Replacing Bone for Dental Implants
Dental implants are among the most popular choices for people who wish to replace one or more missing teeth. However, as many people lose their teeth because of gum disease, which can lead to bone loss if less untreated, for some people, implants aren’t an optimal option. This is because the patient needs to have a sufficient amount of healthy bone present in order for dental implants to properly heal and fuse with the bone, one of the characteristics that helps make implants the stable and durable option that they are. For patients who have lost a substantial amount of the bone in their jaw due to periodontitis, bone grafts can help repair the jawbone and prepare the jaw for successful dental implants. Bone grafts serve the dual function of replacing bone that has been lost while also encouraging the growth of new, healthy bone.
Periodontitis is a chronic infection in the teeth, gums, bones, and connective tissues in the oral cavity and jaw. Caused by the accumulation of bacteria over time, periodontitis is usually the result of poor oral hygiene. Poor oral hygiene allows the bacteria that live in dental plaque to accumulate and flourish, which in turn causes tenderness and inflammation in the gums. The gums swell and are sensitive to pressure, bleeding easily upon brushing, flossing, or other stimulation. In its earlier stages, gum disease is reversible. If left untreated, however, gum disease can develop into periodontitis, which develops when the toxins exuded by plaque bacteria invade and infect the gums and below the gum line. The infection begins to destroy the bone that supports the teeth and the tissues that hold the teeth in place, and, when not addressed, this infection gradually causes the teeth to loosen and fall out while continuing to degrade the bone and other tissues in the oral cavity. In its earlier stages, gum disease may not show many, if any, symptoms, which is why regular dental checkups and professional cleanings are so important: dentists and dental hygienists can detect early gum disease and address it while it is still reversible. Once symptoms do appear, they may include stubborn bad breath, swelling and bleeding in the gum tissue, loose or mobile teeth, and pain and sensitivity in the teeth and mouth, especially when biting or chewing.
Periodontal surgery can help halt the destruction wrought by periodontal disease, and it can also repair damage that has already been done. During a periodontal surgery procedure, the periodontist folds back the gums and cleans beneath the gums, removing infected gum tissue, calculus, and bacteria and smoothing rough surfaces that could encourage future bacterial growth and slow healing. Once the area is thoroughly cleaned, the periodontist places the bone graft material. Bone grafts work in conjunction with the body to build new, healthy bone and can help repair damage so that patients stand a better chance of keeping their natural teeth. If the patient has already lost one or more teeth and plans to replace these missing teeth with dental implants, the bone graft helps grow enough bone to accommodate dental implants.
To perform bone graft surgery, the periodontist may remove a small piece of bone from another area of the patient’s body and transplant it into the jaw. For some bone graft surgeries, artificial bone may be used instead of the patient’s own bone. The graft is allowed to heal for several months, and, over this time, new bone will gradually replace the graft material. Bone grafts can be minor or substantial and differ depending on the type of grafting material that is used. An autograft uses the patient’s own bone, which is usually acquired from the hip bone or from a dense part of the jaw. An allograft is a graft that uses bone that is acquired from a human donor. A xenograft uses animal bone that is usually sourced from a cow. An alloplast uses a synthetic bone grafting material that is composed of calcium, phosphorus, and hydroxylapatite. Each procedure and material has its own set of pros and cons, and you and your dentist can discuss which type of graft is best suited to your needs and preferences.
In addition to bone grafts, some dentists use methods to encourage tissue regeneration. These methods include guided tissue regeneration, or GTR. In the guided tissue regeneration procedure, which is performed after a bone graft, a small mesh membrane is placed between the gum and the bone. This membrane prevents the gum tissue from growing into the area where bone is supposed to grow. Some dentists may also use tissue-stimulating growth factor proteins to encourage bone growth. These are just two of the many innovations that are constantly being developed as dentists seek to improve the methods of repairing periodontal defects and regenerating lost tissue, and additional materials, membranes, and techniques are tested and introduced regularly.
Of course, the best way to prevent bone loss is by avoiding the development of periodontitis or other gum disease. Oral hygiene is the best first line of defense against gum disease. Dentists recommend brushing the teeth twice daily with a soft-bristled brush and fluoride toothpaste, making sure to gently clean the gum line as well as the surfaces of the teeth and the oral soft tissues. Additionally, dentists recommend daily flossing or other interdental cleaning, again focusing on the area of the gumline and just below it, as well as seeing a dentist for regular checkups and periodic professional cleanings. Dental calculus accumulates over time no matter how meticulous a person’s home hygiene is, and it is only through professional dental cleanings that calculus can be removed from the oral cavity; in addition to helping detect gum disease early, professional dental checkups can be instrumental in helping prevent gum disease in the first place. While dental implants are considered the gold standard for tooth replacement, the best approach is to prevent gum disease in the first place, preserving the health of the oral cavity and the bone and increasing the likelihood of keeping healthy, natural teeth for a lifetime.