Biological dentistry focuses on a comprehensive evaluation, accurate diagnosis, and the use of the safest, most biocompatible materials and techniques for optimal clinical outcomes and the long-term well-being of the patient. This is especially important when it comes to oral surgery and extraction of impacted teeth, infected teeth, and failed root canal-treated teeth. Special care is necessary to remove a tooth as minimally invasive and atraumatic as possible. It is vital to remove the periodontal ligament, which is the connective tissue attaching the tooth to the alveolar bone of the jaw, in order to promote proper healing and reduce the risk of ostoenecrotic lesions, also known as cavitations.
Biological Oral Surgery integrates 3D cone beam imaging, dental ozone, L-PRF™ Platelet Therapy, and biomimetic bone grafting to promote healing and bone regrowth. At Insight Integrative Dentistry, we have been using 3D Cone Beam CT imaging technology for over a decade. Our office was one of the first dental offices in Montana to integrate this technology. These three-dimensional x-ray images allow us to precisely evaluate the anatomy of the tooth and surrounding bone, sinuses, and major blood vessels as well as determine the degree of inflammation or infection around root-canal treated teeth. Accurate 3D CBCT imaging is necessary to help avoid surgical complications. Two-dimensional x-rays are insufficient for wisdom tooth removal, extractions of root-canal treated teeth, cavitation surgery, and dental implant surgery.
Vatech’s PaX-REVE 3D Cone Beam CT imaging and Anatomage software allows for accurate diagnosis and surgical treatment planning.
The Biological Oral Surgery technique can be divided in three integrated steps: 1) complete, careful removal of the tooth, periodontal ligament and dead or infected bone, 2) proper disinfection of the extraction socket and surrounding bone with ozone, especially in the case of infected or root-canal treated teeth and cavitations, and 3) introduction of a biological graft to promote proper bone healing. The biological graft is a mixture of L-PRF™ and an osteobiologic graft of bioactive calcium-potassium-sodium-phosphate graft called Cerasorb®.The Biological Oral Surgery technique can be divided in three integrated steps: 1) complete, careful removal of the tooth, periodontal ligament and dead or infected bone, 2) proper disinfection of the extraction socket and surrounding bone with ozone, especially in the case of infected or root-canal treated teeth and cavitations, and 3) introduction of a biological graft to promote proper bone healing. The biological graft is a mixture of L-PRF™ and an osteobiologic graft of bioactive calcium-potassium-sodium-phosphate graft called Cerasorb®.
LPRF and Biological Grafting
L-PRF™ stands for Leukocyte-Platelet Rich Fibrin. Leukocytes are white blood cells – one of the key parts of our immune system responsible for fighting infections. Platelets are special blood cells that help form clots, attract other healing cells, and produce growth factors. Fibrin is another component of the blood that works with platelets to help stabilize blood clots. L-PRF™ is basically a bioactive “band-aid” that utilizes your body’s own natural healing factors found within your own blood to improve healing and bone growth.
L-PRF™ is created by taking a small blood sample and using the IntraSpin™ centrifuge to separate and concentrate the bioactive clot of white blood cells, platelets, fibrin, and bone growth factors. The IntraSpin™ System is the only FDA cleared medical device for the preparation of L-PRF™. L-PRF™ is 100{90f5dc2c793e733be5e1cd4422eaf5cc621b4aa6d5ed93d29afe0681fae3f875} you – it doesn’t contain any chemicals or synthetic, animal, or other human ingredients. The L-PRF™ can be placed directly in the surgical site or combined with bone graft material or other biomaterials customized to your needs to immediately promote healing.
The combination of L-PRF™ and Cerasorb® biomimetic bone substitute is designed for optimal bone grafting: stimulating the body’s natural healing process to speed up the release of growth factors for physiologic bone regeneration – without the problems associated with autograft or potential safety risks of the human allograft. Our patients experience shorter recovery times with less post-operative pain and swelling and faster healing of both hard and soft tissues around the surgical site.
Biological Oral Surgery Protocol
1. Pretreatment exam with CBCT imaging, health history, and evaluation of nutritional status, especially Vitamin D, C, and Zinc. Additional nutritional supplementation is usually recommended for 1-2 weeks prior to surgery and 6-12 weeks after.
2. A diseased, fractured, or infected tooth is removed with atraumatic minimally-invasive techniques to preserve the surrounding bone. This is especially important if a Zirconia dental implant is planned to replace the tooth in the near future.
3. Infected tissue and bone are removed from the extraction socket or surgical site. The periodontal ligament is also thoroughly removed to promote proper bone healing.
4. Ozonated sterile water and ozone gas are used to completely disinfect the socket and prepare it for the biologic graft. Homeopathic remedies can be injected or placed in the socket for additional healing.
5. L-PRF fibrin blood clot and bone substitute are mixed and placed in the socket, carefully covered, and sutured in place.
6. Instructions are given for home care of extraction or surgery site following the procedure.
7. Ozonated olive oil or a silver gel are applied at home several times a day for post-surgical healing. Homeopathics, like Arnica montana, is used for pain and inflammation control.
8. Injection, ear and/or nasal ozone treatments can be provided to promote further healing over the next several weeks.
9. Sutures are carefully removed after 2-4 weeks and nutritional supplements are continued for up to 6 months to optimize bone and tissue healing.
10. Healing of the surgical site is reevaluated in 4-6 months with 3D CBCT imaging. Zirconia dental implant treatment planning and guided implant surgery can proceed after bone and gum healing are complete.
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