Bone defects often result from tumor resection, congenital malformation, trauma, fractures, surgery, or periodontitis in dentistry. Although dental implants serve as an effective treatment to recover mouth function from tooth defects, many patients do not have the adequate bone volume to build an implant. The gold standard for the reconstruction of large bone defects is the use of autogenous bone grafts. While autogenous bone graft is the most effective clinical method, surgical stress to the part of the bone being extracted and the quantity of extractable bone limit this method. Recently mesenchymal stem cell-based therapies have the potential to provide an effective treatment of osseous defects. In many clinical studies both the current therapy for bone regeneration and the perspectives in the field of stem cell-based regenerative medicine, addressing the sources of stem cells and growth factors used to induce bone regeneration effectively and reproducibly have been discussed.
In this regard, we have adapted a multidisciplinary approach towards engineering dental implants; through the systemic integration of multiple progenitor stem cells isolated from dental pulp tissues, growth factors to support cellular signaling and conductive extracellular matrix scaffold to be able to provide chemical as well as mechanical cues, thus promoting multicellular interactions, orchestrate cellular adhesion, migration and differentiation into a desired cellular lineage.
Accordingly, some indications that may denote a need for regeneration and reconstruction through Bone Grafting include:
Difficulty in swallowing, chewing or biting of food.
Chronic jaw and/or Jaw joint pain and headache.
Chronic mouth breathing or dry mouth.
Immoderate wear to teeth.
Inequitable facial appearance.
Birth Defects or facial injuries
Results of Bone Grafting through Dental Pulp Derived Stem cells and Biodegradable Scaffolds.
Conventional bone grafting techniques still represent many challenges, like availability of suitable grafts, infection, longer recovery period, expenses, deformity as well as scarring, etc. Although, with the cohort of stem cells isolated from periodontal dental pulp tissues and application of synthetic biodegradable matrix, exponential growth has been noted in the elimination of previously described issues, like limited availability, immune rejection, low success rates, etc.
Thus, with the collaborative efforts of scientists, cosmetic experts and surgeons of Advancells; it is possible to achieve the ultimate goal of creating bone grafts to enhance natural repairing and regeneration of bone in the craniofacial region.
Chronic dental disease and tooth loss often lead to the loss of hard tissue in the jaw. Patients with missing teeth by infections, or inflammation may experience bone resorption with loss of the affected part of the jaw. In addition to making a patient uncomfortable, this bone loss can cause unsightly disfigurements and may complicate the fitting of implants and other dental appliances. Although dental implants serve as an effective treatment to recover mouth function from tooth defects, many patients do not have adequate bone volume to build an implant.
Thus, in order to adapt, circumvent and treat these local physiological as well as anatomical limitations; regenerative, reconstruction of bony platform with application of regenerative medicine and modern tissue engineering technology can be emphasized for natural, tailored lifting of sinus membrane, for their functional restoration.
In this regard, the site, size and associated soft tissue defects represent the three most important factors; in determining the impact of treatment procedure on functional restoration and aesthetics.
Our process of jawline reconstruction involves three key elements, which include:
Inductive soluble growth factors
Stem cells isolated from dental pulp tissue
Biocompatible scaffolds made up of Xeno/Allo/Synthetic substitutes
Accordingly, steps involved in the procedures are:
Step 1- Qualification For The Treatment
A safety and efficacy assessments will be prescribed by our experts in order to investigate a degree of severity and a need to undergo particular treatment. Following pretreatment assessments can be suggested.
Infectious Disease Testing
Medical Reports & History
Panorex X Rays
Cephalometric X Rays
Models & Impressions
As per the results, the patient will be further counselled for final treatment that will impact proper jaw functions and an aesthetic appearance of an entire face.
Step 2- Source Extraction
Mesenchymal stem cells and/or neural crest derived stem cells isolated from soft tissue of the wisdom tooth has been confirmed to be the most potent, non-invasive source of stem cells with high proliferation rate, higher degree of differentiation and a better capacity to interact with biocompatible matrices and growth factors for faster regeneration and healing.
Thus, Dental Pulp stem cells sourced from either wisdom tooth or milk tooth, that are already planned to remove will be collected as a better fitting tool due to easy access, and a very low morbidity of the anatomical site.
Step 3- Laboratory Processing
Tissue samples containing stem cells will be transported to our ultramodern GMP grade facility, through placing it, in a screw top vial containing appropriate transportation media; which may nourish it during transportation. Mesenchymal stem cells and/or neural crest derived stem cells will be isolated from a soft dental pulp tissue, which is encased inside a bony cavity of wisdom tooth or milk tooth; under controlled sterile conditions.
Step 4- Stem Cell Implantation
Expanded stem cells will be loaded on a suitable matrix called as scaffold to allow speedy attachment, faster regeneration into specific cell types and easy proliferation. Although scaffolds are of different types, shapes, patterns as well as biocompatible materials; depending upon the necessity, capacity and costing it can be made up of Xeno/Allo/Synthetic substitute.
Tissue Reconstruction through Biodegradable Scaffolds: - We have wide range of ideal scaffolds made up of different biocompatible materials, to provide chemical stability, physical strength and mimicking the surrounding tissue with respect to faster cellular proliferation, better adhesion performance, controlled degradation, easy differentiation and better integration.
A scaffold will further be implanted and secured in a position above and/or below jawline; depending upon the clinical condition to allow faster reconstruction and speedy healing of jawbones.
Step 5- Maintenance & Follow Up
Following the completion of implants, patients are advised to thoroughly clean around the implants as instructed by our dental hygienist. Patients will be called for the regular review so that the health and the integrity of the soft tissues and other bones can be evaluated.
As body‚Äôs natural tendency, a considerable bone resorption is observed after tooth loss; due to which, implanting a new, artificial tooth becomes impossible. In this regard, bone grafting can be suggested to prepare a strong platform for stronger dental implants, in an aesthetic manner. As a matter of fact, bone grafting can also be used to save teeth, which may have experienced bone loss, resulting from gum diseases.
What causes bone loss?
A bone loss can be caused, due to:
Loss of tooth
What are the potential benefits of bone grafting?
Bone grafting is a process that assist your body in regenerating lost bone. Over the period of time, latest technology has been incorporated to make the procedure pain free and minimally invasive; limiting the need to exploit bone from another part of your own body.
With the incorporation of regenerative stem cells, which have been isolated from dental pulp tissues; it is now possible to allow natural regeneration and integration of new bone to restore lost function. Moreover, tissue engineering and application of biocompatible tissue grafts can create a suitable microenvironment for easy acceptance of implants.
How is the bone grafting procedure being accomplished?
Prior to your procedure, you will be advised some preoperative tests that will give us the exact idea of your condition, as well as some specifics about the treatment. On the day of treatment, a local anesthesia will be applied on the grafting site. A small incision will be made around the area, where bone needs to be grafted. A grafting material is generally made within the grafting site that is being made up of biocompatible material, which does not need any removal.
An enriched fraction of mesenchymal stem cells, isolated from dental pulp tissue will be implanted over the scaffolds to integrate themselves into the jawbone and allow speedy regeneration. The material is being stabilized with the protective covering and a small dose of patient‚Äôs own platelet rich plasma is offered for faster regeneration.
How long does bone grafting take place?
Since every individual is unique, the procedure that is being offered will also be very specific. There are several factors, which determine the length and the treatment outcome. They may include overall dental health, integration of stem cells into jaw bone and their internal mechanics. However, in general, a period of 3-6 months is allowed for healing.
Where does grafted bone come from?
Conventionally, the bone required for a bone grafting procedure had to be taken from another part of jawbone and/or body. This requires indulgence into additional surgical procedures and thus, can impact cost as well as recovery period.
However, technology has gained access to different substitutes of bone grafts that are of Auto/Allo/Xeno origin. These grafts are specifically biocompatible grafts that are made up of synthetic material and can be used as a potential, risk free substitute of your own bone.
How stem cells therapy can be useful in undergoing Tissue Regeneration?
Stem cells are known to be the most potent cells in our body with the ability to retain their number back, through mitotic cell division and can undergo directed differentiation into variety of other specialized cells. Mesenchymal stem cells isolated from dental pulp tissue are found to be very helpful in guided tissue regeneration in the craniofacial cavity. However, it has as well been very apparent in different bench side studies that stem cells behavior and differentiation ability can be enhanced significantly through generation of suitable three-dimensional microenvironment. This microenvironment can be constructed through biomimetic scaffolds made up of All/Xeno/Auto substitutes in order to enhance and speed up the process of tissue reconstruction.
Is there any special care I need to take with my grafts?
Dental implants should be cared just like your natural teeth. In general, it is advised to brush twice a day, flossing regularly to prevent further plaque formation and schedule routine dental examinations.
How can I reduce a future risk of bone loss?
A risk of bone loss can be prevented by replacing lost tooth quickly with dental implants. However, if anyone is not ready with dental implants immediately after a tooth loss.
How much will the treatment cost?
Since, it is very difficult to accurately determine different treatment costs without clinically examining the patient; we would advise patients to undergo detailed consultation; wherein, we would assess the issue, through in person consultation, in order to evaluate the cost of treatment.