A key part of periodontal tissue engineering is the use of bone grafts. Patients with low quantities, especially in edentulous sites, require tissue grafting- a procedure that will increase their alveolar bone volume- before a dentist can perform any dental replacement treatment, for example, implantation. The latest improved surgical techniques and advanced biomaterials ensure that Monterey bone grafting patients receive the best and most predictable clinical outcomes.
Why bone grafts are essential in dentistry
The integrity of a dental implant depends on how sufficient the underlying bone is. Healthy tissue means a lesser degree of osseointegration, thus the long-term success of a replaced tooth. Patients who remain with a missing tooth for extended periods of time are at risk of reduced bone volume.
Other reasons grafting is necessary for patients to include issues from periodontitis or trauma, which eventually require tooth extractions. Procedures to remove teeth result in alveolar bone loss, especially within six months: vertical or horizontal. If a patient fails to seek treatment, bone loss can be severe, and ridge volume may be affected up to 40-60% during the first three years. Insufficient bone volume causes surgical and anatomical limitations and may affect the success of a dental implant.
Principles of bone regeneration
- Basic multicellular units
Bone regeneration is possible because of bone-forming cells called osteoblasts and resorbing bone cells called osteoclasts. These two cell types function together to rebuild a bone’s structure. However, they develop separately; from two different embryonic lineages:
- Osteoblasts: These cells are derived from bone marrow stromal stem cells.
- Osteoclasts: These cells are derived from a monocyte lineage.
- Space maintenance
This factor is specifically useful to encourage bone regeneration. Many dentists use titanium meshes with grafting materials to ensure bone resorption is slower and space is maintained. Soft tissues have higher turnover rates than bone; thus, grafts should be of low resorption rates to prevent soft tissues from occupying the space intended for bone formation. When these titanium-reinforced membranes do not support a grafting site, prostheses will collapse.
- Osteogenesis
After augmentation, the presence of growth factors and osteoblast precursors is necessary to promote bone regeneration. Therefore, graft material should contain growth factors that pass onto the recipient’s bed and vasculature, causing higher bone densities at grafted regions. Through diffusion, the osteoprogenitor cells provide nourishment that sustains the grafts.
- Osteoconduction
The initial stages of bone regeneration are bone resorption and formation. The next stage is osteoconduction which involves the development of a tridimensional scaffold containing capillaries and osteoprogenitor cells. A dentist should be careful when choosing grafting materials by focusing on those that encourage osteogenic differentiation necessary for new bone formation.
- Osteoinduction
Osteoinductors influence osteoblast precursors to differentiate into mature osteoblasts. This step is necessary during the first few weeks because it promotes the synthesis of new bone. Therefore, the osteoinductive properties of grafts are key factors for dentists to consider when choosing a suitable material for bone regeneration.
A qualified dentist should understand the principles mentioned above to ensure a smooth grafting procedure that will promote the survival of a tooth or prosthesis. Contact Perio & Implant Centers of Monterey Bay to receive professional bone grafting treatment.
