The following are the most common causes for jawbone deterioration and loss, which may require a bone grafting procedure:
When an adult tooth is removed and not replaced, jawbone deterioration may occur. When teeth are missing, the alveolar bone no longer receives the necessary stimulation,and begins to break down, or resorb. The body no longer senses the “need” for the jawbone, so it diminishes and deteriorates.
The rate of bone deterioration, as well as the amount of bone loss that occurs, varies greatly among individuals. Most loss occurs within the first eighteen months following the extraction, and continues throughout life.
Periodontal diseases are ongoing infections of the gums that gradually destroy the supporting bone of your natural teeth. Periodontal disease affects one or more of the periodontal tissues: alveolar bone, periodontal ligament, cementum, and/or gingiva. While there are many diseases which affect the tooth-supporting structures, plaque-induced inflammatory lesions make up the majority of periodontal issues, and are divided into two categories: gingivitis and periodontitis. While gingivitis, the less serious of the diseases, may never progress into periodontitis, it always precedes periodontitis.
Dental plaque is the primary cause of gingivitis. Plaque is a sticky colorless film, composed primarily of food particles and various types of bacteria, which adhere to your teeth at and below the gum line. Plaque constantly forms on your teeth, even minutes after cleaning. Bacteria found in plaque produce biological toxins that irritate the gums. Gums may become inflamed, red, swollen, and bleed easily. If this irritation is prolonged, it often causes pockets to form. If daily brushing and flossing are neglected, plaque can also harden into a rough, porous substance known as calculus (tartar). This can occur both above and below the gum line.
Periodontitis is affected by bacteria that adhere to the tooth's surface, along with an immune response to these bacteria. If gingivitis progresses into periodontitis, the supporting gum tissue and bone that holds teeth in place deteriorates. The progressive loss of the alveolar bone can lead to loosening and subsequent loss of teeth.
Unanchored dentures are placed on top of the gums, and therefore do not provide any direct stimulation to the underlying alveolar bone. Over time, the lack of stimulation causes the bone to resorb and deteriorate. Because this type of denture relies on the bone to hold them in place, people often experience loosening of their dentures and problems eating and speaking. Eventually, bone loss may become so severe that dentures cannot be held in place even with strong adhesives, and a new set may be required. Proper denture care, repair, and refitting are essential to maintaining oral health.
Some dentures are supported by anchors, which do help adequately stimulate, and therefore preserve bone.
When a tooth is avulsed (knocked out), surrounding alveolar bone is frequently fractured. This usually creates a bony defect, compromising future implant therapy. Bone grafting procedures repair these defects, restoring normal anatomy for implant placement.
Misalignment issues can create a situation in the mouth where some teeth no longer have an opposing tooth structure. The unopposed tooth can over-erupt, causing deterioration of the underlying bone.
Osteomyelitis of the jaw bone is a bacterial infection which leads to inflammation and compromise of the blood supply to the bone. Treatment for osteomyelitis generally requires antibiotics and removal of the affected bone. A bone graft procedure may then be required to restore bone function and growth lost during removal.
Benign facial tumors may grow large and require removal of a portion of the jaw. Malignant mouth tumors almost always spread into the jaw, requiring removal of a section of the jaw. In both cases, reconstructive bone grafting is usually required to help restore function to the jaw. Grafting in patients with malignant tumors may be more challenging because treatment of the cancerous tumor generally requires removal of surrounding soft tissue as well.
Congenitally missing adult teeth frequently result in underdevelopment of the adjacent jaw bone. Bone grafting of these sites is usally necessary for an aesthetic and functional repair.
When molars are removed from the upper jaw, the sinus frequently enlarges to fill part of the space previously occupied by the tooth. This frequently results in insufficient bone for the placement of dental implants. Dr. Brooks can perform a procedure called a “sinus lift” that can treat the enlarged sinus.
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