Title: Dentin Graft, “The Gold Standard” Autogenous Graft

Abstract:

Background Research

Schmidt-Schultz1 and Schultz2, Aug. 2005: For the first time we have extracted, solubilized and identified growth factors and bone morphogenetic protein from archaeological compact human bone and tooth dentin dating from the late pre-ceramic pottery Neolithic and the early Middle Ages. Murata, et al. Nov. 14, 2011: Human dentin autograft was reported in 2003 as a first clinical case while human bone autograft was done in 1820. Kim, et al, April 2010: We developed a novel bone grafting material that incorporates autogenous teeth that contains organic and inorganic mineral components and is prepared from autogenous grafting material, thus eliminating the risk of an immune reaction that may lead to rejection. 

Intech 2013, Ch 16, Young-Kyun Kim et al : Autogenous bone is the most ideal since it is capable of osteogenesis, osteoinduction, and osteoconduction. Its advantage is the rapid healing time without immune rejection. Dentin has inorganic and organic components that are very similar to those of human bone. Dentin also contains bone morphogenetic proteins (BMP), which promote the differentiation of mesenchymal stem cells into chondrocytes and consequently enhance bone formation. Itzhak Binderman , et al 2014:

Conclusion: Autogenous mineralized dentin particulate grafted immediately after extractions  should be considered as the gold standard for socket preservation, bone augmentation in sinuses and bone defects. 

Armamentarium and Protocol

The following armamentarium are required to deliver a successful dentin graft: autogenous extracted teeth, high speed drill with 1557 carbide or comparable, Smart Dentin Grinder or comparable, Disposable Grinding Chamber, 0.5 M NaOH with 20% ethanol cleanser, phosphate buffered saline. The Kometabio protocol is utilized: autogenous extracted teeth are debrided of all caries, restorations, and soft tissue and dried; debrided teeth are placed into grinding chamber, grinded and sorted to ideal particle size of  250-1000 micron; particulate is then cleansed and rinsed as to protocol; graft is then utilized with or without PRF for grafting at extraction sites, periodontal defects, and (according to Kim, et al, sinus graft).

Personal Clinical Cases
This clinician has various and numerous clinical cases demonstrating the effectiveness of dentin graft in his private practice. 

Summary 
This clinician concurs with Binderman, 2014, that “dentin graft should be considered the gold standard for socket preservation and bone augmentation.“ 

Proposal
This clinician makes a proposal that exodontists and child caretakers enable patients to save their own avulsed, extracted, and shedded deciduous teeth and extracted, avulsed 3rd molars and other teeth for future need at periodontal and extraction site defects.

Disclosure
This clinician is promoting dentin graft based on his own understanding and experience. He is not compensated in any way from KometaBio.

Biography:

Barry E. Goodspeed graduated from Louisiana State University School of Dentistry in 1987 as a member of the C. Edmond Kells Honorary Society and Louisiana State University undergraduate with a B.S. in Zoology in 1983. Dr. Goodspeed runs a private solo general dentistry practice in Birmingham, Alabama, USA with an emphasis on single to full arch implant placement and CAD/CAM restorative. He is currently a member of the Birmingham District Dental Society, the Birmingham Society of Advanced Dentistry, Birmingham Cerec Study Club, Alabama Dental Association, American Dental Association, and Academy of General Dentistry. He has taken various advanced surgical courses in implant placement and restoration, including the Comprehensive Implant Residency Program, Bessemer, Alabama, USA in 2017. Dr. Goodspeed has completed cerecdoctors.com training levels 1-7 and serves as CEREC Mentor and Sirona trainer. Dr. Goodspeed has presented locally and regionally topics including Dentin Graft and CBCT integration with CAD/CAM. Dr. Goodspeed's most relevant technologies to this course include Sirona XG3D Cone Beam CT, KometaBio Smart Dentin Grinder, and PRF Duo Centrifuge. His private solo practice is one of very few in Birmingham, AL, USA with the knowledge and expertise to perform a Dentin Graft.