Bone and Tissue Regeneration
Dental implant success and longevity is achieved when there is sufficient supporting bone and tissue present. Whether bone is deficient in height, width, or just missing due to the disease process, it can be augmented using various grafting techniques. The grafting-related materials include bone, membranes, fixation screws, and biological promoters.
We offer a number of different techniques and materials carefully selected for the desired tissue augmentation or healing process.
Bone Grafting Materials
Bone-graft material may be in form of calcified granules such as mineralized freeze dried human bone, bovine bone, or synthetic materials provided in single pre-packed bottles. These bone materials are safe and have been used for many years. They provide a bone matrix that allows the regeneration of natural bone wherever placed. This is the type of bone often used for extraction site preservation / augmentation grafting as it is readily available, easy to use, highly predictable, and does not require getting it from the patient.
Bone may also be obtained directly from the patient. Known as autogenous bone, it is considered the gold standard for bone grafting. Autogenous bone is often used for larger bone defects. Depending on the amount of bone necessary for grafting, it may be harvested from three sources:
- Ramus (lower wisdom teeth area): Ideal for augmenting partial areas of bone deficiency
- Chin: May be used as a second source if more bone is needed
- Hip: Indicated for very large defects where significant amounts of bone are needed. This procedure is performed in a hospital under general anesthesia and patients often go home the following day. It is a relatively conservative procedure and patients usually recover remarkably well and quickly.
How Does the Bone Graft Heal?
Any type of bone graft heals in four to six months during which the body’s bone producing cells gradually replace the grafted material and form actual bone. Implants placed in these grafts generally have the same success rates as implants placed in non-grafted bone.
Bone Graft Safety:
Bone grafts such as freeze-dried bone, bovine bone, and other synthetic materials have long history of safety and do not carry risks of disease transmission. Any bone obtained from a patient for their own surgery is also very safe and offers the best type of bone for implant placement.
Guided Bone Regeneration Membranes
Guided-bone-regeneration membranes provide a physical protective and occlusive medium over the bone graft that promotes bone maturation. Membranes may be either resorbable or non-resorbable or may be used in conjunction with fixation screws for stability. The precise type of membrane and stabilization technique is selected by the surgeon depending on the site and nature of bone augmentation.
Platelet Rich Growth Factor
Platelet Rich Growth Factor (PRGF), is an adjunctive procedure to bone grafting, teeth extractions, and other oral surgery procedures that permits the body to take advantage of the normal healing pathways at a greatly accelerated rate. PRGF is derived from a small volume of the patient’s own blood on the day of surgery. It is mixed with bone grafting material and placed where bone is being augmented. It may also be directly placed in extraction sites, biopsy sites, or any surgical sites. PRGF works by inducing the body’s own cells involved in the tissue healing. It promotes bone healing and improves soft tissue healing.
During the healing process, the body rushes many cells and cell-types to the wound in order to initiate the healing process. One of those cell types is platelets. Platelets perform many functions, including formation of a blood clot and release of growth factors (GFs) into the wound.
These growth factors (platelet derived growth factors PGDF, transforming growth factor beta TGF, and insulin-like growth factor ILGF) assist the body in repairing itself by stimulating stem cells to regenerate new tissue. The more growth factors released into the wound, the more stem cells are stimulated to produce new host tissue. Thus, PRP permits the body to heal faster and more efficiently.
A subfamily of TGF is bone morphogenic protein (BMP). BMP has been shown to induce the formation of new bone in research studies in animals and humans. This is of great significance to the surgeon who places dental implants. By adding PRP, and thus BMP, to the implant site with bone substitute particles, the implant surgeon can now grow bone more predictably and faster than ever before.
rhBMP2 & Growth Factors
Growth factors are proteins that are derived either from a patient’s own blood or produced using recombinant technology (rhMBP-2). When added to the bone graft or site of surgery, they promote the healing of bone and soft tissue. Many studies have shown enhanced bone growth and quality as well as faster healing of the overlying soft tissues. Growth factors are high in concentration in platelets. Dr. Kazemi has used growth factors in bone regeneration therapy for years with excellent results. They are safe, easy to obtain, and allow faster and better healing of the bone and soft tissues.