Bone grafting and the associated augmentation techniques are the mainstay for increasing the platform for implant therapy and assuring suitable esthetic results. Most clinicians agree that the autogenous bone graft provides the best results with the most predictability. However, the necessary second surgical procedure increases surgical morbidity and the potential for complications at the donor site. The discovery of a family of bone morphogenetic proteins able to grow ectopic bone and subsequent development of the technology has enabled clinicians to augment deficient alveolar ridges, atrophic maxillary sinuses, and socket defects without a second site surgery. However, there are still bone defects that can only be treated with block grafts and associated techniques that require major surgical incisions. These procedures carry a certain complication rate; wound dehiscence is the most common problem. This dehiscence often leads to the loss of the entire graft. Use of dynamic cell therapy in conjunction with the graft can reduce the incidence of wound dehiscence and promote increased healing. The cell therapy supports soft tissue regeneration by adding an array of cytokines and growth factors known to be associated with all phases of the wound healing. This discussion will focus on the use of bone proteins and cell therapy for augmentation procedures that previously were treated with conventional grafting techniques. Case histories will be utilized to illustrate the behavior of these new and exciting therapies.
Jay P. Malmquist, DMD, is associate professor of oral and general pathology and oral and maxillofacial surgery at Oregon Health Sciences University. He also maintains a private practice limited to oral and maxillofacial surgery in Portland, Oregon. Dr Malmquist is a diplomate of the American Board of Oral and Maxillofacial Surgery, the National Dental Board of Anesthesiology, and the International Congress of Oral Implantologists.
Approximate Running Time: 45 minutes