to Process Extracted Teeth for Immediate Grafting of Autogenous Dentin

Background: Extracted teeth are still considered a clinical waste and therefore being discarded. It is evident that chemical composition of dentin is similar to bone. Following tooth replantation the tooth is replaced by bone then followed by root resorption and ankyloses and finally integrated into the surrounding alveolar bone. Aims: Here we present a novel procedure in a clinical setting that employs freshly extracted teeth that are processed into a bacteria-free particulate dentin, and then grafted immediately into extraction sites or bone deficiencies. Methods: The procedure consists of reducing any restorations, caries or debris. The clean and dry tooth, mostly dentin, is immediately grinded using a specially designed 'Smart Dentin Grinder'. The dentin particulate of 300-1200 um is sieved through a special sorting system. The sorted particulate dentin is immersed in basic alcohol cleanser in a sterile container to dissolve all organic debris and bacteria. Then, the particulate is washed by sterile saline. The bacteria-free particulate dentin is ready for immediate grafting into extraction sites or into bone defect sites. Results: During the period of two years, more than 100 procedures were performed, most of which for the purpose of preservation of alveolar bone. In those patients, implant insertion was possible as soon as 2-3 month after grafting of autogenous dentin. On x-rays and biopsy of grafting sites a dense dentin-bone composite was found. No wound healing complications were observed. Conclusion: Autogenous mineralized dentin particulate grafted immediately after extractions should be considered as the gold standard for socket preservation, bone augmentation in sinuses and bone defects.