Bone grafting
Bone grafting is a surgical procedure that replaces missing bone in order to repair bone fractures that are extremely complex, pose a significant health risk to the patient, or fail to heal properly.
Bone generally has the ability to regenerate completely but requires a very small fracture space or some sort of scaffold to do so. Bone grafts may be autologous (bone harvested from the patient’s own body, often from the iliac crest), allograft (cadaveric bone usually obtained from a bone bank), or synthetic (often made of hydroxyapatite or other naturally occurring and biocompatible substances) with similar mechanical properties to bone. Most bone grafts are expected to be reabsorbed and replaced as the natural bone heals over a few months’ time.
The principles involved in successful bone grafts include osteoconduction (guiding the reparative growth of the natural bone), osteoinduction (encouraging undifferentiated cells to become active osteoblasts), and osteogenesis (living bone cells in the graft material contribute to bone remodeling). Osteogenesis only occurs with autografts.
Biological mechanism
Bone grafting is possible because bone tissue, unlike most other tissues, has the ability to regenerate completely if provided the space into which to grow. As native bone grows, it will generally replace the graft material completely, resulting in a fully integrated region of new bone. The biologic mechanisms that provide a rationale for bone grafting are osteoconduction, osteoinduction and osteogenesis.
Properties of various types of bone graft sources.
Osteoconductive |
Osteoinductive |
Osteogenic |
|
Alloplast |
+ | – |
– |
Xenograft |
+ | – |
– |
Allograft |
+ | + /– |
– |
Autograft |
+ | + |
+ |
Osteoconduction
Osteoconduction occurs when the bone graft material serves as a scaffold for new bone growth that is perpetuated by the native bone. Osteoblasts from the margin of the defect that is being grafted utilize the bone graft material as a framework upon which to spread and generate new bone. In the very least, a bone graft material should be osteoconductive.
Osteoinduction
Osteoinduction involves the stimulation of osteoprogenitor cells to differentiate into osteoblasts that then
begin new bone formation. The most widely studied type of osteoinductive cell mediators are bone morphogenetic proteins (BMPs). A bone graft material that is osteoconductive and osteoinductive will not only serve as a scaffold for currently existing osteoblasts but will also trigger the formation of new osteoblasts, theoretically promoting faster integration of the graft.
Osteopromotion
Osteopromotion involves the enhancement of osteoinduction without the possession of osteoinductive properties. For example, enamel matrix derivative has been shown to enhance the osteoinductive effect of demineralized freeze dried bone allograft (DFDBA), but will not stimulate de novo bone growth alone.
Osteogenesis
Osteogenesis occurs when vital osteoblasts originating from the bone graft material contribute to new bone growth along with bone growth generated via the other two mechanisms.
Autograft
Autologous (or autogenous) bone grafting involves utilizing bone obtained from the same individual receiving the graft. Bone can be harvested from non-essential bones, such as from the iliac crest, or more commonly in oral and maxillofacial surgery, from the mandibular symphysis (chin area) or anterior mandibular ramus (the coronoid process); this is particularly true for block grafts, in which a small block of bone is placed whole in the area being grafted. When a block graft will be performed, autogenous bone is the most preferred because there is less risk of the graft rejection because the graft originated from the patient’s own body. As indicated in the chart above, such a graft would be osteoinductive and osteogenic, as well as osteoconductive. A negative aspect of autologous grafts is that an additional surgical site is required, in effect adding another potential location for post-operative pain and complications.
Autologous bone is typically harvested from intra-oral sources as the chin or extra-oral sources as the iliac crest, the fibula, the ribs, the mandible and even parts of the skull.
All bone requires a blood supply in the transplanted site. Depending on where the transplant site is and the size of the graft, an additional blood supply may be required. For these types of grafts, extraction of the part of the periosteum and accompanying blood vessels along with donor bone is required. This kind of graft is known as a vital bone graft.
An autograft may also be performed without a solid bony structure, for example using bone reamed from the anterior superior iliac spine. In this case there is an osteoinductive and osteogenic action, however there is no osteoconductive action, as there is no solid bony structure.
Our Strict Health & Sanitation Protocols
Avail our Affordable Dental Treatment Packages as our share in helping our clients in these current difficult times. We would like to inform our friends and patients that we follow Strict Health & Sanitation Protocols, set-ups recommended by WHO, DOH in the Dental Clinic when doing routine dental procedures on our patients.
We also use Extra oral Suction by our trusted Dental Supplier Fortress Dental, the amazing and best one available in the market for the safety of the Dentist, the patient, and other dental personnel.
All on 4 Dental Implants System
n 1990, All on 4 Dental Implant System was introduced, affordable, more permanent solution, popular, with 4 Dental Implants to secure a full set of teeth in a denture for the upper and the lower to the maxilla and the mandible.
It still has a fake gum, unattractive false gum on the roof of the mouth.
Oral hygiene is difficult and the denture needs to be removed to be cleaned in the Dental Clinic every six months (time-consuming and expensive procedure)
The All on 4 Dental Implants System needs 2 dental implants on the front and 2 dental implants on the back (the 2 dental implants in the back are placed at an angle in the bone)
The denture is not strong, can easily break or sometimes is made to be thick and heavy for strength.
Because only 4 dental implants
are used, if 1 or 2 dental implants fail, the patient would need to redo the whole procedure all over again so it becomes more expensive in the long run. The 3 on 6 Dental Implants System was introduced in 2015.
The patient can regain their confidence, beautiful Smile and look 20 years younger.
There are no fake gums, no gumline involved. You have your own natural gumline.
3 individual, separate permanent bridges are placed directly on 6 dental implants.
It looks natural, it never needs to be removed (a more permanent solution that a patient is usually looking for like your own teeth)
It looks natural, a more hygienic way of cleaning by yourself at home, (flossing, brushing, cleaning using Water Pik Irrigation, standard cleaning)
You get a more comfortable, confident Smile.
The 3 on 6 Dental Implants System is the most advanced and affordable way for a white, permanent, beautiful, confident smile.
There is a good spread of load of teeth on the 6 Dental Implants
For successful Dental Implant Treatment with durability and its longevity.
3D computer-guided Dental Implants System is used for precision placement and accuracy of the dental implants
positions for good success of the treatment procedures.
Centuria advances medical tourism in PH
More clinics and health and wellness outlets have opened at the 28-storey Centuria Medical Makati, the Philippines’ first and largest medical tourism hub, located at Century City, Makati.
I first visited Centuria back in 2016 and it was then already fast shaping up to the vision of Century Properties Group chair Jose E.B. Antonio—which was to revolutionize preventive health and outpatient care by gathering the best industry practitioners and serving medical tourists and locals in a well-designed and inclusive facility.
With more than 500 clinics, Centuria stands as the biggest one-stop shop outpatient facility in the country. Not only does it serve patients with different health and medical needs —from executive checkups to breast care, eye care, skin care, dental and much more.
It also stands regally among the magnificent towers of the Century City mixed-use development in Makati City.
Centuria has several specialized clinics like the New Life Plastic Surgery and Core: Center for Optimum Rejuvenation.
Interior designer Tessa Alindogan and I designed the New Life Clinic of Dr. Cricri Puyat last year. We chose a more elegant and classic style with well curated accents. For the Core Clinic, Dr. Sheree Bondoc got her designer to use wood and marble accents to furnish her masterfully designed interiors. The Core Clinic was designed by Arch. Maila Manalang of MAS (Manalang and Sons).
If you haven’t checked out the area yet, Century City is in the burgeoning district of Poblacion, now Makati’s hip social center. This 3.4-ha site along Kalayaan Avenue used to be a portion of the old International School Manila and is now transformed into a vertical village comprising of designer skyscrapers. Among Century City’s towers are the New York-inspired Gramercy Residences, the London-inspired Knightsbridge Residences, Milano Residences which was interior designed by Versace Home, Trump Tower Philippines, the Century City Mall, Centuria Medical, and two more upcoming towers: the office building Century Diamond Tower which is opening this year and the Armani Casa-designed residential-office Century Spire, which is topping off this April.
Broadway Malyan was responsible for Centuria’s architectural concept and design that features a bespoke and dynamic façade and a modern healthcare design to create an advanced yet comfortable space for patients.
“What we have envisioned for Centuria is to serve as an avenue for doctors and healthcare practitioners to do what they do best in a supportive environment, and for patients here and abroad to experience the genuine Filipino brand of healthcare that doesn’t necessarily feel you’re in a hospital setting. With more and more clinics now opening in Centuria, this fulfills our vision to change the game in health care and provide an elevated form of outpatient experience,” Antonio explained.
Century Properties is on its 33rd year in Philippine real estate and has done other medical facilities in the past.
Medical Plaza Makati and Ortigas, as well as the medical arts wing of the Asian Hospital are part of its 43 completed projects and Centuria is considered a crown jewel by the developer for its unique purpose to elevate the standards of medical tourism in the Philippines.
Contact the Centuria Medical Makati concierge at (02) 793-8611 or at ask@centuriamedical.com.ph.
Read more: https://business.inquirer.net/265163/centuria-advances-medical-tourism-in-ph#ixzz5hxA8LKz5
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