3. Discussion
TNF-α
MINERALIZATION, POSTOPERATIVE COMPLICATIONS
The purpose of alveolar ridge preservation is to minimize alveolar ridge resorption after extraction [Depending on the preparation protocol and degree of mineralization, three types of ADG can be distinguished: demineralized dentin matrix, partially demineralized dentin matrix, and undermineralized dentin [The osteoinductive and osteoconductive capabilities of ADG were examined histologically in studies using an experimental animal model. ADG was found to be fully integrated into newly formed bone [More than 15 types of BMPs belonging to the TGF-β family have been discovered, but only three stimulate bone formation at the graft site, namely BMP-2, BMP-4, and BMP-7. Their presence stimulates mesenchymal cells to differentiate into osteoblasts, which it is strong evidence of osteoinductive properties [Radiographic studies of ADG performance in the alveolar ridge are characterized by very high heterogeneity. The study by Li et al. [From a clinical point of view, ADG shows some additional advantages compared to BX+AB. The surgical procedure (chair time) is shorter since the preparation of ADG is performed by the dental assistant during the surgery. There is also no need for additional autologous bone harvesting, which prolongs the procedure and may cause more morbidity and postoperative complications for the patient. Finally, the cost of the procedure is lower since there is no extra material used other than autologous dentin from the patient.It should be noted that the sample size of the analyzed CBCTs and bone biopsies is small. However, we only studied the anterior part of the maxilla, which is also known as the esthetic zone and includes exclusively maxillary incisors, canines and premolars; thus, a smaller sample size is justified. In addition, this is one of the first studies to investigate TNF-α and BMP-4 expression in human alveolar bone, making this study an important demonstration of the osteogenic potential of ADG.In conclusion, according to this study, ADG is biocompatible and has been shown to have osteoconductive and osteoinductive properties comparable to those of commonly used BX+AB (in radiological and histological comparison). The significantly higher expression of BMP-4 in the BX+AB group indicates good osteoinductive properties, due to the addition of the autologous bone. The significantly higher expression of TNF-α in the same group indicates an active bone remodeling, which has resulted in a high percentage of newly formed bone. This statistically significant difference should be further investigated and be the focus of future clinical studies.