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Bone Grafting

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Over time, the jawbone associated with a missing tooth or teeth may undergo atrophy or reabsorption. This situation can result in the remaining bone needing more quality and quantity for the successful placement of dental implants. Consequently, many patients facing this challenge may need to be more eligible for dental implant procedures. Fortunately, advancements in dental technology now allow for the growth of replacement bone in necessary areas. This innovative approach not only provides a new opportunity to position implants with the correct dimensions but also enables the restoration of functionality and the aesthetic appearance of the teeth.

Major Bone Grafting

Bone grafting is a procedure employed to address insufficient bone structure at implant locations, often resulting from injuries, gum disease, damage, or past extractions. The bone necessary for grafting can be sourced from the patient’s jaw, hip, tibia, or a tissue bank. Sinus bone grafts are occasionally utilized to replace damaged bone in the rear of the upper jaw. Another technique, guided bone regeneration (or guided tissue regeneration), involves special membranes placed under the gums to dissolve, shielding the bone graft from additional damage and promoting regeneration.

These procedures are typically employed to rectify defects arising from severe traumatic injuries, congenital disabilities, and tumour surgery. The patient’s bone mass from various locations on their body may be utilized for more extensive defects. Such procedures are conducted in an operating room and may necessitate a hospital stay for adequate recovery.

The Importance of Teeth for Jaw Bone Health

The absence of teeth can result in the reduction of the jawbone in the specific gap area, giving rise to various complications affecting both overall health and appearance. Individuals with such gaps may encounter problems related to their remaining teeth, discomfort, changes in facial aesthetics, and eventually, the impairment of normal speech and eating abilities over time. Addressing these issues promptly is crucial to prevent further complications.

Bone tissue is maintained and strengthened by consistent use. Bone will atrophy just as muscles will. Natural teeth are embedded directly in the jawbone and keep it active through consistent activities like chewing and biting. When a tooth or teeth are missing, the stimulation that the jaw bone requires to stay strong is not there, and it starts breaking down or reabsorbing. The body views the jawbone as not being necessary, so it deteriorates.  

Potential Consequences of Tooth and Jawbone Loss

  • Problems with your other teeth, including but not limited to, drifting loosening, loss, and misalignment.
  • The collapse of your facial profile
  • Reduced lip support
  • Skin wrinkling in and around the mouth
  • Distorted facial features
  • Temporomandibular joint (TMJ or jaw) pain, headaches, and facial pain
  • Struggling to speak or communicate in general
  • Nutritional issues caused by a poor diet due to an inability to effectively chew without pain
  • Sinus expansion

Causes of jawbone loss and deterioration

The following are the most common causes for jawbone deterioration and loss leading to the possible requirement of a bone grafting procedure:

Tooth Extractions:

The primary factor contributing to jawbone deterioration necessitating bone grafting is often tooth extraction. The gaps resulting from tooth removal lead to an unstimulated jaw, initiating the deterioration process. The extent of damage varies considerably from individual to individual. On average, deterioration typically begins within the initial eighteen months post-extraction, with complications persisting throughout the patient’s lifetime.

Periodontal Disease:

Jawbone loss can also be attributed to periodontal disease, a persistent infection of the gums that gradually undermines the natural teeth’s support. This condition affects various periodontal tissues, including the gingiva, cementum, periodontal ligament, and alveolar bone. While multiple factors can harm structures supporting teeth, most periodontal issues stem from an inflammatory response triggered by plaque. These issues are categorized into gingivitis, a milder form, and periodontitis.

Dental plaque, primarily composed of food particles and various bacteria adhering to the teeth around the gum line, is the primary cause of gingivitis in susceptible individuals. This sticky film accumulates rapidly, causing irritation and inflammation of the gums, often resulting in swelling, redness, and bleeding. Prolonged exposure can lead to gum recession and the formation of pockets around the teeth. Insufficient dental hygiene practices, such as infrequent brushing and flossing, allow plaque to harden into calculus or tartar.

On the other hand, periodontitis arises when bacteria attach to the teeth, coupled with an overactive immune response from the body. If gingivitis is not addressed and progresses to periodontitis, the gum tissue supporting and securing the teeth weakens. This degradation can result in jawbone loss, tooth mobility, and eventual tooth loss. Regular dental care is essential to prevent these complications and maintain optimal oral health.

Dentures & Bridgework:

Dentures that lack complete anchoring and rest atop the gum line fail to provide the necessary stimulation to the jaw, contributing to its deterioration. Since this type of denture relies on the underlying bone for stability, prolonged damage to the bone can result in an insecure fit, causing difficulties in speech and eating. As the bone undergoes further deterioration, a secure fit becomes increasingly challenging, often necessitating the replacement of dentures for an improved fit. Hence, meticulous denture care is crucial, and prompt repair or refitting is essential to prevent additional complications.

Contrastingly, some dentures are equipped with anchors at their base, actively stimulating the jawbone and aiding in its preservation.

Bridgework, which involves teeth on both sides of the bridge, provides the necessary stimulation to maintain the health of the surrounding bone. However, the gap within the bridge, where teeth are missing, does pose a risk of bone deterioration. To counteract this, a bone graft procedure can effectively restore much of the lost bone function and growth, mitigating the adverse effects of inadequate denture care. Regular maintenance and timely interventions are crucial to preserving oral health and preventing complications associated with denture use.

Trauma:

Trauma is a significant contributor to bone damage, particularly when a tooth is lost or damaged to the extent that it lacks a biting surface beneath the gum line. In such cases, the bone becomes under-stimulated and susceptible to damage. Jaw and tooth trauma encompasses various incidents, such as teeth being knocked during injuries or jaw fractures. Interestingly, teeth with a history of trauma may exhibit signs of bone loss even years after the initial injury, potentially leading to ongoing complications.

To address severe bone deterioration resulting from trauma, bone grafting becomes a necessary intervention. The objective is to reverse the adverse effects by restoring function and promoting renewed bone growth in the area. This procedure aims to enhance the structural integrity of the bone and mitigate the consequences of trauma-induced damage, fostering overall oral health and well-being.