Thomas M. Weil, D.D.S
Steve L. Koo, D.D.S
Diplomats of the American Association of Oral & Maxillofacial Surgeons

Tissue & Bone Engineering

With new advent of tissue and bone engineering technology coming into practical application, Piney Point Oral and maxillofacial surgeons have utilizing this technology with great success in multiple of surgical applications. With this technology, the surgeons have been able to grow bone and tissue in severe defects to augment areas that would often require multiple surgeries to accomplish. With advances in tissue engineering technology, we can now add the benefits of molecular and biological factors to enhance the healing process, bone and soft tissue regeneration, and ultimately the outcome. Here are the key tissue engineering techniques used in maxillofacial surgery and Implant surgery:

bone grafting houston txPlatelet Rich Plasma (PRP): Derived from patients own blood; a concentrated platelet component containing various growth factors are added to bone graft material to enhance healing and promote better bone and soft tissue healing.These proteins have biological activity, among which are the growth factors to stimulate and speed up tissue regeneration. The process takes about 15 minutes, is safe, and without any side effects.

gum tissue surgery houstonrhPDGF: GEM 21S® Growth-factor Enhanced Matrix was developed utilizing innovative tissue engineering principles which combine a bioactive protein (highly purified recombinant human platelet-derived growth factor, rhPDGF-BB) with an osteoconductive matrix (beta tricalcium phosphate, ?-TCP). This completely synthetic grafting system is engineered to stimulate wound healing and bone regeneration by triggering a cascade of molecular events when implanted into the body that continues on even after the implanted PDGF is gone.

bone graft houstonrhBMP2: Recombinant (engineered) human bone morphogenetic protein-2; a genetically engineered version of a protein everyone’s body produces naturally in small amounts to regulate bone growth and healing. rhBMP2 attracts body’s own bone-building cells to the site and over time, new bone is formed. Bone grows where the rhBMP2 Bone Graft is placed, for predictable bone growth results.

tooth enamel houstonEnamel Matrix Protein: This technology found its beginnings more than a decade ago when a breakthrough in the basic biology of tooth development revealed a native complex of enamel matrix proteins and the key role they play in the development of tooth-supporting tissues. As shown below, these “matrix proteins” mediate the formation of a cellular cementum on the root of the developing tooth, providing a foundation for all of the necessary tissues associated with atrue functional attachment. Enamel matrix protein is comprised of a number of proteins that self-assemble to create a matrix. The dominant protein in this matrix is amelogenin, which has been remarkably well-conserved. These enamel matrix protein stimulates the formation of new periodontal attachment in soft tissue, measured as clinical attachment level gain and probing pocket depth of reduction and hard tissue stimulation.

Benefits of Tissue & Bone Engineering Technology

For maxillofacial surgery, loss of bone or tissue in the face can occur from a multiple etiology including trauma, infection, pathology, etc. The use of evolving technology in surgical techniques and tissue and bone engineering are exciting area in which new developments greatly increase the capability of tissue and bone augmentation and have reduced morbidity and complications from donor sites.

For dental implant surgery, bone and gum tissue loss, whether due to trauma or gum disease, has long been a limiting factor for patients seeking dental implants to replace their teeth. In such patients, bone grafting techniques allow us restore missing or defective jaw bone and create sufficient foundation necessary for strong and long-lasting dental implant- supported teeth. Bone grafting procedures performed on daily basis include extraction site bone grafting, onlay bone grafting, and sinus lift bone grafting.

Our key challenges in today’s surgical success are primarily the speed, aesthetics, and the stability of our treatments in long term. Tissue engineering and regeneration technology is an exciting and evolving science that helps us face such challenges with great promising results.