Replacing Bone For Dental Implants
Dental implants are one of the best ways to restore one or more missing teeth in the mouth. In order for an implant to be successful, sufficient gum tissue bone structure is necessary. Periodontal disease can lead to a number of gentle issues including gum recession and bone loss in the jar. When the bone begins to deteriorate, otherwise healthy teeth can become loose and even fall out. The patient may even notice changes to their facial structure and overall appearance. In order to restore lost bone structure, a patient may require a bone graft before a dental implant can be placed or even to save natural teeth.
How does periodontal disease contribute to bone loss?
Gum disease can be detrimental to a patient's oral health. Gum disease develops in stages starting with gingivitis and left untreated, overtime progresses to periodontitis. Periodontitis is a chronic bacterial infection residing in the gum tissue and the gum pockets around the base of the teeth which can develop from poor oral hygiene, medical conditions, or even certain medications. Some patients may have a genetic predisposition for periodontal disease and may benefit from more frequent professional cleanings with their dental office than the (insurance industry!) standard of twice a year in order to prevent gingivitis from developing and to keep everything healthy. Once a patient presents with gingivitis symptoms, it is important to address the problem before it can become more advanced.
Once periodontitis has developed, the infection in the gum pockets will cause the gum tissue to pull away from the surface of the root of the tooth, causing it to become exposed and extremely sensitive which can be very painful and could require a gum graft in order to restore the area. Left untreated, the periodontal infection will only progress and can lead to bone deterioration in the jaw. When the jaw bone begins to break down, the 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 help different areas of deterioration in the mouth.
Addressing symptoms of gum disease as soon as they arise will help to keep your mouth as healthy as possible! Symptoms of gum disease may present as:
- Swollen and puffy gums that bleed upon flossing and brushing
- Tooth sensitivity to hot or cold foods and beverages
- Chronic bad breath (halitosis)
- Loose teeth
- Pain when eating
Replacing Bone For Dental Implants
In order for a dental implant to be successful, there must be sufficient supporting bone structure in the jaw. Patients who lack enough bone structure, a bone graft can be performed as a preparatory procedure before an implant is placed. A bone graft uses either synthetic bone or donor bone to help stimulate bone regeneration. A donor bone may be harvested from a cadaver or from another area of the patient’s body such as another part of the mouth or their hip.
For a bone graft procedure, a Periodontist or Oral Surgeon will administer a local anesthetic before making a small incision in the gum tissue at the area being treated in order to access the affected bone, removing any infection in the gum tissue as they go. The bone graft is then placed and the gum tissue is closed. The bone graft will integrate with existing bone structure and help rebuild the jaw bone and to be able to support the natural teeth or any restorative dental prosthesis that may be set.
A few months of healing time is necessary to ensure that the new bone material has fully integrated with the natural bone before any other restorative work can begin. If a patient only needs a small amount of bone added to one area that is to receive an implant, the graft may be able to be performed at the same time as the implant placement, depending on the health and individual case of the patient.
Is there more than one type of bone graft?
There are actually a few different types of bone grafts available to restore bone structure. Your doctor will decide which option is best for your individual case. Types of bone grafts include:
- Autograft: For this type of bone graft, your doctor will take a piece of bone from your hip or from the back of your jaw.
- Allograft: This type of graft utilizes a piece of bone harvested from a human donor cadaver.
- Xenograft: This is another type of donor bone graft but this type uses bone harvested from an animal, usually a cow.
- Alloplast: This bone graft uses synthetic material that contains calcium, phosphorus, and hydroxylapatite, a natural mineral that is chemically similar to hard tissue.
Preventing Bone Loss
Prevention is the best way to avoid periodontal disease and its negative effects on your oral and overall health. Gum disease is a common problem and is not always a result of poor oral hygiene. Genetics can play a role in a person’s oral health as can other medical conditions and certain medications, even pregnancy. If you begin to display signs of gingivitis, it is crucial to visit your dentist for treatment to prevent it from progressing into periodontal disease. A healthy diet accompanied by good home care and regular visits to your dentist for professional cleanings can help prevent the progression of gum disease and even reverse any damage that it may have caused.
Regenerating Gum Tissue For Dental Implants
Periodontal disease can have a great impact on the gum tissue so a patient may require a gum graft as well. Sometimes, the doctor may place a membrane with the bone graft to help encourage tissue growth. A guided tissue regeneration, or GTR, is a small piece of mesh that your doctor will insert between the gum and bone to prevent the tissue from growing into a new area where bone needs to develop. Bone graft, gum graft, and GTR are some of the more advanced treatment methods that doctors can utilize to reverse the negative effects of periodontal disease on bone and gum tissue before a dental implant is placed.
Patients who have a genetic predisposition for periodontal disease and patients that display symptoms of gum disease may need to have more than two professional cleanings per year. A lot of people do not realize that two cleanings per year is NOT the dental industry standard but is a precedent set by insurance companies that have failed to keep up with advances in oral care. If you are displaying symptoms of gum disease, your dentist may recommend that you receive a deep cleaning, or scaling and root planing, to bring your teeth and gums back to a healthy state. After a deep cleaning, it is important to continue with professional cleanings more frequently than twice a year. A patient suffering from periodontal disease may require 3 to 4 cleanings per year to maintain their oral health.