Patients

Bone Regeneration

What is bone regeneration?

It is the natural ability of bone to repair itself, a fundamental in skeletal development and the continuous remodeling that the skeleton undergoes throughout adult life.

What can disrupt the regeneration process?

While bone can repair itself in response to injury, there are circumstances in which bone regeneration may be impaired or delayed, such as in cases of tumor resection, trauma, and infection. Certain medical conditions including osteoporosis can also impact your body’s ability to repair bone.

What to do in case of regeneration issues?

In these cases, outside intervention is needed, and bone grafting is the most common technique used to aid in bone regeneration. It is a surgical procedure to repair and rebuild diseased or damaged bones. During a bone grafting procedure, a new piece of bone is placed where a bone needs to heal or join. The cells inside the new bone can then seal themselves to the old bone.

Bone grafting may be needed for different medical reasons such as dental implant surgery, spinal fusion surgery, and surgeries to help promote bone growth around surgically implanted devices such as in knee replacement. These bone grafts can provide a framework for the growth of new bone. Jaw, hips, knees, and spine are common locations for bone grafting.

What are the different types of bone grafts?

There are four common types of bone grafts: autografts, allografts, xenografts, and synthetic materials. Each graft type has advantages and disadvantages. Your dental provider will decide which material is best suited for your needs and specific case.

  • Autografts originate from your own tissue. While considered the “gold standard” due to their safety and fast healing time, they do require a second surgical site to harvest the bone tissue.
  • Allografts use bone tissue donated from another human. They are used when you are not a candidate for an autograft.
  • Xenografts are derived from the tissue of an animal. They are used when you are not a candidate for an autograft or allograft.
  • Synthetic materials such as polymers, metals or ceramics are manufactured to mimic the natural properties of bone. They are used when you are not a candidate for the other graft types.

Does bone regeneration last forever?

Bone regeneration through bone grafting has a high success rate and can last a lifetime. However, like any medical or dental procedure, issues can occur. These can be due to your health, how the bone graft was placed, and the surgical technique used.

Dental

Tooth Removal

Which conditions typically require tooth removal?

Here are the most common causes:

  • Tooth decay
  • Severe gum disease
  • Fractured teeth
  • Impacted teeth
  • Crowded teeth
  • Dental trauma

Do teeth need to be replaced after removal?

The decision to replace extracted teeth is one that should be made between you and your dental provider. While every case is different, it is important to know what can happen if a tooth is not replaced.

What are the possible issues of missing teeth?

Teeth play multiple important roles in our lives; they help us chew, speak, and impact our physical appearance. When teeth are missing, it can lead to shrinkage of the jawbone due to lack of stimulation normally provided by contact of the teeth and chewing which can lead further to conditions below.

Alveolar resorption or loss of bone
This can cause further tooth loss, and pain with chewing or speaking.
Malalignment of the teeth or jaw
This can lead to jaw pain, teeth grinding, and even tooth decay and gum disease.

What can be done once bone loss has occurred?

When too much bone density is already lost, bone grafting may be needed to provide enough bone for, if prescribed, a dental implant or to support the resorped jawbone due to the missing teeth or a gum disease. When bone graft is placed in the affected area, the surrounding bone creates new bone cells around the material to produce new growth that will eventually replace the graft.

Periodontitis

What are the causes and early signs?

Periodontitis, or gum disease, is caused by the accumulation of plaque. Plaque harbors harmful bacteria that trigger an immune response, leading to the inflammation of the gums and erosion of the bone. Early signs of periodontitis include red, inflamed gums that may bleed during brushing, flossing, or eating hard food.

What does an advanced stage periodontitis look like?

Advanced periodontitis is indicated by the presence of bone loss, the recession of the gums, and deepening periodontal pockets. Teeth may become loose and fall out. Other signs include pain with chewing, bad breath and a metallic taste in the mouth.

How can periodontitis be treated?

Prevention is key in treating periodontitis. The earlier it’s caught, the better the outcome. Gingivitis, the earliest stage of periodontitis, is reversible. However, later stages of periodontitis can lead to irreversible damage. Treatment will ultimately depend on how advanced the disease is:

  • If in the earlier stages, non-surgical intervention may be appropriate. These include scaling, root planing and antibiotics for any infections.
  • If periodontitis is advanced, surgical intervention may be needed. These may include flap surgery, bone and gum grafts, and guided tissue regeneration.

Dental Implants

What is a dental implant?

Bone loss can be prevented by replacing missing teeth in the jawbone through dental implants. They are placed into the bone and serve to fill in the resulting gaps. Implants preserve jaw structure and have the benefit of functioning just like regular teeth. There are three main types of dental implants.

Zygomatic
This implant type is placed in the cheekbone.

Endosteal
This implant type is placed in the jawbone.

Subperiosteal
This implant type is placed between the gum tissue and the bone.

There are also different options of dental implant procedures, each with its own pros and cons. Your dental provider will tailor your treatment plan to best suit your needs as a patient.

Single-tooth implants

Implant-supported bridges

Fixed full-arch implants

Implant-supported dentures

What can happen should a complication occur?

Complications can affect the grafted bone and/or the implant, and early signs include bleeding, infection, and pain. Left untreated, these issues can cause peri-implantitis which is an inflammation of the tissues surrounding the dental implant. This condition can and will usually lead to bone loss, resulting in the implant becoming loose.

While not common, dental implant rejection can also occur. It is important to follow all post-op care instructions and to notify your dental provider if any symptoms of infection or rejection occur.

Orthopedic

How does bone grafting work in spine surgeries?

Spinal fusion is one of the most common surgeries performed on the neck or the back. The idea is to fuse together damaged bones in the spine so that they heal into one single, solid bone. In order for bones to fuse or heal together, additional bone is needed, and it is administered through bone grafting.

What other procedures does bone grafting apply to?

Bone grafting is a common orthopedic procedure to promote bone healing by providing a foundation for the patient’s body to grow new bone and to provide structural support to the skeleton by filling large gaps between bones. Bone grafting is required for bone healing around implants, such as plates, screws, and joint replacements. For instance, during trauma surgery, a metal rod may be used to stabilize the bone while bone graft is placed at the fracture site to stimulate bone healing and growth.