Application of Dentin Matrix in Tissue Regeneration

A special issue of Journal of Functional Biomaterials (ISSN 2079-4983). This special issue belongs to the section "Dental Biomaterials".

Deadline for manuscript submissions: closed (28 February 2023) | Viewed by 17952

Special Issue Editors


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Guest Editor
Korea Tooth Bank, Seoul, Korea
Interests: demineralized dentin matrix(DDM); bone regeneration; implant dentistry

E-Mail Website
Guest Editor
Division of Oral Regenerative Medicine, Health Sciences University of Hokkaido, Ishikari District, Hokkaido, Japan
Interests: biomaterials; bone induction; DDM; BMPs; bone augmentation

Special Issue Information

Dear Colleagues,

The idea of DDM was largely developed by Urist in 1965. Yeomans and Urist were the first to use extracted teeth as a graft material in 1967, where they discovered and verified that decalcified dentin matrix can induce bone formation.

Since 2010, many preclinical studies have reported that demineralized dentin matrix (DDM) is an “inductive substrate” because the bone inducer originating from the extracellular dentin matrix has similar osteoinductivity that transforms the mesenchymal fibroblasts into cartilage or bone cells. One of the transforming factors present in both the dentin and bone matrix is BMP. Consequently, clinical trials have shown promising results for the past decade.

This Special Issue will be a great opportunity to bring together all research related to dentin matrix that are scattered around various countries among researchers, clinicians, etc., because the historical background of dentin matrix is not so long. In order that we can discuss where we are and where we wish to go in the future with dentin matrix as a reliable, evidence-based biomaterial, we need to spread awareness of this novel approach in the dental field.

Dentin matrix, in the form of powder, block, and membrane, has evolved very quickly from a novel scaffold for tissue regeneration to a carrier of growth factors and composites with stem cells and drug delivery systems—from alveolar bone regeneration to dentin repair and viable pulp regeneration. 

We are looking for papers on case reports, case series, cohort studies, or randomized controlled clinical trials (RCT) on the topics of growth factors in dentin, dentin extracts, dentin regeneration, dentin as drug delivery system, and dentin as a carrier of growth factors and stem cells.

Dr. In-Woong Um
Prof. Dr. Masaru Murata
Guest Editors

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Keywords

  • implant dentistry
  • dentin regeneration
  • tooth graft
  • alveolar bone augmentation
  • bone tissue engineering
  • demineralized dentin matrix
  • dentin collagen
  • growth factors
  • osteoinduction
  • scaffold
  • stem cells

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Published Papers (6 papers)

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9 pages, 2264 KiB  
Article
Impact of Autogenous Demineralized Dentin Matrix on Mandibular Second Molar after Third Molar Extraction: Retrospective Study
by Yesel Kim, Jeong-Kui Ku, In-Woong Um, Hyun Seok and Dae Ho Leem
J. Funct. Biomater. 2023, 14(1), 4; https://doi.org/10.3390/jfb14010004 - 20 Dec 2022
Cited by 11 | Viewed by 2011
Abstract
The purpose of this retrospective study was to evaluate bone healing after autogenous demineralized dentin matrix (DDM) grafts, focusing on the distal root of the mandibular second molar after the extraction of the third. We included retrospective data from 20 patients who had [...] Read more.
The purpose of this retrospective study was to evaluate bone healing after autogenous demineralized dentin matrix (DDM) grafts, focusing on the distal root of the mandibular second molar after the extraction of the third. We included retrospective data from 20 patients who had undergone molar extractions (15 male, 41.9 ± 12.0 years) between January 2020 and September 2022 and had DDM grafts implanted on the extraction socket, immediately (“immediate graft”) or 6 weeks (“delayed graft”) after the first surgery without primary closure. Patients who underwent grafting on only one side were used as the control group (n = 4). Bone defects at the mandibular second molar were measured preoperatively and 4 months after the graft surgery using cone-beam computed tomography (CBCT). Improvement of bone defect (i.e., the change in the bony defect pre- vs. postoperatively) was compared between the control and graft groups using the Wilcoxon Signed Rank test, and the difference between immediate and delayed grafts was analyzed with the Mann-Whitney U test. Complications such as infections or graft failure did not occur. Although pre-operative defects were smaller in the control than in the graft group (2.98 ± 1.77 and 10.02 ± 3.22 mm, p = 0.001), post-operative defects were similar in both (2.12 ± 0.59 and 2.29 ± 1.67 mm, respectively). The improvement ratio was not statistically significant in the control group (22.68 ± 15.36%) but a difference was observed in the graft group (76.70 ± 15.36%, p = 0.001). The amount of improvement of bone defect was not affected by graft timing or patient sex. In conclusion, DDM can improve bone defect at the distal aspect of the mandibular second molar after third molar extraction. Full article
(This article belongs to the Special Issue Application of Dentin Matrix in Tissue Regeneration)
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12 pages, 2912 KiB  
Article
Effect of Gamma Irradiation on the Osteoinductivity of Demineralized Dentin Matrix for Allografts: A Preliminary Study
by Jeong-Kui Ku, Il-hyung Kim, In-Woong Um, Bo-Hyun Kim and Pil-Young Yun
J. Funct. Biomater. 2022, 13(1), 14; https://doi.org/10.3390/jfb13010014 - 31 Jan 2022
Cited by 5 | Viewed by 3583
Abstract
Demineralized dentin matrix (DDM) treated with gamma irradiation (GR) has shown promising results as an allograft without any adverse effects in in vivo and clinical studies. The purpose of this study was to evaluate the effects of 15 and 25 kGy GR on [...] Read more.
Demineralized dentin matrix (DDM) treated with gamma irradiation (GR) has shown promising results as an allograft without any adverse effects in in vivo and clinical studies. The purpose of this study was to evaluate the effects of 15 and 25 kGy GR on the osteoinductive properties of DDM at extra-skeletal sites. As a control group, non-irradiated DDM powder was implanted into the right subcutaneous tissues of the dorsal thigh muscles of 20 nude mice. DDM powder irradiated with 15 and 25 kGy was implanted into the left side. After two and four weeks, the bone mineral density (BMD) was measured with dual-energy X-ray absorptiometry. After confirming osteoblast- and osteoclast-specific activities by alkaline phosphatase (ALP) and tartrate-resistant acid phosphatase (TRAP) staining, a histological analysis was performed to measure the new bone formation and the number of osteoblasts and osteoclast-like cells on the surface of the DDMs. Histomorphometry was used to calculate the new bone formation area on the surface of the DDM particles (DDMs). The BMD in all the groups increased from two and four weeks without statistically significant differences. The osteoblasts were dominantly activated on DDM without GR, and DDM treated with 25 kGy compared to DDM treated with 15 kGy. Among the groups, new bone formation was identified in all the groups at each time point. In conclusion, GR at doses of 15 and 25 kGy does not affect the osteoinductive properties of DDM powder. Full article
(This article belongs to the Special Issue Application of Dentin Matrix in Tissue Regeneration)
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8 pages, 4023 KiB  
Case Report
Incorporating Moldable Demineralized Dentin Matrix into Treatment for a Jaw Cyst
by Jeong-Kui Ku, Han-Wool Kwak and In-Woong Um
J. Funct. Biomater. 2023, 14(5), 258; https://doi.org/10.3390/jfb14050258 - 7 May 2023
Cited by 1 | Viewed by 1662
Abstract
The enucleation procedure is a standard treatment for jaw cysts; however, it often results in post-operative bony defects. These defects can lead to serious complications such as the risk of pathologic fracture and delayed wound healing, especially in the case of large cysts [...] Read more.
The enucleation procedure is a standard treatment for jaw cysts; however, it often results in post-operative bony defects. These defects can lead to serious complications such as the risk of pathologic fracture and delayed wound healing, especially in the case of large cysts where there may be soft tissue dehiscence. Even in the case of smaller cysts, most cystic defects remain visible on postoperative radiographs and can be mistaken for cyst recurrence during follow-up periods. To avoid such complications, the use of bone graft materials should be considered. While autogenous bone is the most ideal graft material as it can be regenerated into functional bone, it has limitations due to the inevitable harvesting surgery. Many tissue engineering studies have been conducted to develop substitutes for autogenous bone. One such material is moldable-demineralized dentin matrix (M-DDM), which can aid in regeneration in cases of cystic defects. This case report highlights a patient who demonstrated the efficacy of M-DDM in bone healing for filling the cystic defect. Full article
(This article belongs to the Special Issue Application of Dentin Matrix in Tissue Regeneration)
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10 pages, 3257 KiB  
Case Report
Primary Teeth-Derived Demineralized Dentin Matrix Autograft for Unilateral Maxillary Alveolar Cleft during Mixed Dentition
by Yusuke Matsuzawa, Naoto Okubo, Soichi Tanaka, Haruhiko Kashiwazaki, Yoshimasa Kitagawa, Yoichi Ohiro, Tadashi Mikoya, Toshiyuki Akazawa and Masaru Murata
J. Funct. Biomater. 2022, 13(3), 153; https://doi.org/10.3390/jfb13030153 - 15 Sep 2022
Cited by 3 | Viewed by 2682
Abstract
This clinical report describes the immediate autograft of primary (milk) teeth-derived demineralized dentin matrix (DDM) granules for a 6-year-old boy with unilateral alveolar cleft. First, four primary teeth were extracted, crushed in an electric mill for 1 min, and the crushed granules were [...] Read more.
This clinical report describes the immediate autograft of primary (milk) teeth-derived demineralized dentin matrix (DDM) granules for a 6-year-old boy with unilateral alveolar cleft. First, four primary teeth were extracted, crushed in an electric mill for 1 min, and the crushed granules were demineralized in 2% HNO3 solution for 20 min. Simultaneously, the nasal mucoperiosteum was pushed upwards above the apices of the permanent central incisor adjacent to the cleft. The nasal and palatal openings were closed by suturing the mucoperiosteum on both sides of the cleft with absorbable threads. The wet DDM granules were grafted into the managed cleft triangle space, and a labial flap was repositioned. The radiographic images at 6 months showed the continuous hard tissues in the cleft area and DDM granules onto lateral incisor (22) and impacted canine (23). The 3D-CT views at 2 years showed impacted tooth (22) blocked by primary canine and the replacement of DDM granules by bone near teeth (22,23). At 4 years, tooth crown (22) was situated just under the mucous membrane, and teeth (22,23) erupted spontaneously until 6 years without a maxillary expansion and a tow guidance of canine. The DDM granules contributed to bone formation without the inhibition of spontaneous tooth eruption. We concluded that autogenous primary teeth DDM graft should become a minimally invasive procedure without bone harvesting and morbidities for unilateral alveolar cleft. Full article
(This article belongs to the Special Issue Application of Dentin Matrix in Tissue Regeneration)
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12 pages, 4043 KiB  
Case Report
Immediate Tooth Autotransplantation with Root Canal Filling and Partially Demineralized Dentin/Cementum Matrix into Congenital Missing Tooth Region
by Masaru Murata, Yasuhiro Nakanishi, Kaoru Kusano, Yukito Hirose, Junichi Tazaki, Toshiyuki Akazawa and Itaru Mizoguchi
J. Funct. Biomater. 2022, 13(2), 82; https://doi.org/10.3390/jfb13020082 - 16 Jun 2022
Cited by 5 | Viewed by 4520
Abstract
This clinical report describes immediate tooth auto-transplantation with an autograft of partially demineralized dentin/cementum matrix (pDDM), based on an orthodontic treatment plan for a 16-year-old male patient with a congenital missing tooth (#45). First, vital teeth (#14, #24) were extracted, and root canal [...] Read more.
This clinical report describes immediate tooth auto-transplantation with an autograft of partially demineralized dentin/cementum matrix (pDDM), based on an orthodontic treatment plan for a 16-year-old male patient with a congenital missing tooth (#45). First, vital teeth (#14, #24) were extracted, and root canal filling (#14) was immediately performed with the support of a fixation device. Simultaneously, the tooth (#24) was crushed in an electric mill for 1 min, and the crushed granules were partially demineralized in 2% HNO3 solution for 20 min as the graft material. Next, the donor tooth was transplanted into the created socket (#45), and stabilized using an enamel bonding agent. The wet pDDM was loaded into the location of the congenital missing tooth, and the flap was repositioned. The bonding agent for stabilization was removed at 28 days, and also small contact points between the transplanted tooth and the upper premolar (#14) were added using photopolymerizable composite resin. X-ray photos were taken sequentially, and there were no postoperative complications. The radiographic images showed that the periodontal ligament space and alveolar ridge line could be observed at 18 months. The pDDM was harmonized with the mandible, and the remodeled bone-like shadow was observed in the graft region. We concluded that immediate tooth transplantation with root canal fillings and autogenous pDDM may be a valuable alternative to dental implanting or bridge formation for patients with a congenital missing tooth, followed by orthodontic treatment. Full article
(This article belongs to the Special Issue Application of Dentin Matrix in Tissue Regeneration)
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8 pages, 1597 KiB  
Case Report
Histological Evidences of Autograft of Dentin/Cementum Granules into Unhealed Socket at 5 Months after Tooth Extraction for Implant Placement
by Masaru Murata, Md Arafat Kabir, Yukito Hirose, Morio Ochi, Naoto Okubo, Toshiyuki Akazawa and Haruhiko Kashiwazaki
J. Funct. Biomater. 2022, 13(2), 66; https://doi.org/10.3390/jfb13020066 - 25 May 2022
Cited by 5 | Viewed by 2424
Abstract
The aim of this clinical case study was to observe biopsy tissues at 5 months after an autograft of a partially demineralized dentin/cementum matrix (pDDM) into a tooth-extracted socket exhibiting healing failure. A 66-year-old female presented with healing failure in the cavity for [...] Read more.
The aim of this clinical case study was to observe biopsy tissues at 5 months after an autograft of a partially demineralized dentin/cementum matrix (pDDM) into a tooth-extracted socket exhibiting healing failure. A 66-year-old female presented with healing failure in the cavity for 2 months after the extraction (#36). Initial X-ray photos showed a clear remainder of lamina dura (#36), a residual root (#37), and a horizontal impaction (#38). The vital tooth (#38) was selected for pDDM. The third molar crushed by electric mill was decalcified in 1.0 L of 2.0% HNO3 for 20 min and rinsed in cold distilled water. The pDDM granules (size: 0.5–2.0 mm) were grafted immediately into the treated socket. X-ray views just after pDDM graft showed radio-opaque granules. At 5 months after pDDM graft, the surface of regenerated bone was harmonized with the mandibular line, and bone-like radio-opacity was found in the graft region. The biopsy tissue (diameter: 3.0 mm) at 5 months after pDDM graft showed that mature bone was interconnected with the remaining pDDM. The novel histological evidence highlighted that newly formed bone was connected directly with both dentin-area and cementum-area matrix of pDDM. We concluded that pDDM contributed to the regeneration of bone in the unhealed socket, and this regeneration prepared the socket for implant placement. Autogenous pDDM could be immediately recycled as an innovative biomaterial for local bone regeneration. Full article
(This article belongs to the Special Issue Application of Dentin Matrix in Tissue Regeneration)
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