Replacing Bone For Dental Implants
Bone loss can play a major role in a patient's ability to receive dental implants. Implants are one of the best ways to restore one or more missing teeth in the mouth but in order for an implant to be successful, sufficient bone mass and gum tissue is vital. One major cause that can lead to bone loss is periodontal disease. When the bone begins to deteriorate, otherwise healthy teeth can become loose and even fall out. The patient may even notice changes in their facial structure but fortunately, there is a procedure available to replace bone for some patients.
Does periodontal disease cause bone loss?
Periodontal disease is an advanced stage of gum disease and can be detrimental to a patient's oral and overall health. In its early stages, gum disease presents as gingivitis and can be treated pretty easily. When it is left untreated, gingivitis progresses into periodontitis which is a chronic bacterial infection residing in the gum tissue and the gum pockets around the base of the teeth. Periodontitis can develop from poor oral hygiene, underlying medical conditions, or even certain medication. Some patients may even have a genetic predisposition for periodontal disease and can benefit from a more frequent recall schedule with their dental hygienist.
Signs and symptoms of gum disease may present as:
- Swollen and puffy gums that bleed upon flossing/brushing
- Tooth sensitivity to hot or cold foods and beverages
- Chronic bad breath (halitosis)
- Loose teeth
- Pain when chewing
If a patient displays signs of gingivitis, it is important to address the problem before it can become more advanced. Once periodontitis has developed, the infection in the gum pockets can cause the gum tissue to pull away from the root of the tooth, causing it to become exposed and extremely sensitive and could require a gum graft in order to restore the area to prevent further damage. Left untreated, the infection will only worsen and can lead to bone loss in the jaw. When the jaw bone begins to break down, otherwise healthy teeth become loose from the lack of support and can eventually fall out. Periodontal disease is the number one cause of tooth loss in adult patients, however, there are treatments available to restore bone loss.
Bone Loss and Dental Implants
As we mentioned, sufficient bone and gum tissue are vital to the success of a dental implant. Patients who lack enough bone mass may be able to have a bone graft placed to help restore the area and prepare it for an implant. Your doctor may choose to use either synthetic bone, donor bone, or bone harvested from another area of your body to place in the area being treated to help stimulate bone regeneration. Donor bone may be harvested from a cadaver or from the patient's own hip or another part of their mouth.
A periodontist or oral surgeon will be the dental professional to perform not only your bone graft but also eventually your implant surgery. To begin the procedure for a bone graft, the doctor will administer a local anesthetic to the area being treated before making a small incision in the gum tissue to gain access to the affected bone. The new bone is placed and the gum tissue is sutured closed. The bone graft will integrate with existing bone structure to help rebuild the jawbone and enable it to support remaining natural teeth and any restorative prostheses. Your doctor will allow a few months for the bone to heal and integrate with your natural bone before any restorative work can begin. Depending on the health of the individual patient, the bone graft may actually be able to be placed at the same time as the implant.
Types of Bone Graft
There are actually a few different types of bone grafts available. Your doctor will review your options before you both decide which is best for your individual case. Types of bone grafts include:
- Alloplast: An alloplast graft uses synthetic material that contains calcium, phosphorus, and hydroxylapatite, a natural mineral that is chemically similar to hard tissue.
- Autograft: An autograft uses a piece of bone harvested from the patient’s hip or the back of their jaw.
- Allograft: An allograft utilizes a piece of bone harvested from a human cadaver donor.
- Xenograft: A xenograf is another type of donor bone graft but instead, uses bone harvested from an animal, usually a cow.
How can I prevent bone loss?
Gum disease is a common dental issue and is not always due to bad oral hygiene. A patient can be genetically predisposed to oral issues including gum disease, so it is important to maintain a good oral care routine to give yourself the best chance of preventing periodontal disease and bone loss. If you notice any symptoms of gingivitis, it is important to visit your dentist as soon as possible to receive treatment and prevent minor gum disease from turning into something more severe. Gum recession can result from periodontal disease as well but, a gum graft can restore your tissue and protect the underlying bone from infection.
Good home care and a healthy diet along with regular visits to your dental office can help prevent gum disease from developing in the first place and can even reverse any damage that existing gum disease may have caused.
If your dental hygienist recommends that you come in for a routine cleaning more often than twice a year, it is important to follow through. Insurance companies have said the "industry standard" of two cleanings a year but most people are better served with three or four cleanings a year. Your dental insurance may not cover additional cleanings but paying out-of-pocket for one or two cleanings is a lot less costly than having to undergo treatment for periodontal disease and bone loss.