Wednesday, September 19, 2012

Bone Grafting--Science, Uses, and Safety

It has been some time since I discussed bone grafting and why it is essential in today's dentistry. So I thought I would provide general explanations about how it works, how we use the science, and how we keep the grafting procedures safe for our patients.

When a tooth is removed, the supporting bone will atrophy in that area. It's similar to how bodybuilders' muscles can atrophy if they stop going to the gym. Bone atrophy can affect the missing tooth space as well as adjacent teeth. Bone needs teeth in order for bone to stick around. Up to 60% of the bony volume is lost in the first 6 months following a tooth removal. So maintaining bone is a good solution if you want to replace a tooth or prevent bone loss.

We routinely place preservation bone grafts; those are to preserve bone in an area where a patient intends to replace a tooth. The components of the donor bone stimulate your body to grow new bone cells (called osteoinduction). Some graft components serve as a foundation or latticework to allow your body's bone cells to grow on the graft (called osteoconduction). When we replace teeth with implants, we typically use a combination of the two processes to grow your bone. We typically use a particulate (ground-up) bone graft. Some grafts are block bone grafts, which are used in conjunction with particulate bone to rebuild larger areas of bone loss.

The type of bone growth you need depends on your goals. Some grafts resorb, some grafts remain in the area. We will explain what type of bone growth is best for your needs when you contact us for an appointment

Many patients ask me about what is in the graft, where does it come from, and is it safe? The donor tissue is usually bone from human cadavers that have been put though a lengthy process to prepare it for safe use. Below are the steps taken to ensure safety:

1) Donation Process
    • Tissue is donated through a certified Organ Procurement Organization (OPO).
    • Strict screening of donors and donated tissue includes in depth review of donors’ medical
    history and extensive serological and microbiological testing of the donated tissue.
2) Tissue Selection
    • Each lot of processed tissue is from a single donor.
    • The tissue undergoes physical inspection prior to any processing. The tissue then undergoes
    debridement process in ISO class clean rooms.
3) Preparation for Cleaning Process
    • Tissue is carefully weighed and then subjected to a proprietary combination of cleansing and reagents.
4) Cleaning Process
    • Tissue is subjected to a deep penetrating cleaning process that relies on cleansing reagents with computer-controlled mechanical processes.          
5) Post Treatment
    • Tissue undergoes additional microbial inspections and then is terminally sterilized
     through the use of low dosage gamma radiation.


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