The four sources of material for the graft, each of which has its own advantages and risk.
Teeth are held intact by gums, bone, and other tissues, however gum diseases can cause the bone to break down and regenerative procedures can be used to stimulate growth of new bone, this gives the tooth more support. It increases the amount of attachment around the root of the tooth. Restoring even half of the amount of lost bone extends the life of the tooth. Among the many procedures available to accomplish this task are bone grafts, PRF and guided tissue regeneration (GTR).
Bone grafting is a procedure that replaces missing bone with material from patient′s own body, an artificial, synthetic, or natural substitute.
Bone grafting is possible because bone tissue has the ability to regenerate completely if provided the space into which it has to grow. As natural bone grows, it generally replaces the graft material completely, resulting in a fully integrated region of new bone.
Bone grafting is a technique that is required when a patient does not have a sufficient amount of healthy natural bones in his or her mouth that are capable of supporting your teeth or dental implant. Bone grafting ensures the jawbone is thick, dense and wide enough to support the tooth.
The four sources of material for the graft, each of which has its own advantages and risk.
Types of dental bone graftsthis involves bone from your own body, such as your jaw or hip. The preferred approach for dental bone grafting is to use your own bone, this is known as an autograft. Autografts are usually the “gold standard,” since they increase bony support in the jaw and promote faster healing and new bone formation.
Allografts: This graft uses bone from different person, usually a cadaver.
Xenografts: This involves bone from another species, such as cow, pig or coral.
Alloplast: This deals with synthetic material, such as calcium phosphate or calcium sodium phosphosilicate
Here’s how the typical dental bone graft is done:
1. You’ll receive anesthesia before the procedure, and your vital signs will be monitored throughout.
2. The periodontist will clean the affected area.
3. Your periodontist will make an incision in the gum to separate it from the bone where the graft is to be placed.
4. The bone material is placed in the defect area.
5. The bone graft is secured with a dissolvable adhesive material or membrane.
6. The incision is then brought up together to begin healing.
Here are some of the most common reasons you may need a dental bone graft.
.Tooth loss because of gum diseaseDental bone grafting may be necessary to support a section of the jaw that has lost bone because of tooth loss or gum disease. Bone loss can start to affect nearby teeth and gum tissue. Stabilizing the jaw with a bone graft can help prevent further bone loss and the long-term health complications that come with it.
People who are going to receive implants in place of missing teeth are common candidates for dental bone grafts. Often, bone grafting is necessary to provide a strong enough base for an implant.
No, there is little to no pain associated with bone grafting because the patient will be under local anesthesia during the procedure. After the procedure, there will be some swelling, but the pain associated with it is minimal.
A dental bone graft that doesn’t involve harvesting bone material from a patient’s own body is a relatively minor procedure. Depending on how much work is being done, you may experience some discomfort. But if bone material is obtained from your own body, the recovery can be more painful, as surgery is done in two locations. The amount of bone that’s harvested and then grafted is usually quite small, so the period of discomfort should be brief.
After the procedure, the patient will be given antibiotics to prevent infection, the periodontist will provide pain medication as well.
The recovery period depends on many factors,
• the type of surgery
• the person’s age, physical health and overall health.
Generally speaking, the recovery time can be anywhere from two weeks to over two months.
After a dental bone graft, you’ll probably leave the dentist’s office with gauze packed around the incision in your mouth. You should be given instructions for changing the dressing during the next 24 hours.
Prescription for antibiotics to help prevent an infection and you may also be given a prescription for pain relievers.
Other postoperative care tips include:
• applying ice packs to help reduce pain and swelling for the first day or two
• eating soft, bland foods for the first few days
During the initial recovery period, you should avoid:
• hot liquids, such as coffee or soup
• hard or crunchy foods, such as nuts
• any physical activity, such as contact sports, that may put the incision at risk
After a week or so, the dull pain in your jaw should give way to some mild discomfort and should feel like it’s improving. Your jaw should start to feel normal after a few weeks. But it usually takes a few months before your jaw is strong enough to receive implants. Plan on periodic visits to your dentist, including at least one round of X-rays, to check on healing during this time.
Though this procedure is usually safe and well tolerated, there are always risks. Infection is a concern with any surgical procedure, so it’s extremely important to take the full course of antibiotics. Other unusual (but serious) potential side effect include rejection of the bone graft.
A dental bone graft is usually a safe and effective procedure. But when complications develop, see your doctor as soon as possible. Signs of trouble include:
• pain that persists or worsens several days after the procedure
• redness and increased swelling around the gums
• persistent tingling or numbness
The costs of a dental bone graft can vary considerably. The complexity of the procedure and the material used are the two main factors influencing the cost.
The takeaway
• Dental bone grafts are done to help prevent long-term health problems associated with tooth loss and
gum disease as well as to provide sufficient bone material to support dental implants.
• This common procedure is usually safe and well tolerated, though there are risks of side effects and
complications.
• Following your doctor’s guidance during recovery will help minimize your chances of having problems
after the procedure and improve the odds of maintaining good dental health in the years ahead.
This surgical procedure helps regenerate the lost bone and gum. A barrier or membrane is placed over the bone defect and under the gum, which eventually persuades the body into growing new bone. The barrier serves to give access in the site of bone repair to those cells that grow bone, and at the same time exclude those cells that don’t.
GTR (guided tissue regeneration) is a method used to repair periodontal defects so that a tooth has more support and stability. Periodontal disease causes the hard and soft tissues that support the teeth to break down. In certain cases, this leads to gaps that form between the teeth and bone. These gaps, or bony defects, often need to be treated with a separate procedure known as a bone graft to promote new bone growth. GTR uses a resorbable or nonresorbable artificial membrane, these keep soft tissue from growing into the gaps. The membrane blocks the fast-growing soft tissue cells from growing into the site. This lets the slower-growing bone-making cells to grow there instead.
The first step is to clean out the harmful bacteria pockets in the degraded bone. Now comes the “guided” part. Normally, the fast-growing gum tissue would fill in where the missing bone tissue once was. But, gum tissue can’t support your teeth the way bone does. It’s essential to allow the bone to regenerate, which it does, but at a much slower rate than gum tissue. So, a special membrane is placed between the hard and soft tissues, guiding the gum tissue away from filling the pocket and letting the bone grow naturally. This establishes a stable foundation for your tooth with adequate support from both bone and gum tissue.
With Platelet-Rich Fibrin (PRF) therapy we now have a new treatment designed to directly harness the natural regenerative abilities of the human body and focus them efficiently on dental applications. Platelet Rich Fibrin techniques can be used to accelerate the recovery process following a dental procedure, or it can be utilized to repair and replace damaged oral tissues directly.
Platelet Rich Fibrin (PRF), is the latest, and surprisingly well-established therapeutic technique. The healing potential of platelets has been known for over 20 years.
Platelet Rich Fibrin is derived from a small amount of a patient’s blood which is centrifuged and processed to separate red blood cells from platelets and leukocytes which form the basis of a complex fibrin matrix membrane. When a PRF matrix membrane is placed over a wound, the platelets are activated releasing several regenerative proteins with real therapeutic potential. It is a process that harvests stem cells and growth factors from the patient’s own blood which can then be put in to surgical sites to encourage more rapid healing and better bone and tissue formation.
PRF can be of benefit in all surgical procedures from simple extractions to complex bone grafts. PRF has been shown to speed up the healing time following surgery and reduce the risk of post-operative infection. In addition it can help reduce the amount of bone lost after a tooth has been extracted and retaining sufficient bone height is essential for any future implant placement.
Usually only one to two tubes, roughly the same as a normal blood test.
If we Periodontist at FMS feel the PRF procedure is of benefit we will firstly discuss this with you and if you decide together to go ahead then we will take a small amount of blood from you that will then be placed into a special centrifuge where it is spun to separate the red blood cells away from the beneficial white cells creating a special high fibrin substance called PRF (Platelet-Rich Fibrin) . This will then be used at your surgical site.
This tissue contains high concentrations of the most important components of a normal blood clot which means the following:
• Quick healing
• No adverse reactions
• Good regenerative ability
• Less chance of infection
• Reduced postoperative pain
• Accelerated bone formation
The PRF procedure doesn’t take any longer than a normal surgery would, apart from taking the blood sample patients will be unaware of anything different.
Platelet rich fibrin is a combination of white blood cells, platelets and fibrin. It contains high levels of platelet derived growth factor and other growth factors that together regenerate soft tissue and bone to help the body heal faster. This process is quick and painless and is performed on the same day as your scheduled periodontal procedure.
PRF Therapy is an ideal choice for most patients. However, individuals with blood clotting disorders and those taking certain medications may not be suited for this treatment.
Platelet-rich fibrin is a second-generation platelet concentrate which can boost both soft and hard tissue healing. Its benefits over platelet-rich plasma include simplicity in preparation, ease of application, minimal expense, and lack of biochemical modification
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