Bone Grafting, PRP, PRGF
Bone grafting is a procedure which involves the replacement of missing bone with bone from another part of the patient’s body, bone from a donor or a substitute material. This surgical procedure is often necessary for patients undergoing dental restorations such as bridge work and dental implants. When a patient’s jawbone has either receded or become damaged, it will not provide sufficient support for implants. It is in such cases that bone grafting is necessary in order to provide a stable foundation for restorative work.
Reasons for Bone Loss
The stability and volume of the patient’s jawbone can be affected by a number of factors. The most common of such factors include:
Periodontal disease – Periodontal disease is the leading cause of bone loss in the oral cavity causing permanent damage to tissue and bone. When this disease affects the jawbone, it can ultimately lead to the loosening and loss of teeth as the support structures become progressively less stable.
Dental injuries and infections — Trauma to the jawbone caused by physical injuries or oral infections can cause the jawbone to deteriorate and recede.
Tooth extractions — Tooth extractions typically lead to the loss of 40 to 60 percent of the surrounding bone over the three years following the extraction procedure.
Reasons for Bone Grafting
- Dental implants – Implants are the preferred replacement method for missing teeth because they restore full functionality to the mouth; however, implants need to be firmly anchored to the jawbone to be effective. If the jawbone lacks the necessary quality or quantity of bone, bone grafting can strengthen and thicken the implant site.
- Sinus lift – A sinus lift entails elevating the sinus membrane and grafting bone onto the sinus floor so that implants can be securely placed.
- Ridge augmentation – Ridges in the bone can occur due to trauma, injury, birth defects, or severe periodontal disease. The bone graft is used to fill in the ridge and make the jawbone a uniform shape.
- Nerve repositioning – If the inferior alveolar nerve requires movement to allow for the placement of implants, a bone grafting procedure may be required. The inferior alveolar nerve allows feeling and sensation in the lower chin and lip.
Types of Bone Grafts
There are several types of dental bone grafts. The following are the most common:
- Autogenous – This type of bone graft uses bone from the patient’s own body (often from another part of the jaw) to repair the damaged or deteriorated areas of the jawbone. Since the harvested bone comes from the patient’s own body, this method provides the most predictable and successful results and is therefore generally the preferred method.
- Allograft – Synthetic bone (manmade) can be created in the laboratory and used in the bone grafting procedure. Bone can also be obtained from a bone bank (cadaver bone).
- Xenograft – These grafts use cow bone which has been processed and sterilized to ensure that it is biocompatible.
When the human, cow or synthetic bone is added to the affected area it will fuse with the existing bone. While the entire process can take several months, bone grafting provides greater bone mass and therefore greater support for dental implants.
Platelet Rich Plasma (PRP)
Platelet Rich Plasma or PRP is a by-product of blood that is exceptionally rich in platelets. PRP has long been used in hospitals to accelerate the body’s own healing process, but it is only fairly recently that advances in technology have allowed this same technique to be used in the dental office. The blood platelets perform several essential functions in the body, including blood clot formation and the release of growth factors that help to heal wounds. These growth factors stimulate the stem cells to produce new host tissue as quickly as possible, which is why platelet rich plasma is so effective in the post-treatment healing process.
There are several ways in which PRP can be used in clinical dentistry:
Bone Grafting For Implants – This includes closure of a cleft lip and cleft palate deformities, sinus lifts, ridge augmentation, and both inlay and onlay grafts.
Bone Repair – PRP can be used in facial trauma reconstruction, repairing of defects due to tooth removal, or the removal of growths and cysts.
Fistula Repair – This includes the repair of fistulas between the mouth and the sinus cavity.
Reasons for PRP Treatment
Platelet rich plasma application is now widely used to expedite the post-procedure healing process and is completely safe. Since the blood used will come from the patient’s own body, disease transmission is not a factor. Almost all patients report a much greater degree of comfort immediately after their procedure.
There are also several more distinct advantages of PRP:
Lower Infection Risk – PRP is smeared thickly on the wound after the procedure by the dentist and actually seals the wound away from infectious agents, lowering the risk of problems.
Accelerated Healing – The saturation of the wound with PRP helps increase tissue synthesis due to its growth factors, and this in turn results in faster tissue regeneration. Speedier healing decreases the risk of later infections, complications, and discomfort.
Safety and Convenience – Disease transmission is non-issue since the blood is harvested from the patient’s own blood supply. The amount of blood needed is small and can be collected during a routine outpatient procedure.