Bone Grafting & Tissue Engineering

Jawbone atrophy occurs in areas of tooth loss, the bone tissue that once anchored tooth roots shrinking away over time. Bone loss can also happen in response to dental problems, gum disease or injury. This often creates issues with poor bone quantity or quality, leaving these sites unsuitable for dental implant placement. However, with today’s bone grafting and tissue engineering techniques and technologies, we now have the ability to grow bone where it is needed, renewing these sites to allow placement of dental implants to restore the oral function and appearance of patients.

Regeneration Via Stem Cells And Growth Factors

Increasing knowledge about tissue regeneration has given rise to a number of new methods for promoting the growth of bone in deficient areas, which can eliminate the need for traditional bone grafts in many cases. These methods use various growth factors, which are proteins that interact with stem cells in the body to generate new bone growth. Commonly used growth factors include Recombinant Bone Morphogenetic Protein (BMP) and rhBMP-2, which are bioengineered growth factors, and Platelet Rich Plasma (PRP).

Bone Grafting, Minor And Major

Dr. Arroyo may repair inadequate bone structure with bone grafting, using bone obtained from a tissue bank or from the patient’s own jaw, hip or tibia (shin bone). Sinus bone grafts are common to replace bone in the posterior upper jaw, as are bone grafts to repair sites that have lost bone due to tooth loss, injury or gum disease. Guided bone or tissue regeneration is often used in conjunction with bone grafting, a technique that places special membranes under the gum tissue, where they dissolve and act to protect the graft and encourage bone regeneration.

Major bone grafting is a procedure that is typically done to repair defects in the jaws, which may be caused by injury, surgical removal of tumors or congenital factors. For large defects, bone is harvested from the patient’s own body, most commonly the skull, hip or tibia. These procedures are generally done in a hospital operating room and patients typically require a hospital stay after the procedure.

Maxillary sinuses are located behind the cheeks and over the upper teeth. A thin wall of bone separates these cavities from the mouth, with roots of upper teeth often extending into them. When those teeth are lost, that wall becomes even thinner with bone loss, often so much so that dental implant placement is impossible.

However, a sinus lift procedure can thicken that bone, creating adequate support for dental implants. To augment the area, Dr. Arroyo will insert bone graft material into the floor of the sinus cavity, which will become part of the jawbone as the area heals.

Expansion of the jaw ridge is done when bone resorption has degraded its height and/or width. This procedure uses mechanical means and/or bone grafting to restore height and/or width to make implant placement possible.
To place implants in certain areas of the lower jaw, it is sometimes necessary to more the inferior alveolar nerve, which provides feeling to the chin and lower lip. To access this nerve, the surgeon must remove a small section of the jawbone, which is then refilled with bone graft material.

Today’s advanced therapies for bone grafting and tissue engineering have improved lives, opening the door to dental implant treatment for many patients who once would have been turned away. To make that possible, Dr. Arroyo may use a combination of these treatments in a patient, with most done right in our office using local anesthesia and, when necessary, IV sedation.


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