Auto-tooth Bone grafts: An emerging option.

Regenerative medicine, which remained a medical myth, begins to materialize with a deeper understanding of human cell physiology as earlier as the 19th century. With the introduction of these concepts, the search for a good medium or a substrate, better known as a bioscaffold, also began. In the late part of 20th century and early part of 21st century, more works started to emerge in regenerative efforts of jaw bones.[1]

Traditionally, collagen (bovine or auto or any such source), artificial materials such as apatite crystals, and naturally occurring materials such as corals were attempted as scaffold.[2] These materials had their own advantages and disadvantages. Evolution of material science saw an emergence of tooth as an excellent source of one such graft. Bulk of the tooth is made of dentin, which is rich in collagens with abundant matrix proteins and noncollagenous proteins. The proteins such as bone morphogenic proteins and growth factor stimulating proteins primarily also modulate the bioremodeling of bone.[3] Use of freshly extracted or well-preserved teeth, especially dentin, is an ideal source of the bioscaffold. In situ ation, which requires minimal scaffold materials such as limited cleft palate closure or similar situation, well-formed teeth, such as third molars, would serve as an excellent source material. They being autogenous would lack allergic reactions, rich in pro-bone forming signal protein molecules. Furthermore, the calcified material being resorbable will be resorbed back automatically once it serves the purpose, avoiding the need of the secondary surgery.[4]

The Korea Tooth Bank has been quite progressively using the technology and even has delivery system and a tooth bank that preserves the tooth for the purpose. Specially designed, patented pulverizer of tooth is now commercially available.[4] In addition, there has been a series of cases highlighting the success of tooth material as a scaffold. With more widespread use and in a variety of situation, the science of Auto-Tooth Bone grafts will emerge more.[56] The next decade will be interesting as we now extend the frontier of commercially developing a new tooth, wherein the use of Auto-Tooth Bone grafts will be an asset.

I sincerely believe that the maxillofacial surgery fraternity will quickly imbibe the easily available, less allergenic, graft for their specific graft purposes.