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Abstract
Introduction
Research on dental bone graft material has been actively conducted. Recently, demineralized dentin matrix material has been developed and introduced. This study examined the effect of demineralized dentin matrix material on bone healing.
Subjects and Methods
The patients who received no treatment after extraction were used as the control group and patients who underwent demineralized dentin matrix material application in the extraction socket after extraction were used as the experimental group. Panorama radiography was performed at the baseline and at 3.5 months after graft material placement and CT was taken at 3.5 months after graft material placement for a radiologic evaluation. Bony tissue specimens were collected from the alveolar crest in the middle of the extraction socket using a 2 mm trephine bur after 3.5 months for the histology and hostomorphometric study.
Results
1. On the panoramic view, a higher bone density was observed in the subject group. 2. On the panoramic view, the bone density increased significantly in the extraction socket, from the baseline to 3.5 months: a 7 and 10 gray-level scale was observed in the control and experimental group, respectively (P<0.05). 3. The CT view evaluation at 3.5 months revealed significantly higher bone density in the subject group than the control group (P<0.05). 4. The histological findings showed more active new bone and lamellar bone formation in the subject group. Dentin with osteoinduction ability and enamel with osteoconduction ability appeared. 5. On histomorphometric analysis, the subject group showed significantly more new bone, lamellar bone area and lower soft tissue area (P<0.05). The difference between the groups was significant (P<0.05).
References
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Fig. 1.
Gary level histogram. A. Gray level in dental socket. B. Gray level of surrounding bone. Jae-Ho Chung et al: Study of bone healing pattern in extraction socket after application of demineralized dentin matrix material. J Korean Assoc Oral Maxillofac Surg 2011
Fig. 2.
Distal root socket was treated with deminerlalized dentin matrix material (DMDMM) and showed more radio-opacity than medial root socket. A. Initial panoramic view. B. Panoramic view after 3.5 month. Jae-Ho Chung et al: Study of bone healing pattern in extraction socket after application of demineralized dentin matrix material. J Korean Assoc Oral Maxillofac Surg 2011
Fig. 3.
Control group showed less radio-opacity than subject group(Aveolar socket treated with demineralized dentin matrix material) after 3.5 month. A, B. Control group. C, D. Subject group. Jae-Ho Chung et al: Study of bone healing pattern in extraction socket after application of demineralized dentin matrix material. J Korean Assoc Oral Maxillofac Surg 2011
Fig. 4.
Newbone was formed (arrow), but area was small in control group patient I. A. Optical microscopic view.(H&E staining, original magnification × 40) B. Polarizing microscopic view.(H&E staining, original magnification × 40) Jae-Ho Chung et al: Study of bone healing pattern in extraction socket after application of demineralized dentin matrix material. J Korean Assoc Oral Maxillofac Surg 2011
Fig. 5.
Newbone was forme. Lamellar bone formation (arrow) was seen with in small area in control group patient II. A. Optical microscopic view.(H&E staining, original magnification × 40) B. Polarizing microscopic view.(H&E staining, original magnification × 40) Jae-Ho Chung et al: Study of bone healing pattern in extraction socket after application of demineralized dentin matrix material. J Korean Assoc Oral Maxillofac Surg 2011
Fig. 6.
This slide showed extensive fibrosis without bone formation in control group patient III. A. Optical microscopic view.(H&E staining, original magnification × 40) B. Polarizing microscopic view.(H&E staining, original magnification × 40) Jae-Ho Chung et al: Study of bone healing pattern in extraction socket after application of demineralized dentin matrix material. J Korean Assoc Oral Maxillofac Surg 2011
Fig. 7.
Absorbing enamel (yellow arrow) and dentin (blue arrow) were identified. Some enamel was staying independently (orange arrow) without surrounding bone in subject group patient I. A. Optical microscopic view.(H&E staining, original magnification × 40) B. Polarizing microscopic view.(H&E staining, original magnification × 40) C, D. Optical microscopic view.(H&E staining, original magnification × 100) Jae-Ho Chung et al: Study of bone healing pattern in extraction socket after application of demineralized dentin matrix material. J Korean Assoc Oral Maxillofac Surg 2011
Fig. 8.
Almost absorbed dentin maxtrix (blue arrow) and new bone formation (black arrow) was demonstrated in subject group patient II. New bone induction (black arrow), besides absorbing dentin maxtrix (blue arrow), was demonstrated in C and D. A. Optical microscopic view.(H&E staining, original magnification × 40) B. Polarizing microscopic view.(H&E staining, original magnification × 40) C. Optical microscopic view.(H&E staining, original magnification × 100) D. Polarizing microscopic view.(H&E staining, original magnification × 100) Jae-Ho Chung et al: Study of bone healing pattern in extraction socket after application of demineralized dentin matrix material. J Korean Assoc Oral Maxillofac Surg 2011
Fig. 9.
Implanted dentin matrix (blue arrow), wide new bone formation and lamellar bone (red arrow) was demonstrated in subject group patient III. Osteoblast (black arrow) were seen in lamellar bone. A. Optical microscopic view. (H&E staining, original magnification × 40) B. Polarizing microscopic view. (H&E staining, original magnification × 40) C. Optical microscopic view. (H&E staining, original magnification × 100) D. Optical microscopic view. (H&E staining, original magnification × 100) Jae-Ho Chung et al: Study of bone healing pattern in extraction socket after application of demineralized dentin matrix material. J Korean Assoc Oral Maxillofac Surg 2011
Table 1.
Control and subject group patients
Table 2.
Bone density comparative evaluation after 3.5 month in panoramic view
| Control group | Subject group | P-value | |
|---|---|---|---|
| Absolute value (gray-scale) bone density | 78±19.23 | 98±14.23 | 0.109 |
| Relative value (%) bone density | 90±8.29 | 114±6.36 | 0.004 |
Table 3.
Bone density increasement evaluation after 3.5 month in panoramic view
| Initial bone density | 3.5month bone density | P-value | |
|---|---|---|---|
| Control group | 71±15.97 | 78±19.23 | 0.027 |
| Subject group | 88±16.34 | 98±14.23 | 0.027 |
Table 4.
Bone density comparative evaluation after 3.5 month in CT view
| Control group | Subject group | P-value | |
|---|---|---|---|
| Absolute value(gray scale) bone density | 87±35.14 | 128±30.61 | 0.037 |
| Relative value(%) bone density | 71±12.76 | 119±4.89 | 0.004 |
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