Over a period of time, the jawbone associated with missing teeth atrophies or is reabsorbed. This often leaves a condition in which there is poor quality and quantity of bone suitable for placement of dental implants. In these situations, most patients are not candidates for placement of dental implants.
Today, we have the ability to grow bone where needed. If you require a tooth extraction, a bone graft is often needed to preserve the shape of your jaw and overlying gum, allowing a comfortable and natural-appearing replacement tooth with minimal trauma to neighboring healthy teeth. Alternatively, if you’ve been missing a tooth for some time, or if you have had severe gum disease, bone in the affected area might (and likely will) have been further damaged. A bone graft can easily replace missing bone and even stimulate new bone growth, so your mouth will be able to support a dental implant. This not only gives us the opportunity to place implants of proper length and width, it also gives us a chance to restore functionality and esthetic appearance
common causes of bone grafting
- Tooth Extractions: Natural teeth are embedded in the jawbone and stimulate the jawbone through activities such as chewing and biting. When teeth are missing, the lack of stimulation causes the bone to break down and resorb. The rate the bone loss varies greatly among individuals. However, most loss occurs within the first eighteen months following the extraction, and continues throughout life.
- Periodontal Disease: Periodontal disease gradually destroys the support of your natural teeth. Plaque-induced inflammatory lesions make up the majority of periodontal issues, and are divided into two categories: gingivitis and periodontitis. While gingivitis, the less serious of the diseases, may never progress into periodontitis, it always precedes periodontitis. If gingivitis does progresses into periodontitis, the supporting gum tissue and bone that holds teeth in place deteriorates. The progressive loss of this bone, the alveolar, can lead to loosening and subsequent loss of teeth.
- Dentures/Bridgework: Unanchored dentures are placed on top of the gum line, and therefore do not provide any direct stimulation to the underlying alveolar bone. Over time, the lack of stimulation causes the bone to resorb and deteriorate. Because this type of denture relies on the bone to hold them in place, people often experience loosening of their dentures and problems eating and speaking. Eventually, bone loss may become so severe that dentures cannot be held in place even with strong adhesives, and a new set may be required. Proper denture care, repair, and refitting are essential to maintaining oral health. Some dentures are supported by anchors, which do help adequately stimulate, and therefore preserve bone. With bridgework, the teeth on either side of the appliance provide sufficient stimulation to the bone, but the portion of the bridge that spans the gap where the teeth are missing receives no direct stimulation. Bone loss can occur in this area.
- Trauma: When a tooth is knocked out or broken to the extent that no biting surface is left below the gum line, bone stimulation stops, which results in jaw bone loss. Some common forms of tooth and jaw trauma include: teeth knocked out from injury or accident, jaw fractures, or teeth with a history of trauma that may die and lead to bone loss years after the initial trauma.
- Misalignment: Misalignment issues can create a situation in the mouth where some teeth no longer have an opposing tooth structure. The unopposed tooth can over-erupt, causing deterioration of the underlying bone. Issues such as TMJ problems, normal wear-and-tear, and lack of treatment can also create abnormal physical forces that interfere with the teeth’s ability to grind and chew properly. Over time, bone deterioration can occur where bone is losing stimulation.
- Sinus Deficiencies: When molars are removed from the upper jaw, air pressure from the air cavity in the maxilla (maxillary sinus), causes resorption of the bone that formerly helped the teeth in place. As a result, the sinuses become enlarged, a condition called hyperneumatized sinus. This condition usually develops over several years, and may result in insufficient bone for the placement of dental implants. Wilde can perform a procedure called a “sinus lift” that can treat enlarged sinuses.
In severe cases, the ridge has been reabsorbed and a bone graft is placed to increase ridge height and/or width. This is a technique used to restore the lost bone dimension when the jaw ridge gets too thin to place conventional implants. In this procedure, the bony ridge of the jaw is literally expanded by mechanical means. Bone graft material can be placed and matured for a few months before placing the implant.
Dr. Greggory Wilde, Periodontist at Lowell Street Dental Implant and Surgical Center in Silverdale, WA
Serving the Olympic Peninsula, Kitsap County & Jefferson County communities including Silverdale, Bremerton, Bainbridge Island, Port Angeles, Poulsbo, Sequim & Port Orchard WA Serving Silverdale, Bremerton, Port Orchard, WA