Bone Grafting Treatments in Kansas City Missouri
The jaw bones provide the foundation for many of the structures in the mouth and face. Among these structures are the teeth which allow us to chew our food, and provide a beautiful smile. If there is a deficiency in the bone of the jaws it can lead to tooth loss, inability to chew effectively, and cosmetic changes in your face and smile. Working with your dentist, we can almost always find a solution to improve your chewing ability and to restore your smile with dental implants. In a majority of cases, the success of a proposed solution can hinge on the height, depth, and width of the jaw bone at the implant site. When the jaw bone has receded or sustained significant damage, the implant(s) cannot be supported on this unstable foundation and bone grafting is usually recommended.
There are several major factors that affect jaw bone volume:
- Periodontal Disease – Periodontal disease can affect and permanently damage the jaw bone that supports the teeth. Affected areas progressively worsen until the teeth become unstable.
- Tooth Extraction – Studies have shown that patients who have experienced a tooth extraction subsequently lose 40-60% of the bone surrounding the extraction site as it heals.
- Injuries, Infections, Tumors, and Cysts – Dental injuries and other physical injuries resulting from a blow to the jaw can cause the bone to recede. Infections tumors and cysts can also cause the jaw bone to recede in a similar way.
- Sinus Enlargement — There is a hollow air-filled cavity immediately above the upper back teeth called the maxillary sinus. As we get older, and especially if teeth are missing in the area, this hollow sinus enlarges leaving inadequate bone in the area.
Types of Bone Grafting Procedures
Preservation grafts are performed at Facial Surgery Group on a daily basis, and are the most common bone graft we provide. As its name implies, the preservation graft is designed to minimize or prevent the shrinkage of bone that occurs at an extraction site where a dental implant is planned.
Under certain circumstances, the preservation graft can be used to maintain bone at an extraction site where a dental bridge will be used to replace the missing tooth. This application of the preservation graft usually involves an upper front tooth where the gums will be readily seen when smiling, and a defect in the bone would be noticeable.
Augmentation Bone Grafts
- The Ridge Augmentation Graft If you have inadequate bone at the site of a missing tooth, an augmentation graft can add bone to prepare the site for a dental implant. There are various techniques for augmenting the bone. The following is a link to an educational video of one of the techniques.
- The Sinus-Lift Augmentation Graft As previously mentioned, the maxillary sinus is an air-filled void in the bone located just above the upper back teeth and is lined with a thin layer of tissue. As we age, the sinus slowly enlarges and displaces bone. The roots of the upper back teeth sometimes act like tent poles holding the sinus in place. When the teeth are removed the sinus enlargement is unimpeded and over years very little bone remains in the area. During a sinus lift bone graft, the lining of the sinus is gently raised from the inside floor of the sinus and the space is filled with bone graft material. If only a small amount of bone needs to be added to the sinus, the graft can sometimes be done simultaneously with implant placement; however, if a larger graft is indicated it will need to be allowed to heal prior to placing implants.
- Bone Grafting Supplements In some instances when large or complicated grafting is needed the area can also be treated with supplements that promote bone growth. By using these supplements the need for harvesting an individual’s own bone (autograft) can usually be avoided. This saves patients from the pain and possible complications associated with the secondary harvest procedure required for autografts. These supplements include: platelet rich plasma (PRP), platelet-derived growth factor (PDGF) and bone morphogenic protein (BMP). These products can be added to bone grafts in order to promote bone growth.
- Platelet Rich Plasma or PRP is a byproduct of blood that is exceptionally rich in platelets. 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. Platelet rich plasma is used to expedite the post-procedure healing process and is completely safe. A small (about 2 oz) sample of your blood will be collected. The blood will be placed into a centrifuge to separate the plasma from the red blood cells. A second centrifuge will be used to concentrate the platelets which contain the growth factor. Immediately after suturing the wound, the surgeon will apply the PRP to the surgical area in a high concentration. This will expedite your healing and decrease the amount of discomfort and swelling.
- Platelet-derived Growth Factor or PDGF is one of the main growth factors found in the human body and is well known for its wound healing. Although present naturally in your body, it can be generated synthetically in the much higher concentration needed for bone graft healing. There is approximately 1000 times more growth factor in PDGF than blood or PRP (platelet rich plasma). When added to a bone graft, PDGF stimulates wound healing and bone regeneration that continues even after the PDGF is gone. PDGF exerts its effects by recruiting and activating various cells from the surrounding tissue, that build bone, and grow blood vessels. These blood vessels provide nutrients to the new bone and help maintain long-term health of the grafted site.
- Bone Morphogenic Protein or BMP is a commercially produced recombinant material that induces new bone formation by stimulating the recruitment and differentiation of bone forming cells. Stem cells and bone producing cells are attracted to the area and stimulated to multiply and then become bone producing cells or osteoblasts. These newly differentiated osteoblasts produce bone and new blood vessel formation is also observed in the area which is vital for continued healing. Although BMP is very effective, it is expensive and is usually reserved for larger more complicated grafting situations when more conventional techniques are thought to be less predictable and successful.
Diagnosis of Deficient Bone Using Digital Radiography
Prior to placing a dental implant you will receive a state of the art cone-beam CT scan. Facial Surgery Group’s cone beam CT scanner maximizes the radiographic information received while minimizing radiation exposure. After transferring the digital scan into special software Dr. Tanner and Dr. Call will place your implants virtually on the computer and take precise measurements to evaluate if a bone graft will be needed prior to or during the implant procedure. Using this same technology, we can formulate and present a treatment plan to restore your chewing ability, and smile before to decide to start treatment.