Growth Factors / Bone Morphogenic Protein
Significant research has been performed for the last 50 years on mechanisms and cellular processes that are involved in wound healing and bone growth and repair. When the body sustains a wound, blood flows into the wounded area containing vital cells and platelets to help with coagulation and wound healing and repair. Platelets in the blood contain numerous growth factors that stimulate healing on a cellular basis. White blood cells and special healing cells cells are also present which help the wound to heal.
Platelet rich plasma (PRP) is exactly what the name suggests. The substance is a by-product of your blood (plasma) that is rich in platelets and growth factors. Lymphocytes and special healing cells are also present. Until recently, its use has been confined to the hospital setting. Drs. Blecha and Jandali has purchased several medical grade machines that concentrate a patient’s platelets and growth factors. New technology permits the doctor to harvest and produce a sufficient quantity of platelets from only a small amount of blood drawn from the patient while they are having outpatient surgery in the office. There are two products that Drs. Blecha and Jandali can create from the patient’s blood:
- Platelet rich plasma (PRP)
- Plasma rich fibrin (PRF)
PRP and PRF are not chemically altered. There are no synthetic, animal, or other human ingredients. The patient’s own concentrated platelets and other key blood cells are concentrated and delivered to the area of surgery to help stimulate healing.
There is an additional synthetic product (not from the patients blood) that is called platelet derived growth factor (PDGF). Drs. Blecha and Jandali will select the type of platelet product to use based upon the bone defect he is treating.
All of the above products are designed to recruit cells from the patient’s body to come into the surgical area and enhance the healing of the wound.
What type of surgical wounds can be helped by platelet growth factors? Platelet growth factors stimulate the healing of both soft tissue and bone wounds. They help wounds that do not want to heal. They are used in soft tissue and bone graft applications.
BONE MORPHOGENETIC PROTEIN (BMP)
Medical research, which began in the 1950’s, discovered a mixture of biologic proteins in the human body that are the most active in stimulating bone healing. Research has actively continued and will continue to be performed to isolate the various proteins and to understand the manner in which these proteins act, and under what conditions they work the best. Following this research clinical studies were then performed in patients for both orthopedics and oral surgery bone graft applications.
What does BMP do? It stimulates the patient’s body to recruit bone precursor cell to the graft site to form bone. Drs. Blecha and Jandali utilizes BMP in select bone grafting applications where he feels they are needed for various types of bone grafting procedures.
WHY ALL THE EXCITEMENT ABOUT PLATELET GROWTH FACTORS AND BMP?
For many years surgeons in orthopedics and oral surgery have tried to utilize many different bone grafting technics to rebuild bone. Use of the patient’s bone works well but requires that we harvest bone from the patient’s hip or tibia (the lower leg). This creates additional wounds, scarring, often requires hospitalization, and involves a longer patient recovery. Platelet growth factors and BMP stimulate bone and soft tissue healing. They often provide better graft results when used with the patient’s own bone and they often allow us to avoid use of the patient’s own bone and to use other types of grafting material such as human bone bank bone or cow bone, and still achieve excellent results.
Why does this occur? The more growth factors released into the wound, the more the body is stimulated to send appropriate cells to the wound to promote either bone or soft tissue healing. Thus today through research and technology we are excited to have better procedures and products to help us reconstruct bone and soft tissue defects than we have ever had before.
Drs. Blecha and Jandali will manage each bone defect in an individual manner using the most appropriate products to achieve the desired result with the least patient disturbance.
FREQUENTLY ASKED QUESTIONS ABOUT PLATELET GROWTH FACTORS AND BMP
ARE PLATELET GROWTH FACTORS SAFE?
PRP and PRF are derived from the patient’s own blood. During the outpatient surgical procedure, a small amount of your own blood is drawn. This blood is then placed in a special centrifuge machine that isolates and concentrates the platelets in your blood and is spun down. In about 20 minutes, the platelet growth factors are isolated and prepared and are ready to use. These products are thus 100% natural.
PRGF and BMP are synthetically derived and should be avoided on patients with active cancer, pregnancy, or active untreated acute infection.
WILL MY INSURANCE COVER THE COST?
Insurance coverage is highly variable, depending on the quality of your dental insurance. Medical insurance does not typically cover this cost.
CAN PLATELET RICH GROWTH FACTORS OR BMP BE USED TO FORM BONE BY ITSELF?
Platelet rich fibrin can be used by itself in certain situations. Typically we need to add the patient’s own bone or a substitute such as human bone bank bone or cow bone with PRP, PRF, PDGF, and BMP to achieve the best result. Please see the bone grafting section of our website for further information about bone grafting.