**4. Clinical application of AutoBT**

**Figure 10.** Experimental group of 8 weeks. New bone is actively formed around the tooth powder granules. Asterisks and arrows indicate graft tooth granule materials and new bone formation around the tooth granules, respectively. Hematoloxylin and eosin staining (×100). (Kim J.Y., et al. Bone healing capacity of demineralized dentin matrix materi‐

**Figure 9.** Results of the X-ray diffraction analysis. AutoBT D+: AutoBT root, AutoBT E+: AutoBT crown, Cancellous bone: ICB. (Kim Y.K., et al. Autogenous teeth used for bone grafting: a comparison to traditional grafting materials.

als in a mini-pig cranium defect. J. Korean Dent. Sci., 2012.)

Oral Surg. Oral Med. Oral Pathol. Oral Radiol., 2013, in press)

414 Advances in Biomaterials Science and Biomedical Applications

Kim, et al developed a novel bone grafting material using autogenous teeth (AutoBT) in 2008 and provided the basis for its clinical application. Having organic and inorganic mineral components, AutoBT is prepared from autogenous grafting material; thus eliminating the risk of immune reaction that may lead to rejection. AutoBT was used at the time of implant placement -- simultaneously with guided bone regeneration -- and excellent bone healing by osteoinduction and osteoconduction was confirmed [3]. In a total of 6 patients, guided bone regeneration was performed simultaneously at the time of implant placement, and tissue samples were then harvested at the time of the second surgery with the patient's consent. In the histomorphometric analysis of the samples collected from 6 patients during the 3 ~ 6 months' healing period, new bone formation was detected in 46 ~ 87% of the area of interest, and excellent bone remodeling was achieved (Table 3) (Figure 12). Clinically available AutoBT consists of powder, chips, and block (Figure 13).

**Figure 12.** Newly formed bone and tooth materials showing remodeling were identified around the implant chip and at the periphery of the implant chip, respectively (H&E staining, X 100). (Kim Y.K., et al. Development of a novel bone grafting material using autogenous teeth. Oral Surg. Oral Med. Oral Pathol. Oral Radiol. Endod., 2010.)

**Figure 13.** Three types of AutoBT can be fabricated from extracted teeth. a): Extracted teeth. Foreign body such as prosthetic crown, cements, calculus, and soft tissue are removed. AutoBT is then fabricated through pulverization, de‐ fatting, demineralization, and lyophilization. b): AutoBT one-powder. Crown and root portion are mixed. c): AutoBT crown and root powder. d): AutoBT chips. e): AutoBT block.


WB: woven bone; LB: lamellar bone; IM: residual implant material

and excellent bone remodeling was achieved (Table 3) (Figure 12). Clinically available AutoBT

**Newly formed bone**

**Figure 12.** Newly formed bone and tooth materials showing remodeling were identified around the implant chip and at the periphery of the implant chip, respectively (H&E staining, X 100). (Kim Y.K., et al. Development of a novel bone

grafting material using autogenous teeth. Oral Surg. Oral Med. Oral Pathol. Oral Radiol. Endod., 2010.)

**Remodelling of Newly formed bone**

consists of powder, chips, and block (Figure 13).

416 Advances in Biomaterials Science and Biomedical Applications

**Tooth material**

**Remodelling of newly formed bone**

**And tooth materials**

**Table 3.** Histomorphometric finding (Kim Y.K., et al. Development of a novel bone grafting material using autogenous teeth. Oral Surg. Oral Med. Oral Pathol. Oral Radiol. Endod., 2010.)

Lee and Kim [60]performed a retrospective study to evaluate the clinical efficacy of AutoBT. This study included 37 patients (54 implants) into which AutoBT was grafted between Oct. 2008 and Dec. 2009. The mean follow-up period was 31 months. Postoperative complications and marginal bone status around the implants were evaluated using medical records and dental radiography. Wound dehiscence and hematoma developed in 7 patients (8 implants). Osseointegration failure in 2 patients (4 implants) was recorded. These complications were well managed through conservative treatment and re-implantation. Mean peri-implant marginal bone loss 1 year after implant placement was 0.33±0.63mm. Autogenous tooth bone graft was confirmed to be a safe procedure, showing excellent bone healing through a 2-year retrospective study (Tables 4, 5, 6).


#### **Table 4.** Types of surgery


**Table 5.** Types of AutoBT


**Table 6.** Types of complications
