Platelet-rich Plasma Enhances Bone and Tissue Growth for Dental Implants
Laser Treatments Enhance Dental Implant Outcomes
Dentists Urged to Place More Implants
NEW ORLEANS, Nov. 13, 2009 – An exciting treatment gaining acceptance in orthopedics and sports medicine, called platelet-rich plasma therapy (PRP), is showing strong potential for accelerated healing of dental implant procedures, according to a prominent dental researcher speaking at the American Academy of Implant Dentistry (AAID) annual meeting.
James Rutkowski, DMD, PhD, editor of the Journal of Oral Implantology and a practicing implant dentist in Pennsylvania, told the AAID convention that for dental-implant patients, platelet-rich plasma therapy can accelerate bone and tissue growth and wound healing and help assure long-term success of implant placements.
“What could be better than using the body’s own regenerative powers to grow bone and soft tissue safely and quickly? For dental implant procedures, PRP treatments can jump start bone growth and implant adherence in just two weeks, which cuts down the time between implant placement and affixing the permanent crown,” said Rutkowski.
Platelet-rich plasma is obtained from a small sample of the patient’s own blood. It is centrifuged to separate platelet growth factors from red blood cells. The concentration of platelets triggers rapid growth of new bone and soft tissue. “There is very little risk because we are accelerating the natural process in which the body heals itself,” said Rutkowski. “PRP speeds up the healing process at the cellular level, and there is virtually no risk for allergic reaction or rejection because we use the patient’s own blood.”
Rutkowski noted that some orthopedic physicians have been using PRP with success for painful and hard to treat injuries like tennis elbow, tendonitis and ligament damage. An avid Pittsburgh Steelers fan, Rutkowski couldn’t resist mentioning that PRP was used in 2009 pre-game Super Bowl treatment for two Steeler players (Heinz Ward and Troy Polamalo), and both were instrumental in the team winning its 6th Super Bowl.
For dental surgery applications, Rutkowski explained that PRP is mixed as a gel that can be applied directly in tooth sockets and other sites. It also is effective in cases when bone grafts are required to foster proper bone integration for implants. Growth factors in PRP preparations help the grafts bond faster with the patient’s own bone. Rutkowski reported that in one of his studies there was increased radiographic bone density during the initial two weeks following PRP treatment when compared to sites that did not receive PRP treatment.
“Accelerated healing is a goal we’ve been seeking in implant dentistry and we now have treatment that activates the natural healing process. It is a very promising development for implant dentistry,” explained Rutkowski. He estimates that about 10 percent of practicing implant dentists have used PRP treatment and predicts it will become more common as more studies are performed.
Laser Treatments Enhance Dental Implant Outcomes
Laser treatments offer several benefits for making dental implant surgery more predictable, long lasting and aesthetically pleasing, according to a South Dakota implant dentist speaking today at the American Academy of Implant Dentistry (AAID) Annual Scientific Meeting.
Edward Kusek, DDS of Sioux Falls told his AAID colleagues that he has employed lasers in most of the surgeries he has performed in the last five years, which include implants and endodontic procedures. He said the lasers use low levels of non-ionizing radiation and actually generate less heat and discomfort than other devices commonly used in dental surgery.
“Erbium and/or diode lasers can accelerate healing in dental surgery and are very effective for detoxifying an area to clear up infection,” said Kusek. “In our practice and in several studies we have conducted, lasers have proven to stimulate better tissue growth and height and also foster stronger bone growth and better contact with the implant. As a result, we have cut the cycle time for most implant procedures from six to three months.”
Kusek added that for most patients, laser detoxification allows immediate placement of the implant and securing a temporary crown in one visit. “Being able to send the patient home in one day with an immediate load implant in the smile zone helps socially because the missing teeth aren’t noticeable,” said Kusek. “Three months later, the permanent crown can be affixed.”
In his presentation, Kusek covered a case of young women whose root canal failed because the root cracked and the area was badly infected. The tooth was extracted and the laser was used to clear up the infection. “Once the socket and surrounding area were detoxified by the laser treatment, the implant was inserted and a temporary crown attached. The patient went home with her smile looking great and the final outcome in three months was excellent,” said Kusek. “Given the degree of infection, she would not have received an immediate-load implant in the same visit without the laser treatment.”
Kusek said about 7 percent of dentists have some type of lasers in their offices and many are evaluating the cost benefits. “In my experience, nothing matches laser applications for overall implant procedure outcomes in infection management, bone regeneration, osseointegration, tissue-growth enhancement and overall aesthetic success,” he said.
Dentists Urged to Place More Implants
In a candid address, noted dental researcher, author and lecturer Gordon Christensen, DDS, PhD, urged more dentists to add implants to their practices, but said the procedure must become simpler and less costly to achieve optimal public and professional acceptance. Christensen spoke at the American Academy of Implant Dentistry Annual Scientific Meeting.
“I strongly encourage more dentists to add implants to their practices and make this treatment accessible and affordable for their patients,” said Christensen. “The statistics on missing teeth in the U.S are staggering and frankly embarrassing for the dental profession. We can make a major contribution to improving the nation’s oral health by further utilization of dental implants, but we must get serious about reducing the cost of the procedure. Ultimately, costly implant placements don’t serve the public or the profession, even though dental implants are the best treatment available for replacing missing teeth, ” he said.
Impressive advances in technology have made implant procedures safer and more predictable with 95 percent-plus success rates, Christensen noted. “However, we need more innovative and simpler implant designs – short, wide, narrow, hollow, non-round -- and simpler and more reliable methods for evaluating bone quality, quantity and osseointegration.”
Christensen also commented that digital imaging has revolutionized dental implant surgery but contributes to the high cost of the procedure. “No doubt, the most dramatic practice improvements are attributable to state-of-the art digital imaging vs. two dimensional slides that enable implant dentists to analyze the anatomy of the patient’s jaw without surgery, which saves time and shortens implant recovery,” he said. “While the advantages of CT scans in dentistry have been well known for many years, cone-beam units for dentists’ offices are a major capital expense that many dentists today might not be able to afford. This may prevent many from performing implants, so we need to find ways to make digital imaging more mainstream in dental practices.”
Despite these challenges, Christensen urged leaders in dentistry to continue to apply the principles of evidence-based dentistry to help make implant procedures simpler and less costly. “As implant dentistry grows in popularity, evidence-based research holds great promise for developing streamlined protocols that will make implants affordable for greater numbers of patients.”
About AAID
AAID can help consumers find a local credentialed implant dentist at www.aaid.com. AAID is based in Chicago and has more than 3,500 members. It is the first organization dedicated to maintaining the highest standards of implant dentistry by supporting research and education to advance comprehensive implant knowledge.