The tooth transformer® revolution: autologous dentin biomaterials and platelet concentrates in oral regeneration. A parallel narrative systematic review

Aim: Bone regeneration in oral and maxillofacial surgery remains a clinical challenge, particularly in cases of severe alveolar atrophy or large post-pathological bone defects. Autologous biomaterials including dentin grafts processed with the Tooth Transformer® device and platelet concentrates such as Concentrated Growth Factors (CGF), PRF, i-PRF, and TPRF-have gained attention due to their biocompatibility and regenerative potential. However, no direct head-to-head clinical studies comparing these autologous approaches are currently available. Materials and methods: This review was conducted according to PRISMA 2020 guidelines. Literature searches were performed in PubMed, Scopus and Web of Science for clinical studies published in English between January 2010 and December 2025. Eligible designs included randomized trials, prospective/retrospective studies, and case series with ≥5 patients. Owing to the paucity of CGF-only studies, the comparison was broadened to include platelet concentrates (CGF/PRF/L-PRF/i-PRF/TPRF). Outcomes included bone volume gain, radiographic density, histologic new bone formation, healing time, implant survival, and postoperative complications. Results: The search yielded 1,004 records; 10 studies met the inclusion criteria. Autologous dentin grafts demonstrated favorable volumetric stability and bone density compatible with mature bone, while platelet concentrates consistently improved early healing, angiogenesis, and trabecular organization-particularly in contained defects. Substantial methodological heterogeneity and the absence of direct comparative trials precluded quantitative synthesis. Conclusions: Autologous dentin grafts and platelet concentrates appear to play complementary roles: the former provides a structural scaffold for three-dimensional augmentation, whereas the latter enhances biological healing and tissue maturation. Combined protocols show promise but require validation through well-designed, multicenter randomized controlled trials.