By Alexander Germanis
For millennia, horticulturalists have been utilizing a technique originally unique to their field in order to improve multiple aspects of the trees, bushes, and other plants in their care. The art of grafting has been used for, among other things, making plants more resistant to disease and pestilence, for breeding purposes and for increasing cold weather hardiness. But it is for the purpose of repair that grafting eventually crossed scientific paths with medicine.
Although most people are somewhat familiar with the concept of skin grafting, there is a lesser known medical technique called bone grafting, whereby a piece of bone is removed, usually from elsewhere in a patient’s body, and inserted in an area in need of new bone growth. The graft provides a frame upon which new bone can grow and is often necessary to replace bone in an area where complex fractures have occurred or where bone loss has occurred due to disease.
At least that was the past state of bone grafting as Dr. Stephen Doran, D.M.D. of Doran, Capodice, Efaw and Ocheltree, LLC in Bloomington recalls. When he first started in the field of oral and maxillofacial surgery, “You could take bone from a hip, a tibia, from another place in the mouth or from the cranium and transfer it to where you needed it to get new bone to grow.”
“Now,” he continues, “we have techniques where we’re using synthetically derived bone grafting materials that chemically induce the surrounding tissue to form bone.”
His colleague, Jack Capodice Jr., M.D., D.M.D., explains further: “We pull blood products out of your own blood and we spin that down to the growth factors that help with healing and improve bone grafting. The research on that is ongoing because if you can replace bone without having to take it from a donor site everybody is a lot happier.”
The improved grafting techniques have put a new face on their particular field of expertise — opening new ways to better the looks and lives of their patients. “You can actually widen a jaw or make more room for a dental implant,” Dr. Doran says. Known as a bone ridge expansion procedure, the additional room is created, as the doctor says, “by spreading the jaw apart and then interpositionally or internally grafting synthetic bone.”
“Or,” Dr. Capodice adds, another technique can be used, “called INFUSE bone grafting, a human derived signal protein that induces the body to grow natural bone, and predictably grows bone in that scenario for certain without having to take bone from another area.”
Regardless of the method by which the bone is grafted in, once the grafting is complete in the ridge expansion, a re-constructed jaw can serve as the site of the proper size dental implant, “rather than just going with a narrower ridge and putting a narrower implant in there and not having as wide an implant as you want to replace the tooth that you’re missing,” the doctor continues.
Perhaps the biggest advance in implant dentistry, however, is the sinus lift procedure, which also owes its success to bone grafting. Dr. Doran cites placing a new molar in the upper jaw as an example of why bone grafting is necessary for such a procedure: “Because of the nature of the bone of the upper jaw, we’re usually not able to get the same length of implant in there as the tooth you’ve lost. Say there’s five millimeters of available bone in the upper jaw before you enter the maxillary sinus,” he says. “Five millimeters of bone is not an adequate length implant to chew against a tooth on the lower jaw; it would physically get knocked out. So, you have to find some way to get a longer implant in there.”
Dr. Capodice explains further: “What we can do now with very good predictability and very good success is we can actually graft bone into the maxillary sinus and then place your implant simultaneously into that bone graft. And the implant would be of adequate length and of adequate diameter. Then you let that heal for more than a regular implant — closer to six months.”
Thanks to bone grafting and the sinus lift procedure, the result is new molar teeth in the upper jaw — something that, according to Dr. Doran, “was not even considered just a few years ago. In years past,” he continues, “if you lost your upper molar teeth, you had to use some kind of partial or full denture.”
The changing face of the profession means the profession’s ability to restore the faces of its patients has changed dramatically in recent years. Dr. Capodice concludes: “The improvements in implants and bone grafting give us just about every option that we want. That’s just phenomenal.”
Drs. Doran, Capodice, Efaw, and Ocheltree provide a full scope of oral and maxillofacial surgery with expertise ranging from wisdom tooth removal and dental implants to bone grafting procedures, corrective jaw surgery, and cosmetic facial surgery. Their office is located at 109 Regency Dr. in Bloomington with satellite offices in Watseka and Lincoln. For more information, you may call 309-663-2526 or visit them online at www.dceooms.com.
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