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Dentin autograft for socket preservation
Posted on 09.24.2020 07:30 AM By snjezana pohl In Bone Grafting
The patient (heavy smoker) was referred for extractions of non-restorable teeth and implant placement. Due to the defects in the left upper maxilla, immediate implant placement was not an option for me. Limited bone amount apical-palatal in the canine area would jeopardize the primary implant stability and Glocker procedure (socket shield with delayed implant placement) would have been an option. With residual bone height 4-5 mm in the posterior maxilla, a two-stage sinus lift was not necessary. Nevertheless, we decided to perform sinus elevation together with teeth extractions and sockets grafting, in order to prepare implant sites for immediate loading. Sockets preservation was done utilizing partially demineralized dentin covered with PRF membranes. CBCT superimposition shows absolutely satisfactory ridge dimension maintenance, the ridge appearance at re-entry similar to the native bone. The final image and x-ray are taken this week, one year after the treatment was finished.
snjezana pohl says on 09.24.2020 07:31 AM
One year follow up.
Haakon Kuit638 says on 10.21.2020 03:46 AM
Great case Snjezana!
My question is how long does the whole grinding process takes? so from grinding the teeth to demineralize it for use.
snjezana pohl says on 10.21.2020 01:18 PM
Dear Haakon, it is nice to meet you here:)
Cleansing: 5 min, 2x washing, it is 7 minutes. Partial demineralization is optional and it takes additional 2 minutes. Dentin is demineralized with EDTA. Only the surface is demineralized, exposing the organized matrix. Here SEM image showing partially exposed dentin particles.
George Kotsakis says on 10.25.2020 12:29 PM
Magnificent case and documentation as always!! I want to know more about indications for non-demineralized vs. partially demineralized dentin. Do you feel that for type II sockets a combination may help with mechanical stability?
Petrônio Guimarães says on 10.21.2020 08:13 AM
This result is what we are all looking for. Great case and when I see it looks easy, but it is not! what the technique you used to obtain the sterile demineralized dentin? Thanks to show Dra.Snjezana! Petrônio Guimarães
snjezana pohl says on 10.21.2020 01:23 PM
Dear Petronio, thank you so much. It was easy, indeed. Dentin grafted sites do not require primary closure and it makes the surgery very easy, both for the patient and clinician.
I utilized Kometabio for particulate dentin production. Dentin graft was partially demineralized with EDTA, it takes 2 minutes to get the surface demineralized. Completely demineralized dentin does not maintain the ridge volume very well, because it gets resorbed too fast.
It is a very simple and economical procedure.
Thank you for your comment.
Petrônio Guimarães says on 10.21.2020 04:48 PM
Snjezana thanks for your attention. Since I'm here at dental XP I'm learning a lot from your lectures and posts. Best regards. Petrônio Guimarães
snjezana pohl says on 10.23.2020 10:18 AM
Thank you, it means a lot! I have learned so much on Dental XP and I am still learning. The best place to learn and be updated!
Julia Makhija says on 06.22.2021 03:15 AM
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