Tissue Engineering

Oral & Maxillofacial Surgery of San Buenaventura CA

Bone Morphogenic Protein (BMP)

Recombinant Bone Morphogenetic Protein (BMP) is the protein that your bone uses to repair itself when it is fractured or when going through a repair. The DNA code for this protein is known, and when the DNA is placed in cell cultures, BMP is made by the cells in a large container. The BMP protein is purified by the manufacturer, freeze dried, and sent to the doctor as a powder. We use this protein to form bone in your sinuses or large cysts. For your sinus graft, the sinus membrane is elevated and the protein is placed into the prepared sinus site. Bone forms within six months. Bone formation is often confirmed by conventional radiographs or by a ct scan. Implants are then placed into the bone formed by the use of recombinant genetic engineering. The benefit of this procedure is elimination of the need to use bone from your hip, chin, or leg, and it also eliminates the need to use another persons bone (allograft) or bone from a cow (xenograft). Your personal preferences and your needs will be discussed at your consultation visit.

Platelet Rich Plasma

Platelet Rich Plasma (PRP) is exactly what its name suggests. This growth factor is a by-product of blood (plasma) that is rich in platelets. Until now, its use has been confined to the hospital setting. This was due mainly to the cost of separating the platelets from the blood and the large amount of blood needed to produce a suitable quantity of platelets. New technology permits the doctor to harvest and produce a sufficient quantity of platelets from only 55 cc of blood drawn from the patient while they are having outpatient surgery. In our office we have the option of using the latest equipment in preparation of PRP for our patients surgical needs.

 

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Why all the excitement about PRP?

PRP permits the body to take advantage of the normal healing pathways at a greatly accelerated rate. During the healing process, the body rushes many cells and cell-types to the wound in order to initiate the healing process. One of those cell types is platelets. Platelets perform many functions, including formation of a blood clot and release of growth factors (GF) into the wound. These GF (platelet derived growth factors PGDF, transforming growth factor beta TGF, and insulin-like growth factor ILGF) function to assist the body in repairing itself by stimulating stem cells to regenerate new tissue. The more growth factors released sequestered into the wound, the more stem cells stimulated to produce new host tissue. Thus, one can easily see that PRP permits the body to heal faster and more efficiently.

A subfamily of TGF, is bone morphogenic protein (BMP). BMP has been shown to induce the formation of new bone in research studies in animals and humans. This is of great significance to the surgeon who places dental implants. By adding PRP, and thus BMP, to the implant site with bone substitute particles, the implant surgeon can now grow bone more predictably and faster than ever before.

PRP has many clinical applications:

  • Bone grafting for dental implants. This includes onlay and inlay grafts, sinus lift procedures, ridge augmentation procedures, and closure of cleft, lip and palate defects.
  • Repair of bone defects creating by removal of teeth or small cysts.
  • Repair of fistulas between the sinus cavity and mouth.

PRP also has many advantages:

Safety: PRP is a by-product of the patients own blood, therefore, disease transmission is not an issue.

Convenience: PRP can be generated in either of our offices while the patient is undergoing an outpatient surgical procedure, such as placement of dental implants.

Faster healing: The super-saturation of the wound with PRP, and thus growth factors, produces an increase of tissue synthesis and thus faster tissue regeneration.

Cost effectiveness: Since PRP harvesting is done with only 55 cc of blood in the doctors office, the patient need not incur the expense of the harvesting procedure in hospital or at the blood bank.

Ease of use: PRP is easy to handle and actually improves the ease of application of bone substitute materials and bone grafting products by making them more gel-like.

Frequently asked questions about PRP:

Is PRP safe? Yes. During the outpatient surgical procedure a small amount of your own blood is drawn out via the IV. This blood is then placed in the PRP centrifuge machine and spun down. In less than fifteen minutes, the PRP is formed and ready to use.

Should PRP be used in all bone-grafting cases? Not always. In most cases, there is no need for PRP. However, in some cases, application of PRP to the graft will increase the final amount of bone present in addition to making the wound heal faster and more efficiently.

Will my insurance cover the costs? Unfortunately not. The cost of the PRP application (approximately $400) is paid by the patient.

Can PRP be used alone to stimulate bone formation? No. PRP must be mixed with either the patients own bone, a bone substitute material such as demineralized freeze-dried bone, or a synthetic bone product, such as BIO-OSS.

Are there any contraindications to PRP? Very few. Obviously, patients with bleeding disorders or hematologic diseases do not qualify for this in-office procedure. Check with your surgeon and/or primary care physician to determine if PRP is right for you.