Replacing Bone For Dental Implants
Some patients have severe form of gum disease called periodontitis. When gum disease progresses to this advanced form, it often results in the loss of bone which secures the teeth in place. This can result in the teeth becoming loose or even falling out. In other cases, when a patient loses a tooth, they bone in the jaw may begin to retract or resorb due to the lack or stimulation from the tooth. The dentist or periodontist, who is a gum disease specialist, may recommend undergoing a bone graft procedure. Bone grafts are commonly used to aid in growing new bone and replacing bone which has been destroyed by periodontitis or other dental issues.
Bone Loss and Gum Disease
When gum disease remains untreated and worsens over time, it often results in the loss teeth and gum tissue. However, severe gum disease can also cause issues and the loss of bone in the jaw. Periodontitis is a chronic bacterial infection which effects many adults. More specifically, the infection affects the important bone and gums which support the teeth. When a patient has a poor oral hygiene regimen, it allows bacteria which lives in the dental plaque to thrive. This causes inflammation and increased sensitivity in the gums. The initial stages of gum disease is called gingivitis. When a patient has gingivitis, their gums are often swollen and bleed easily during routine activities such as brushing and flossing.
Periodontitis, which is the most severe form of gum disease, develops when bacteria and the resulting toxins produced by the plaque infect the gums. The bacteria also invades below the gum line and can infect tissue under the teeth. During this later stage of gum disease, the infection is able to destroy the bone and tissues which secure the teeth. When periodontitis remains untreated, the infection and destruction will continue until the teeth become loose as a result of the lack of support. In some cases, the teeth will eventually fall out. Unfortunately, periodontal disease is the most common cause for the loss of teeth amongst adults. Fortunately, periodontal surgical procedures, such as bone grafts are available. The procedures can aid in reversing some of the damage that results from periodontal disease.
Some of the most common symptoms associated with gum disease includes:
- Loose teeth
- Mouth pain and discomfort when eating
- Persistent bad breath or foul odor in the mouth
- Sensitive teeth
- Swollen gums which easily bleed
Bone Grafts
During periodontal surgery, it may be necessary for the periodontist to place a bone graft to aid in the regeneration of supporting bone which was lost. With a bone graft, the periodontist will fold back a portion of the gum and remove any infected gum tissue, bacteria covered calculus and rough surfaces of the tooth. Each of these things can worsen gum disease. Bone graft material is then placed. The bone graft material will work with the body to stimulate the formation of new bone. Bone grafts are commonly used to repair damage which results from gum disease and can also increase a patient’s chances of maintaining their teeth.
When the loss of the tooth has already taken place, the dentist may recommend a dental implant. During the implant procedure, a metal post or implant, is inserted directly into the jawbone and serves as an artificial root for the prosthetic tooth. Because the implant fuses to the bone over time, the procedure requires that the patient has strong and adequate bone to receive the implant and act as a secure base. When there is an insufficient amount of bone present, a bone graft is required prior to proceeding with the implant process. When bone grafting is completed, a small piece of bone is typically removed from another part of the jaw or another part of the body, such as the hip. This bone is then transplanted to the jawbone. In some cases, artificial bone will be used. Prior to receiving the dental implant, the bone needs to fully heal. This healing process typically takes several months. The growth of new bone eventually replaces the graft material or transplanted bone. In some cases, only minor bone grafting is required. This can often be completed in conjunction with surgery for the implant placement.
There are various types of bone grafts available. Each type differs based on the type of material used and is summarized below:
- Allograft: bone graft which uses bone sourced from another human donor
- Alloplast: bone graft that uses a synthetic material which contains calcium, phosphorous and hydroxylapatite
- Autograft: bone graft using the patient’s own bone. The bone is often transplanted from another portion of the jaw or the hip bone
- Xenograft: bone graft that uses bone from an animal, such as a cow
It is important to discuss these options with your dentist to fully understand the benefits and challenges associated with each type of bone graft.
Tissue Regeneration
In addition to a bone graft, mesh filter membranes or tissue-stimulating growth factor proteins can also be used. These materials help encourage the body to regenerate bone and tissue in a specific area. In some cases this is used in combination with a bone graft. There is a procedure which is called guided tissue regeneration (GTR). With GTR, the periodontist will insert a small piece of mesh between the gum and bone following the placement of the bone graft. This mesh helps to prevent the gums from growing into areas where the new bone is intended to grow. Techniques and materials are continuing to be developed for the treatment of bone loss resulting from periodontitis.
Bone grafts and the GTR procedure are some of the more advanced solutions which dental professionals are able use in combating the effects of gum disease. Studies are continuing to be done regarding how these procedures can aid patients in maintaining their natural teeth longer.
The best method for avoiding bone loss is by working to prevent gum disease through good oral hygiene practices. A good oral hygiene regimen includes the following components:
- Brushing the teeth twice daily using gentle motions and a soft toothbrush with fluoride toothpaste
- Floss the teeth each day
- Visit the dentist regularly for an examination and professional cleaning
It is especially important for patients with periodontal disease to practice good oral hygiene, maintain a balanced diet, and obtain routine periodontal maintenance care to aid in order to manage the disease and maintain their natural teeth.