Autogenous Demineralized Dentin Matrix for Maxillary Sinus Augmentation in Humans: The First Clinical Report

Background: Dentin and bone contain bone morphogenetic proteins (BMPs). In our previous report, we confirmed the induction of bone and cartilage by human demineralized freezed-dried dentin matrix in subcutaneous pockets in nude mice. Objective: The aim of this study was to evaluate the osteoinductive property of autogenous demineralized dentin matrix (ADDM) particles for maxillary sinus floor augmentation by clinical and histological examinations. This case is the first successful use of ADDM in the world. Methods: A 48-year-old man presented with a severe atrophy of posterior maxilla. The ADDM were obtained from an impacted tooth and a malposed tooth that were vital and not associated with the occlusion, and prepared by a modified Reddi's method. The sinus cavity was augmented using ADDM (2.06g), mixed with platelet-rich plasma (1.5ml) and autogenous demineralized freezed-dried bone matrix (0.14g). Cortical perforations were performed in the opened wall of sinus and the maxilla before the filling of autogenous grafts. The primary closure was done without a membrane technique. Results: CT scans in the augmented region at 3 months after sinus lift revealed a radiopacity, similar to the density of the host cortical bone. At 5 months, a total of 3 bone biopsies was taken at the same places where dental implants were installed. Specimen showed that the ADDM particles induced bone formation and were incorporated by the newly formed bone tissue and partially absorbed. Conclusion:Our results indicate that dentin matrix of extracted teeth can be recycled as a bioabsorbable autograft material (ADDM), showing osteoinductive properties and being completely replaced by new bone. E-mail: murata@hoku-iryo-u.ac.jp