What is BMP?
BMP stands for Bone Morphogenetic Protein. There are a number of proteins in the body which serve as signaling proteins to initiate bodily functions. Bone morphogenetic proteins play an important role in the development of bone and cartilage. Science has identified several BMP proteins. BMP-2 protein is commercially available for use in humans to help grow bone.
BMP -2, either alone, or in conjunction with bone bank bone (allograft bone), is known to improve the bone formation rate in bone grafts. Quicker bone formation and more complete bone fill in the graft site leads to improved outcomes. BMP to is available commercially as Infuse bone graft manufactured by Medtronics and approved by the FDA for use in oral and maxillofacial bone grafting procedures. The most common applications for BMP to is in maxillary sinus lift bone grafts or alveolar ridge augmentation.
One of the biggest drawbacks to bone grafting in the past, was the need to harvest bone from a 2nd area in the patient’s body-Donor site. A huge advantage of BMP-2 is that it reduces the need for a donor site from the patient and therefore reduces surgical times and decreases pain. The beauty of BMP-2 is that it allows us to be able to obtain proven and predictable bone formation without having to harvest the patient’s bone. This reduces postoperative discomfort and improves outcomes.
Dr. Stewart and Dr. Michael will discuss with you, whether you would benefit from the use of BMP-2 in your bone grafting procedures. Texas Oral Surgery Group is excited to be able to provide this cutting edge technology to its patients!
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 55 cc of blood drawn from the patient while they are having outpatient surgery.
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 morphogenetic 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 patient’s own blood, therefore, disease transmission is not an issue.
Faster healing: The supersaturation 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 doctor’s 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 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, 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 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 contraindications to PRP? Very few. Obviously, patients with bleeding disorders or hematologic diseases do not qualify for this in-office procedure. Check with Drs. Stewart and Michael to determine if PRP is right for you.