Dentin matrices for bone regeneration in the maxillofacial region: a review of clinical and experimental evidence

Relevance . Materials derived from extracted teeth are increasingly used as alternatives to autogenous bone to manage alveolar bone deficiencies before dental implant placement, particularly for socket preservation and localized ridge augmentation. The term “dentin matrix” encompasses autogenous, allogeneic, and xenogeneic materials prepared using different protocols. Despite the large number of published systematic reviews and meta-analyses, findings remain heterogeneous because of differences in material composition, indications, and follow-up duration. Objective . To evaluate the effectiveness of dentin matrices by material origin, preparation method, and clinical indication based on clinical and experimental studies. Materials and methods . A structured, analytical literature review was conducted. The initial search covered publications from 2012–2024 in PubMed/MEDLINE, Google Scholar, and eLibrary. English and Russian search terms were used individually and in combination. All search terms are presented here in English: “dentin matrix,” “demineralized dentin matrix,” “demineralized dentin,” “autogenous tooth graft,” “autogenous dentin,” “allogeneic dentin,” “socket preservation,” “alveolar ridge preservation,” “guided bone regeneration,” “dental implant,” and “dental implant placement.” The initial search identified 238 records; 20 publications were included in the analysis after duplicate removal and screening against the inclusion criteria. During manuscript revision, the search was updated to include 8 additional publications from 2022–2026. Reports from the same clinical research program were not treated as independent samples, and no meta-analysis was performed. Manufacturer-provided information unsupported by independent clinical data was not considered evidence of effectiveness. Results . The largest body of evidence was available for autogenous dentin in socket preservation. In a network meta-analysis of 25 randomized trials involving 710 patients and 830 extraction sockets, autogenous dentin particles reduced ridge width loss by 1.67 mm compared with spontaneous healing (95% confidence interval: 0.81–2.54). The proportion of newly formed bone did not differ from that achieved with xenogeneic, allogeneic, or synthetic materials; the certainty of evidence was moderate or low. For sinus floor augmentation, the proportion of vital bone at 4–6 months was 21.5– 36.3%, and implant survival rates were 97–100%. These findings, however, were derived predominantly from case series (7 studies, 128 patients). Allogeneic dentin has been less extensively studied, and no direct clinical comparisons are available for xenogeneic dentin. High-speed grinding results in a loss of 53.5±9.9% of tooth mass, compared with 9.2±2.3% with low-speed grinding. The bone morphogenetic protein 2 (BMP-2) content of the material decreases when extracted teeth are stored at room temperature. Conclusion. Autogenous dentin is a reasonable graft material for socket preservation and repair of small alveolar ridge defects. Findings obtained using one preparation protocol cannot automatically be extrapolated to other dentin materials. Prospective multicenter studies are needed, with preregistered protocols and at least 3–5 years of follow-up after implant loading. These studies should assess clinically relevant outcomes, including implant survival, changes in marginal bone levels, and the need for repeat augmentation, and report the grinding method, degree of demineralization, sterilization method, and tooth storage conditions.