Replacing Bone For Dental Implants

Dental implants are one of the most all around beneficial dental restorations available for replacing missing teeth. Implants help support bone structure to prevent jaw bone deterioration and are incredibly natural looking. Dental implants rely on underlying bone structure and healthy gum tissue for support, so if a patient does not have enough bone mass, that does not mean that they are unable to receive dental implants. A bone graft is a preparatory surgery to help replace and regenerate bone structure.

There are a number of reasons that a patient may begin to lose bone mass including osteoporosis or other medical issues. One of the most common causes of tooth loss is periodontal disease. When the bone begins to deteriorate, otherwise healthy teeth can become loose and fall out. Changes in the patient’s facial structure are another side effect of bone loss but fortunately, a bone graft can bring the jaw back to a healthy state.

How does periodontal disease cause bone loss?

Gum disease can be detrimental to a patient’s oral and overall health. Gingivitis is an early stage of periodontal disease and is easily treated and reversible. Left untreated, gingivitis can progress into periodontitis which is a chronic bacterial infection in the gum pockets. Each of our teeth have pockets between the tooth structure and gum tissue and when they become infected and inflamed, the gum tissue begins to recede from the tooth causing sensitivity and bone loss.

Periodontitis is often a result of poor oral hygiene though may be a side effect of an underlying medical condition or even certain medication. Some patients may even be genetically predisposed to periodontal disease and can benefit from a more frequent schedule for professional cleanings with their dental hygienist.

Signs and symptoms of gum disease include:
* Puffy gums that bleed when flossing/brushing
* Sensitivity to hot or cold foods and beverages
* Halitosis (chronic bad breath)
* Loose teeth
* Pain when chewing

Once periodontitis has developed, the infection in the gum pocket can cause the gum tissue to pull away from the root surface, causing the exposed root to become extremely sensitive. Severe cases of gum recession may require a gum graft to restore the area before bone loss can occur. Without treatment, the jawbone can begin to break down and otherwise healthy teeth will eventually become loose from the lack of support and can fall out. If you begin to notice signs of gingivitis, it is important to have it treated by your dental office before it can progress and cause further damage.

Fortunately, there is a treatment available to restore bone loss.

Bone Loss and Dental Implants

A bone graft can restore an area of bone loss in a patient’s mouth before they receive a dental implant or simply to prevent further damage and tooth loss. An oral surgeon or a periodontist is the dental professional that will perform any preparatory surgeries that you need before implant placement, as well as your implant surgery.

If it is determined that you need a bone graft, your doctor will schedule you for that surgery in anticipation of placing an implant. The procedure for a bone graft is performed under local anesthetic that is administered via injection.

Once the area is sufficiently numb, they will make a small incision in the gum tissue in order to access the affected bone area. The new bone is placed and the gum tissue is sutured around it. As you heal, the bone graft will integrate with existing bone structure to help rebuild The jaw in order to provide a stable support for your dental implants and any remaining natural teeth. The graft site will be allowed to heal for a few months before the implant is placed. Depending on the health of the individual, the implant may be able to be placed at the same time as the bone graft.

There are actually a few different types of bone grafts that may be performed and your doctor will determine which type will give you the best results. The graft can be a synthetic bone material, a donor cadaver bone, or the graft can be harvested from the patient’s hip or even another area of the patient’s mouth

What types of bone graft are available?

Your doctor will review the options available to you before together, you determine which type is preferred.

Types of bone grafts include:
* Alloplast: synthetic material containing calcium, phosphorus, and hydroxylapatite, a natural mineral chemically similar to hard tissue
* Allograft: a piece of bone harvested from a human cadaver donor
* Xenograft: donor bone harvested from an animal, usually cow
* Autograft: bone harvested from the patient’s hip or the back of their jaw

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 accompanied by regular visits to your dental office can help prevent gum disease from developing in the first place and even reverse any damage that existing gum disease may have caused.

If your Dentist and dental hygienist recommend that you have a routine cleaning more often than twice a year, it is important to follow through. Insurance companies have set 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. With all dental care, prevention is key!!

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