Preservaci?n alveolar por medio del injerto de dentina deshidratada de un diente aut?geno

Abstract

[Espa?ol] Una problem?tica que se presenta a la hora de una extracci?n dental es la p?rdida del hueso alveolar, tanto de anchura como de altura. En la pr?ctica cl?nica diaria la regeneraci?n ?sea es un motivo de debate con relaci?n al material a utilizar en cada paciente. Estos materiales tienen como finalidad restablecer la integridad anat?mica y funcional de una estructura alterada; por lo que deben de cumplir con algunos requisitos b?sicos como biocompatibilidad, propiedades mec?nicas a las del tejido ?seo, de f?cil procesado, modificable y consistente duplicable. Para comprender el principio de la t?cnica de regeneraci?n ?sea guiada (ROG) independientemente del material a utilizar, es importante comprender los procesos biol?gicos que ocurren en la fisiolog?a ?sea. Los diferentes tipos de injertos ?seos deben de cumplir con un buen potencial osteoinductivo, osteoconductivo y excelente capacidad de remodelaci?n debido a su naturaleza. El injerto ?seo obtenido a partir de los dientes aut?genos, los cuales previamente son sometidos a un proceso de desmineralizaci?n ha demostrado ser cl?nicamente seguro en varios estudios para utilizarse en preservaciones alveolares y regeneraciones ?sea guiadas. Para este trabajo se efectuaron dos casos cl?nicos a los cuales se le realizaron preservaci?n alveolar por medio del injerto de dentina deshidratada de un diente aut?geno (terceros molares) que le fueron extra?dos y luego se realizaron an?lisis imagenol?gicos para comprobar el volumen ?seo post - extracci?n dental y luego de la utilizaci?n de dentina deshidratada. La utilizaci?n de la dentina desmineralizada como material de injerto ?seo, ha demostrado ser cl?nicamente segura y eficaz ya que tiene un buen potencial osteoinductivo, osteoconductivo, y excelente capacidad de remodelaci?n debido a su naturaleza de col?geno. Independientemente del protocolo a poner en pr?ctica al momento de la obtenci?n del material, el autoinjerto de dentina desmineralizada muestra una capacidad r?pida de cicatrizaci?n, sin reacci?n inflamatoria ni rechazo por parte del cuerpo.

[English] A problem that arises at the time of a dental extraction is the loss of the alveolar bone, both in width and height. In daily clinical practice, bone regeneration is a matter of debate in relation to the material to be used in each patient. These materials are intended to restore the anatomical and functional integrity of an altered structure; therefore, they must meet some basic requirements such as biocompatibility, mechanical properties like those of bone tissue, easy to process, modifiable and consistently duplicable. To understand the principle of the guided bone regeneration (GBR) technique regardless of the material to be used, it is important to understand the biological processes that occur in bone physiology. The different types of bone grafts must have good osteoinductive and osteoconductive potential and excellent remodeling capacity due to their nature. The bone graft obtained from autogenous teeth, which are previously subjected to a demineralization process, has been shown to be clinically safe in several studies for use in alveolar preservation and guided bone regeneration. For this work, two clinical cases were carried out in which alveolar preservation was carried out by means of the dehydrated dentin graft of an autogenous tooth (third molars) that were extracted and then imaging analyzes were carried out to check the bone volume post-dental extraction. and after the use of dehydrated dentin. The use of demineralized dentin as bone grafting material has been shown to be clinically safe and effective since it has good osteoinductive and osteoconductive potential and excellent remodeling capacity due to its collagen nature. Regardless of the protocol to be put into practice at the time of obtaining the material, the demineralized dentin autograft shows rapid healing capacity, without inflammatory reaction or rejection by the body.