Description
Grafting materials must be safe, biocompatible and able to guarantee lasting results. Among the fundamental features of the ideal material is the ability to promote bone regeneration. The autologous tooth is a very promising candidate because it allows osteoinduction and its maintenance after the treatment. After examining the current scientific evidence and studies carried out at the Politecnico di Milano (Milan, Italy), The tooth as a graft provides an overview of all the aspects of bone regeneration and the various devices available on the market are presented and compared, their use explained step-by-step, from cleaning the tooth to the grinding, to the treatment of the material before grafting.
Authors:
- Flavio Pisani DDS, PhD Spec in Oral Surgery, MSc in Periodontics, MSc in Implant Dentistry Senior Clinical Lecturer in Periodontology Programme Lead MSc in Clinical Periodontology, University of Central Lancashire (UK)
- Elio Minetti Adjunct Professor, Department of Biomedical, Surgical and Dental Sciences, University of Milan
Table of contents:
Chapter 1
- Vascular anatomy of the maxillaries in relationship to bone regenerative procedures ................................................ 1
- Taschieri, S. Corbella
- Introduction................................................. 1
- Carotid artery ............................................... 2
- Maxillary artery ............................................. 2
- Upper and lower jaw ........................................ 4
- Vascularization of the maxillary sinus . . . . . . . . . . . . . . . . . . . . . . 4
- Vascularization of the anterior jaw........................ 6
Chapter 2
- Fundamentals of oral implantology . ........ 9
- Corbella, S. Taschieri
- Introduction................................................. 9
- Characteristics of the subject ............................... 10
- Surgical procedure .......................................... 13
- Timing of implant placement ............................... 14
- General characteristics of the prosthesis and timing of prosthetic loading...................................... 15
- Implant complications ...................................... 15
Chapter 3
- Guided bone regeneration: rationale and fundamental concepts............. 19
- Minetti
- Development and structure of bone. Types of bone and structural organization............................... 19
- Composition of the bone .................................... 20
- Bone matrix. Cortical bone, medullary bone, lamellar bone, immature bone ........................... 22
- Guided Bone Regeneration (GBR)........................... 24
- Bone growth factors......................................... 26
- Scaffold ...................................................... 27
- Dentin ....................................................... 31
Chapter 4
- The tooth as a source of bone graft ...........33
- Minetti
- Embryogenesis and tooth structure ........................ 33
- Tooth development .......................................... 36
- Mineralization of dental tissues............................. 36
- Enamel....................................................... 38
- Dentin ....................................................... 39
- Cementum................................................... 40
- History and literature review............................... 40
Chapter 5
- In vitro studies with dental materials................................ 61
- Minetti
- Analysis of the type of grinding............................. 61
- Liquid evaluation............................................ 62
- Dentin treatment procedure chosen after the tests carried out ................................. 74
- Bacterial load test ........................................... 75
- Evaluation of the volume needed to completely remove active liquids (HCl and H2O2) .................................... 76
- Deciduous tooth treatment ................................. 78
- Tooth weight ................................................ 81
Chapter 6
- Tools and procedures for processing bone substitute from dental origin..................................... 85
- Minetti
- Proposed procedures........................................ 85
- Devices on the market ...................................... 87
- Protein denaturation........................................ 92
- CE marking .................................................. 94
Chapter 7
- Histological characteristics of the bone substitute of dental origin: scientific evidence .................................... 97
- Biomedical aspects of cyto-histology of bone tissue ... 97
- Casasco, M. CasascoHistology of the bone tissue................................. 97
- Histological methods of studying bone tissue . . . . . . . . . . . . . . 98
- Specific cells of bone tissue ................................. 99
- Composition of the fundamental substance of the bone ... 100
- The bone lamella, an elementary structure of the bone tissue ...................................................... 101
- Histogenesis of bone tissue.................................. 101
- How bone mineralization occurs ........................... 103
- The plasticity of bone tissue and its clinical implications............................... 104
- Review of published articles with histological examples .................................................... 105
- Minetti - Examples of histological material of dental origin...... 105
- Savadori - Preliminary data from ongoing studies.................. 112
- Minetti
- Analysis over time (<4 months, 4-6 months, >6 months) . .... 112
- Analysis by operator . ....................................... 113
- Analysis by surgical technique. Membranes and platelet derivatives . ................................................ 113
- Distribution of the results of histomorphometric analysis ... 113
- Comparison of resorption with other materials mixed with the tooth ...................................... 122
- Minetti
- Radiographic images . ....................................... 124
- Clinical cases . ........................................... 131
- Beca Campoy, F. Bromuri, M. Contessi, U. Gambardella, E. Giacometti,H.K.L. Ho, M. Libertucci, E. Minetti, J. Santillana, J. Schmitz
- Alveolar preservation...................................... 132
- Alveolar preservation with membrane . .................... 132
- Clinical case 1............................................ 132
- Clinical case 2 ........................................... 135
- Alveolar preservation with membrane, platelet derivatives . ....................................... 137
- Clinical case 3 . .......................................... 137
- Clinical case 4 ........................................... 140
- Alveolar preservation without membrane . ................ 143
- Clinical case 5 ........................................... 143
- Clinical case 6 ........................................... 145
- Crest preservation . ........................................ 148
- Ridge preservation with membrane . ....................... 148
- Clinical case 7 ........................................... 148
- Clinical case 8 ........................................... 151
- Clinical case 9 ........................................... 153
- Clinical case 10 .......................................... 155
- Clinical case 11 .......................................... 157
- Clinical case 12 . ......................................... 159
- Ridge preservation with membrane, platelet derivatives . ....................................... 162
- Clinical case 13 . ......................................... 162
- Clinical case 14 . ......................................... 164
- Clinical case 15 . ......................................... 166
- Sinus lift .................................................... 169
- Clinical case 16 .......................................... 169
- Clinical case 17........................................... 171
- Tunnel technique........................................... 173
- Clinical case 18 . ......................................... 173
- Periodontology............................................. 176
- Clinical case 19 .......................................... 176
- Alveolar preservation with protective polypropylene support . ................................... 178
- Clinical case 20 . ......................................... 178
- Appendix . ................................................. 181
- Conclusions .............................................. 187
