THE USE OF AUTOLOGOUS DENTIN-GRAFT TO REPLACE PERIODONTAL DEFECTS: CASE REPORT

The purpose of this study was to evaluate the preservation of vertical alveolar ridge parameters in cases of volumetric post-extraction defects in the mandible using a combination of autologous dentin graft and platelet-rich fibrin, assessed at short-term (3 months) and long-term (12 months) follow-ups. Subjects and methods. A clinical case of patient Zh., 45 years old, who sought dental care at the Department of Maxillofacial Surgery, the Lviv Regional Clinical Hospital, is presented. Cone-beam computed tomography, orthopantomogram were performed followed by surgical treatment in accordance with the recommended protocol. Results. Partial or complete tooth loss, regardless of the causes of its occurrence, is accompanied by physiological reduction (atrophy) of the alveolar processes of the jaws in the vertical and horizontal planes, which is an indication for bone-plastic replacement of post-extraction defects. The technology of manufacturing and application of granulated dentin for the replacement of various defects of the alveolar bone has made it possible to consider autologous dentin graft as the “gold standard” of regenerative bone surgery due to its unique osteogenic, osteoinductive, and osteoconductive properties, and its combination with platelet-rich fibrin containing growth factors has an additional positive effect on the healing of soft- and bone-tissue wounds and regenerative processes. A clinical example of replacement of a large post-extraction defect of the lower jaw using a composition of autologous dentin and platelet-rich fibrin with simultaneous implantation is demonstrated. Control radiological examinations performed 3 and 12 months after the operation showed that the newly formed bone tissue in the area of the former defects did not differ in structure and density from the surrounding areas, and most importantly, no vertical loss of height of the reconstructed alveolar ridge was noted. Conclusion. All of the above indicates that the composition of autologous dentin and platelet-rich fibrin may be a promising therapeutic option for the replacement of post-extraction defects, horizontal or vertical augmentation of alveolar ridge.