It is a pleasure to read and discuss an article that encourages the development of new technology in the dental field.
The main goal of this article1 is to suggest the possibility of recycling benign pathologic hard tissue for use in bone grafts as an alternative to other conventional bone graft materials. The basis of the thesis is that the components and structures of teeth from an odontoma are similar to those of bone and other teeth. However, we could not find sufficient data and evidence to support your thesis and to confirm that the component of an odontoma tooth are suitable as bone substitutes2.
Although you have stated that the grafting procedures used in the two cases were almost same each other, there seem to be differences that could lose consistency to have similar outcomes. For instance, a titanium mesh was applied for Case 1, whereas it is hard to find the titanium mesh on Case 2. Besides, the titanium mesh used to cover the bone block in Fig. 2. C would interrupt the contact with the gum tissue, so that aponeurosis would not happen in terms of histological basis. Also, the 'c' arrow on Fig. 5. C does not seem to be dentin as indicated in the article3.
For Case 1, you should have explained your reasons for using a block in relation to the type of defect and how this coincides with the histological and clinical outcomes. Moreover, compared to the size of other ordinary blocks, the size and type of bone on Fig. 2. B seem to be indicative of bone chips.
The superiority of ultrasonic technology is the reduction of the demineralization time. It would be more reliable to demonstrate the efficiency of the reduced demineralization time by comparing the protocol with other manufacturing methods. Additionally, it is important to provide detailed manufacturing procedures with respect to the demineralization reagents, sterilization, and temperature control.
I do believe that this article would gain strong support with the addition of more successful clinical cases and after resolving confusions, since this thesis could lead to more advanced methods of manufacturing tooth-derived graft materials.
References
1. Lee JH, Lee EY, Park EJ, Kim ES. An alternative treatment option for a bony defect from a large odontoma using a recycled demineralized at chairside. J Korean Assoc Oral Maxillofac Surg. 2015; 41:109–115.
2. Murata M. Collagen biology for bone regenerative surgery. J Korean Assoc Oral Maxillofac Surg. 2012; 38:321–325.
3. Kim YK, Kim SG, Um IW, Kim KW. Bone grafts using autogenous tooth blocks: a case series. Implant Dent. 2013; 22:584–589. PMID: 24225779.