Bone Grafting Procedures & How PRP Makes Them More Effective

What You Need to Know About Bone Grafting

Bone grafting covers several different procedures depending on where the bone loss has occurred and how significant it is. Here's a look at each approach we use, along with how PRP fits into the process.

Where Bone Grafts Come From

The bone used in a grafting procedure can come from a few different sources. In many cases, bone is harvested from the patient's own body, commonly from the jaw, the hip (iliac crest), or the outer skull (cranium). Using the patient's own bone generally produces the best results. Bone can also be obtained from a tissue bank, where it's prepared from donor sources and processed to be safe and effective. In some situations, synthetic bone substitute materials are used to stimulate the body's own bone to grow into the repair site.

Sinus Lift Procedure

The upper back teeth sit just below the maxillary sinuses, which are the air-filled spaces behind your cheeks. When those upper teeth are removed, the floor of the sinus and the roof of the jaw can end up separated by only a very thin layer of bone, sometimes not nearly enough to anchor an implant.

A sinus lift, or sinus graft, solves this problem. The surgeon enters through the area where the upper teeth used to be, gently lifts the sinus membrane upward, and places donor bone in the space between the membrane and the jaw. Over several months, that bone becomes part of the patient's own jaw, creating a stable base for implants. If there's already enough existing bone to stabilize the implant from below, the sinus graft and implant placement can sometimes be done in the same procedure.

Ridge Expansion

In more advanced cases, the jawbone ridge has resorbed so significantly that it's too narrow to support a conventional implant. Ridge expansion addresses this by mechanically widening the bony ridge and placing graft material to increase its height and width. After the graft has matured, implants can be placed in the expanded ridge.

Nerve Repositioning

Sometimes the inferior alveolar nerve, which runs through the lower jaw and provides feeling to the lower lip and chin, needs to be moved to allow implants to be placed in the back of the lower jaw. Our surgeons carefully expose and shift the nerve bundle, place the implants, and then reposition the nerve. Because this procedure almost always causes some temporary numbness in the lower lip and chin area, it's considered only when less invasive options aren't viable.

Major Bone Grafting for Jaw Defects

In cases involving significant defects of the jaw, such as those caused by traumatic injuries, tumor surgery, or congenital conditions, larger-scale reconstruction is required. These major bone grafts use the patient's own bone harvested from the skull (cranium), hip, or knee, and are typically performed in a hospital operating room with an inpatient stay.

The Role of Platelet-rich Plasma (PRP)

Platelet-rich plasma, or PRP, is a product derived from the patient's own blood that's used alongside bone grafts to help the site heal faster and more completely. Here's how it works: a small amount of blood is drawn during the procedure, placed in a centrifuge machine, and spun down. In less than fifteen minutes, the PRP is ready to use. It contains a high concentration of platelets, which release growth factors that signal the body to repair and regenerate tissue more quickly.

One of those growth factors, bone morphogenic protein (BMP), specifically promotes the formation of new bone. By adding PRP to the graft site, our surgeons can encourage bone to grow more predictably and efficiently than with graft material alone. PRP also makes bone substitute materials easier to work with by giving them a gel-like consistency that's simple to apply precisely.

Because PRP comes from the patient's own blood, there's no risk of disease transmission. It's generated right in our office while the patient is already undergoing their procedure, so it adds no extra appointment. That said, PRP isn't used in every case. Our surgeons determine when it's appropriate based on the specifics of each patient's situation.