Retrospective Study on Tooth Shell Technique Using Endodontically Treated Teeth in Lateral Ridge Augmentation

Autogenous dentin has been reported to be a suitable grafting material for certain indications. The purpose of this study was to assess the feasibility of using endodontically treated teeth for this application. In the present retrospective study, one-stage augmentation of lateral ridge defects with a dentin shell and particulate (tooth shell technique (TST)) either obtained from endodontically treated teeth (ETT, 17 patients with 21 implants) or non-endodontically treated teeth (NETT, 17 patients with 24 implants) were analyzed. Follow-up was conducted 3 months after augmentation. The target parameters were biological complications, horizontal hard tissue loss, osseointegration, and the integrity of the buccal lamella. Only minor complications occurred in three implants from three patients, including two cases of wound dehiscence (one each in ETT and NETT) and a localized three-walled defect in the NETT group, which was solved by re-augmentation. All the implants were osseointegrated and the integrity of the buccal lamella was preserved. The mean difference of the resorption of the crestal width and the buccal lamella did not differ statistically between the two groups. As TST using ETT showed, the results comparable to those of NETT dentin from endodontically treated teeth can be safely applied with predictable results for this grafting technique.

Retrospective Study: Lateral Ridge Augmentation Using Autogenous Dentin: Tooth-Shell Technique vs. Bone-Shell Technique

In the literature, autogenous dentin is considered a possible alternative to bone substitute materials and autologous bone for certain indications. The aim of this proof-of-concept study was to use autogenous dentin for lateral ridge augmentation. In the present retrospective study, autogenous dentin slices were obtained from teeth and used for the reconstruction of lateral ridge defects (tooth-shell technique (TST): 28 patients (15 females, 13 males) with 34 regions and 38 implants). The bone-shell technique (BST) according to Khoury (31 patients (16 females, 15 males) with 32 regions and 41 implants) on autogenous bone served as the control. Implants were placed simultaneously in both cases. Follow-up was made 3 months after implantation. Target parameters during this period were clinical complications, horizontal hard tissue loss, osseointegration, and integrity of the buccal lamella. The prosthetic restoration with a fixed denture was carried out after 5 months. The total observation period was 5 months. A total of seven complications occurred. Of these, three implants were affected by wound dehiscences (TST: 1, BST: 2) and four by inflammations (TST: 0, BST: 4). There were no significant differences between the two groups in terms of the total number of complications. One implant with TST exhibited a horizontal hard tissue loss of 1 mm and one with BST of 0.5 mm. Other implants were not affected by hard tissue loss. There were no significant differences between the two groups. Integrity of the buccal lamella was preserved in all implants. All implants were completely osseointegrated in TST and BST. All implants could be prosthetically restored with a fixed denture 5 months after augmentation. TST showed results comparable to those of the BST. Dentin can therefore serve as an alternative material to avoid bone harvesting procedures and thus reduce postoperative discomfort of patients.