Patients of all ages, lifestyles and health conditions can be in need of bone grafting material. Using them helps prevent long-term problems associated with tooth loss, gum disease, and provides sufficient bone to support a dental implant. Aside from the procedure being performed, it’s critical to consider the patients when choosing grafting materials. Grafting procedures are designed to aid in the natural repair process (link to article 1), so how well the procedure will work and how the body responds depend on the patient themselves. While you may prefer certain bone grafting products, or combinations of them, you must choose the ones that are best for your patient. There is an average remodeling time frame, but the patient will ultimately determine how long that bone remodeling time is.
The following factors can impact the bone remodeling time for patients:
Patient comorbidities can also delay the healing process as they interfere with bone restoration. Diseases such as diabetes, hypothyroidism, anemia, osteoporosis, vascular disease, obesity, chronic inflammation can all affect angiogenesis. Diabetic patients in particular have an increased risk of periodontal disease, a greater loss of alveolar bone and may have more post-operative complications.
Your patient requires consideration when selecting bone grafting products that maximize the likelihood of a successful outcome. They have natural bone surrounding a defect which supplies growth factors to the site. With the right grafting material, the mechanisms of bone repair - osteoconductive, osteoinductive, and osteogenic - can heal with fewer complications.
Be aware of the potential patient problems that can affect your next steps. Whether your patient is a smoker, suffers from depression, or is recovering from cancer, there are crucial considerations to ensure the best individual outcomes.
Thomas E. Uveges, PhD is the Vice President of Biologics, ACE SOUTHERN in Brockton, Massachusetts. He received his PhD in Cell Biology from the University of Cincinnati in 2002. He then completed a fellowship at the National Institutes of Health focusing on bone biology in 2007. After his fellowship, Dr. Uveges moved into industry where he has spent over 10 years developing products for use in bone biology research and in regenerative medicine. He has worked in a wide array of therapeutic areas including orthopedics, sports medicine, wound care and dentistry.