The ability of different forms of autogenous tooth graft to promote bone regeneration: a network meta-analysis.

Abstract

Purpose: Several forms of autogenous tooth graft have been presented. However, it is still unclear which form provides better bone formation and is the best to use clinically. This network meta-analysis aimed to thoroughly evaluate the available literature on the ability of different forms of the autogenous tooth graft to promote bone regeneration, in order to explore if any specific type or method of processing would result in better overall outcomes.

Methods: MEDLINE/PubMed, Cochrane library, and Scopus databases were searched, to find randomized clinical trials, published up to November 29, 2023, which compared two forms of autogenous tooth graft or any form of this material with other bone grafts or with empty sockets and reported the percentage of bone formation in the grafted sites.

Results: Of 1129 articles found, nine were included. The outcomes of this meta-analysis indicated that demineralized dentin, demineralized root with BMP-2 and undemineralized tooth all showed significantly higher bone formation, compared to xenograft; Mean difference (MD) = 23.25, 95% Confidence interval (CI) = 7.42 to 39.08, MD = 17.09, 95% CI = 4.03 to 30.15, and MD = 12.40, 95% CI = 5.64 to 19.16, respectively. Following the GRADE system, the level of evidence was judged to be low/very low.

Conclusion: Choosing the undemineralized tooth could be a better option than other forms of this material, considering the complexity, time, and cost of the other forms of autogenous tooth graft. Nevertheless, future investigations with more direct comparisons are highly needed, considering the small number of included studies and the low level of evidence obtained from this meta-analysis.