Aim: Dentin graft has been recently used as a bone substitute in implant surgery. After third molar extraction a distal ridge defect may result. This study aimed to evaluate the effectiveness and complications of using autogenous dentin graft after lower third molars extraction. Materials and methods: The inclusion criteria included patients with mirror-image impacted lower third molars, at least 18 years old, non-smokers, and without any medical disease. Outcomes assessed included pocket depth (PD) at the lower second molars, Recession (MG), Clinical Attachment level (CAL), Pain using visual analogue score (VAS), Swelling, and Healing. PD, MG and CAL were assessed at three time points (point 1: pre-surgery, point 2: one-month post extraction, point 3: three months post extraction). The follow up visits were at 7 days (T1), 42 days (T2), and 92 days (T3) postoperatively. Hypothesis testing was performed using a significance level of 0.05. Results: Ten patients were enrolled in the study but 3 of them failed to follow up and were excluded. Pocket depth was not significantly different between the intervention and control groups at T2 and T3. Gingival recession was significantly lower in the treatment group at T2 (P 0.048) but was not significantly different at T3. The odds of being in a higher category in the dentin graft group at time 3 was 14% the odds in the control arm at time 3 (OR = 0.14, p = 0.09). There was no significant difference between the intervention and control groups for pain VAS, healing, and swelling. Conclusion: Dentin graft is a viable material for bone grafting after extraction of third molar sockets. Although there was no statistically significant difference between tested and control sites, this maybe a result of the small sample size and the nature of the included cases. Clinical significance: Autogenous dentin graft can be used as a cost-effective, safe, and biocompatible bone-substitute after third molar extractions.