Replacing Bone For Dental Implants

Periodontitis is a term used to describe severe gum disease. For some patients with advanced periodontitis, there can be loss of the bone which holds the teeth in place resulting in loose teeth or teeth that fall out. When this takes place, the dentist or periodontist may suggest receiving a bone graft. Bone grafts are able to aid in growing new bone, which helps to replace the bone which has been damaged or destroyed as a result of periodontitis.

Bone Loss and Gum Disease

Some of the common side effects which can result from gum disease which remains untreated can include the loss of teeth and gum tissue. However, when gum disease is not treated, it can also result in bone loss which occurs in the jaw. Periodontitis involves chronic bacterial infection which can negatively impact the gums, teeth and the bone supporting the teeth. When a patient has bad oral hygiene practices, bacteria which is present in dental plaque is able to thrive and grow. This causes inflammation and tenderness of the gums. During this initial stage of gum disease, which is called gingivitis, the gums are often swollen and bleed easily during routine activities such as brushing and flossing.

When periodontitis remains untreated and is able to advance to the most severe form of gum disease, it is called periodontitis. Periodontitis develops when the bacteria and toxins produced by plaque bacteria is able to infect the gums. The bacteria also reaches below the gum line and can infect the tissue located under the teeth. During this advanced stage of periodontitis, the infection is able to break down the bone and tissues which support the teeth and keep them secured in place. When it remains untreated, the damage and decay will continue to worsen. Eventually, the teeth will become loose due to the lack of support and will ultimately fall out. The most common cause for tooth loss in adults is periodontal disease.  Fortunately, there are periodontal surgery procedures available, which may include bone grafts. These treatments are able to reverse some of the damage caused by periodontal disease and prevent the disease from progressing.

The following are some of the most common symptoms associated with gum disease:

  • Chronic and persistently bad breath
  • Gums which are swollen or bleed easily
  • Increased sensitivity in the teeth
  • Loose teeth
  • Pain in the mouth when chewing

Gum Disease and Bone Grafts

During corrective surgery for periodontal disease, the periodontist or oral surgeon may need to use a bone graft in order to aid in regenerating the tooth’s supporting bone which was damaged. During this procedure, the periodontist or dental professional will fold back a portion of the gum and clean out any gum tissue which is infected. This includes bacteria covered calculus and rough tooth surfaces which often worsen gum disease. Once the area has been prepared, the bone graft material is then placed. This material works with the body to aid in building new bone. Bone grafts are able to repair damage which occurs from gum disease. They can also increase a patient’s chance of maintaining their natural teeth.

Dental implants are a common solution which are used for patients who have lost one or more teeth from of gum disease and decay. Once the tooth loss has already take place, an implant is inserted into the jawbone and serves as the root for the artificial tooth. The implant is a metal post, typically made from titanium which resembles a screw. In order to place the implant post, the patient must first have adequate bone which will fuse to the implant. In cases where there is not a sufficient amount of bone present for the procedure, a bone graft is required. With a bone graft, a portion of bone will be removed from another part of the jaw or body. It is common to use bone from the hip and then relocate it to the jawbone. There is also artificial bone material which can be used for bone grafts in the jaw. In most cases, it will take a few months for the transplanted bone to heal and be ready to receive the dental implant. The growth of new bone will eventually replace the transplanted bone or graft material which was used in the procedure. In some cases, the patient may only require a minor amount of bone grafting. This can often be completed at the same time as the surgery for placing the implant.

There are various types of bone grafts available which differ based on what type of material is used for the procedure. The most common bone grafts are summarized below:

  • Allograft: bone graft which uses bone sourced from another human donor
  • Alloplast: bone graft which uses a synthetic material that contains calcium, phosphorous and hydroxylapatite
  • Autograft: bone graft using the patient’s own bone. This is often retrieved from the patient’s hip or the back of their jaw
  • Xenograft: bone graft that uses bone from an animal. Bone from cows is common used

If you are pursuing a bone graft procedure, be sure to speak with you dentist regarding the pros and cons of the various materials and procedures which are available.

Tissue Regeneration

In addition to the bone graft, membranes in the form of a mesh filter, or tissue-stimulating growth factor proteins may also be used. These materials encourage the body to regenerate bone and tissue in the desired location. In some cases, the dentist may suggest a procedure called guided tissue regeneration (GTR) in addition to the bone grafting procedure. With GTR, following the placement of the bone graft, the periodontist will insert a small piece of mesh between the bone and the gum. This mesh helps to prevent the gums from growing into the area which is intended for new bone growth. GTR is considered to be a more advanced procedure which is used with bone grafting. With modern advancements, the clinical techniques and material options used for bone grafting continue to develop and undergo additional research.

The optimal method for avoiding bone or tooth loss is through prevention of gum disease. This can be achieved through the regular practice of an effective oral hygiene regimen. Good oral hygiene includes the following components

  • Brush the teeth twice each day using a fluoride toothpaste and soft bristled toothbrush
  • Floss between the teeth every day
  • Visit dentist for regular exams and professional cleanings

For patients with periodontal disease, good oral hygiene practices, combined with a well-balanced diet and regular periodontal maintenance care can increase the patient’s chances of maintaining their natural teeth.

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