Bone starts disappearing the day a tooth comes out, and the window to do something about it is narrower than most people expect. Dr. Alexandre Aalam, a dual board-certified periodontist in Los Angeles, told me about the constraint he worked under for years. “As a periodontist, my job is to rebuild gums and bones. A patient’s own donor site endowment is often limited, and we had to put patients through multiple procedures or use synthetic substitutes to replace the patient tissues but compromising the tissue quality. That’s because synthetic is not as good as a patient’s own tissue,” he said.
The workaround he helped bring to common practice in the United States starts with a vial of the patient’s own blood. Advanced platelet rich fibrin, known as APRF, takes that blood from the patient, spins it in a centrifuge, and turns it into a living scaffold that goes into the surgical site alongside the graft. Aalam was the first periodontist in the U.S. to train in and perform it.
According to the U.S. Centers for Disease Control and Prevention, nearly 42% of adults age 30 and older have periodontitis, and roughly 8% have the severe form. The agency also names gum disease and cavities as the two leading causes of tooth loss in American adults. For anyone facing a loose tooth or a recommended extraction, the questions worth asking come down to how the technique works, whether it applies to their case, and who’s qualified to do it.