Enamel in Xenogenic Tooth-Derived Bone Grafts Impedes Resorption in a Rat Mandibular Defect Model

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• Picked for Plastic and Reconstructive Surgery (top studies of the week, 18 October 2026): Enamel in tooth‑derived graft delays resorption in mandibular defect

Abstract

BACKGROUND: Tooth-derived bone grafts prepared from extracted teeth are increasingly used as alternative biomaterials for bone regeneration. PURPOSE: The purpose of this study was to evaluate the effect of the enamel layer on the resorption behavior of xenogenic tooth-derived bone grafts in a rat mandibular bicortical defect model. STUDY DESIGN/SETTING/SAMPLE: This animal study was performed at Pamukkale University. Thirty-two adult male Wistar albino rats were randomly allocated to 4 equal groups based on treatment modality. A standardized 5-mm bicortical defect was created at the mandibular angle in each animal. The animals were euthanized, and mandibular specimens were harvested 28 days after surgery. PREDICTOR VARIABLE: The predictor variable was the graft material applied to the mandibular defect. MAIN OUTCOME VARIABLES: The main outcome variables were new bone formation, residual graft material, defect closure, and bone morphogenetic protein-2 and vascular endothelial growth factor immunohistochemical expression. COVARIATES: None. ANALYSES: Intergroup comparisons were performed using appropriate parametric or nonparametric tests according to data distribution. The level of statistical significance was set at P < .05. RESULTS: All 32 animals completed the study without postoperative complications. New bone formation was significantly higher in the autogenous bone graft (1.37 ± 0.25 mm2), enamel-containing tooth-derived graft (1.43 ± 0.13 mm2), and enamel-free tooth-derived graft (1.35 ± 0.56 mm2) groups than in the control group (0.30 ± 0.06 mm2; P < .05), with no significant differences among the grafted groups (P > .05). Residual graft material was greatest in the enamel-containing group (21.76 ± 1.65 mm2), followed by the enamel-free (17.03 ± 0.84 mm2) and autogenous bone graft (13.71 ± 1.61 mm2) groups (P < .05). CONCLUSION AND RELEVANCE: Enamel-containing tooth-derived grafts were associated with delayed resorption while maintaining new bone formation comparable to the other grafted groups. These findings suggest that enamel preservation may influence graft remodeling kinetics, although further long-term and three-dimensional studies are needed.

Abstract as published, via PubMed.