New Classification of Autologous Tooth-Derived Grafting Materials: Fundamental Concepts

The use of dentin grafts is relatively recent, and their efficacy remains a topic of debate. Various techniques and devices are available for dentin grafting; however, their application has been inconsistent, as each method yields a distinct product with unique biological properties and potential uses. One of the challenges that arises with the introduction of a new biomaterial is the potential confusion between different preparations. Specifically, generalization may significantly impact the understanding of unique qualities and/or potential limitations. The various materials that make up the family of tooth-derived graft materials share only one common starting point: the patient's extracted tooth. Beyond that, the processes of grinding, demineralization, and detoxification differ significantly, resulting in final materials with completely different percentages of minerals, bone morphogenetic proteins (BMPs), collagenic and noncollagenic proteins, and residual bacterial load. These differences influence the regenerative potential of one material compared to another, as well as the resorption rate. For instance, incomplete sterilization of the material can accelerate the resorption process, leading to insufficient regeneration. Here, we propose a classification of dentin grafts into four categories based on their processing methods. This classification aims to clarify the successes and challenges encountered to date, offering an objective framework to guide the ongoing development of these techniques. The aim of this study is to establish the first classification system of autogenous partial demineralized tooth-derived grafting biomaterials.