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Bone Grafting &
Platelet Rich Plasma
Rely on the experience of a surgeon.
Bone grafting procedures can be performed with either local anesthesia or IV anesthesia except major bone grafting. Major bone grafting is usually performed to repair large defects in the face or jaws and the bone is typically autogenous and harvested from the iliac crest (hip), the rib, the tibia, or the skull. These procedures are performed in the hospital with general anesthesia.
Bone Grafting Procedure Information
Bone grafting is a surgical procedure that replaces missing bone in order to repair extremely complex bone fractures, to reconstruct lost tissue due to pathology, or to prepare the jaws for dental implants.
Bone generally can regenerate completely but requires a very small fracture space or some sort of scaffold to do so. Bone grafts may be autologous (bone harvested from the patient’s own body, often from the iliac crest), allograft (cadaveric bone usually obtained from a bone bank), or synthetic (often made of hydroxyapatite or other naturally occurring and biocompatible substances) with similar mechanical properties to bone. Most bone grafts are expected to be reabsorbed and replaced as the natural bone heals over a few months.
The principals involved in successful bone grafts include:
- osteoconduction (guiding the reparative growth of the natural bone),
- osteoinduction (encouraging undifferentiated cells to become active osteoblasts), and
- osteogenesis (living bone cells in the graft material contribute to bone remodeling). Osteogenesis only occurs with autografts.
- Socket graft preservation for dental implants
- Filling of defects caused by tumors
- Repair of alveolar clefts in cleft lip and palate patients
- Ridge augmentation for dentures or implants
- Augmenting voids in bone caused by trauma
- Sinus Lift Procedure for Dental Implants
Virginia Facial Surgery
Types of Bone Grafts
Autograft
Autograft in Oral and Maxillofacial Surgery
Autologous (or autogenous) bone grafting involves utilizing bone obtained from the same individual receiving the graft. Bone can be harvested from other specific bones, such as from the iliac crest, or more commonly in oral and maxillofacial surgery, from the mandibular symphysis (chin area), or often from the hip, jaw, ribs, and skull. This is particularly true for block grafts, in which a small block of bone is placed whole in the area being grafted. When a block graft is performed, autogenous bone is the most preferred because there is less risk of graft rejection because the graft originated from the patient’s own body.
Allografts
Using Donated Bone for Grafting
Allograft bone, like autogenous bone, is derived from humans; the difference is that allograft is harvested from an individual other than the one receiving the graft. Allograft bone can be taken from cadavers that have donated their bone so that it can be used for living people who need it; it is typically sourced from a bone bank.
Xenografts
Exploring Bovine and Porcine Xenografts
Xenograft bone substitute has its origin from a species other than human, such as bovine or porcine. Xenografts are usually only distributed as a calcified matrix. Over time, these grafts are resorbed by your body’s natural remodeling processes and are replaced with your bone.
Benefits of Platelet Rich Plasma
The Science Behind Accelerating Healing with PRP
Platelet-Rich Plasma
Platelet-rich plasma (PRP) is exactly what the name suggests. The substance 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 (thousands) and the large amount of blood needed (one unit) to produce a suitable quantity of platelets. New technology permits the doctor to harvest and produce a sufficient quantity of platelets from only a small amount of blood drawn from the patient’s IV during outpatient surgery.
What is the advantage of using 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 to initiate the healing process. One of those cell types is platelets. Platelets perform many functions, including the formation of a blood clot and the 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 that are released into the wound, the more stem cells that are 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 Dr. Mueller when he places dental implants. By adding PRP, and thus BMP, to the implant site with bone substitute particles, Dr. Mueller can now grow bone more predictably and faster than ever before.
Dr. Mueller has been using PRP for over 10 years. He routinely uses PRP for bone grafting, facial and jaw reconstruction, and facial cosmetic surgery. Dr. Mueller has lectured internationally on tissue engineering with the use of PRP and BMP.
PRP Has Many Clinical Applications
- Bone grafting for dental implants. This includes veneer and onlay grafts, sinus lift procedures, ridge augmentation procedures, and closure of cleft, lip, and palate defects.
- Repair of bone defects created 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 patient’s own blood, therefore, disease transmission is not an issue.
- Convenience: PRP can be generated in the doctor’s office while the patient is undergoing an outpatient surgical procedure, such as the placement of dental implants.
- Faster Healing: The super-concentration 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 40 – 60 cc of blood in Doctor Mueller’s office, the patient need not incur the very large expense ($2000 – $3000) of the harvesting procedure in a hospital or at the blood bank.
- Ease of Use: PRP is easy to handle and 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 15 minutes, the PRP is formed and ready to use.
Should PRP Be Used In All Bone Grafting Cases?
Not always. In some cases, there is no need for PRP. However, in the majority of cases, the 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 Cost?
Unfortunately, it does not. The cost of the PRP application (approximately $600 – $700) is paid by the patient.
Can PRP Be Used Alone To Stimulate Bone Formation?
No. PRP must be mixed with the patient’s own bone, a bone substitute material such as demineralized freeze-dried bone, or a synthetic bone product, such as BIO-OSS®.
Are There Any Contradictions 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.
Learn More About
Bone Grafting & Platelet Rich Plasma
Discover the Benefits of Bone Grafting Combined with Platelet Rich Plasma
Dr. Mueller specializes in combining bone grafting with PRP to optimize results and offers consultations to discuss personalized treatment plans. For more information or to schedule a consultation, Contact us today.
Schedule a Consultation
The consultation is perhaps the most important time spent between the doctor, staff, and patient. It is paramount that patients feel relaxed and be prepared to talk and listen. Some patients are nervous when it comes to talking to someone about their cosmetic concerns.
Please feel free to bring a spouse or friend along. It is always good to discuss the treatment at some point with a caregiver or support person.
We will address your concerns, and at the same time, Dr. Mueller will fully evaluate your facial features. He will then discuss the comprehensive changes of aging and the available options to improve and enhance your look. We will discuss your health history and how it relates to safe surgery and anesthesia. Please be prepared to discuss your medical history and have a list of all the medications that you are taking. This includes all supplements and over-the-counter medications. It is also important to know if you smoke and how much.
Dr. Mueller always reminds patients that facial cosmetic surgery is a want or desire to look better. There are always multiple options for rejuvenation and he will discuss various treatment options. We encourage you to take notes since we will be discussing many things. We will provide you with a list of procedures we discussed as well as their costs. We want all of our patients to feel satisfied with their cosmetic surgery results.
