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Why are teeth important for the preservation and health of the underlying bone?
When one or more of your teeth are missing, the bone tissue does not experience adequate stimulation. Just like your muscles need stimulation through exercise to remain strong and healthy, so too does the jawbone. For it, needed stimulation comes from chewing and biting.
When teeth are missing, the bone that anchors your teeth in your mouth doesn’t receive the same stimulation and it will deteriorate over time, potentially causing changes in your physical appearance, problems with your remaining teeth, and negatively affecting your ability to speak and eat normally.
The following are the most common causes of jawbone loss that may require a bone grafting procedure:
When you have an adult tooth removed and it isn’t replaced, your jawbone may deteriorate. Your teeth are embedded in your jawbone, and stimulate the jawbone through activities such as chewing and biting.
When you have missing teeth, the portion of the jawbone that anchors your teeth isn’t stimulated enough and it begins to break down.
The rate at which the bone deteriorates, as well as the amount of bone loss that occurs, varies greatly among individuals. However, most loss happens within the first eighteen months following your extraction and continues throughout your life.
Periodontal diseases are ongoing infections of the gums that gradually destroy the support of your natural teeth.
Plaque constantly forms on your teeth, even minutes after cleaning. Bacteria found in plaque produce toxins or poisons that irritate your gums. Your gums may become inflamed, red, swollen, and bleed easily.
Dental plaque is the main cause of the periodontal disease known as gingivitis, which can progress into periodontitis, a more serious condition where the supporting gum tissue and bone that holds your teeth in place deteriorates. The progressive loss of this bone can lead to loosening and loss of teeth.
Some dentures are supported by anchors and others are unanchored. If your dentures are unanchored, they are placed on top of the gum line and don’t provide direct stimulation to the underlying bone.
Over time, the lack of stimulation causes the bone to break down and deteriorate. This causes your dentures to loosen and you may have problems eating and speaking. Eventually, bone loss may become so bad that even strong adhesives can’t hold your dentures in place and you may need a new set.
Once the new bone has been grafted to the jaw providing a sufficient base, implants can be placed to provide a more natural, stable alternative to dentures that both stimulates the bone encouraging growth and allows individuals to get back to eating the foods they love but had to avoid while wearing dentures.
Injuries to the face often result in broken or knocked out teeth. If not replaced, the underlying bone receives no stimulation and deterioration of the bone results. Trauma-related bone loss can happen at any age and remaining teeth may die years after the initial trauma. A bone grafting procedure reverses the effects of bone deterioration, restoring function and promoting new bone growth in traumatized areas.
When you lose a tooth, another tooth in your mouth is no longer opposed and misalignment issues can result. The unopposed tooth can over-erupt, causing deterioration of the underlying bone.
Various other issues, such as normal wear and tear, can also interfere with your ability to grind and chew, causing bone deterioration.
Osteomyelitis is a type of bacterial infection in the bone and bone marrow of the jaw. The infection leads to inflammation, which can cause less blood supply to the bone. To treat it, you usually need antibiotics and the removal of the affected bone.
If you have a benign facial tumor, it is generally not a threat but if it grows large, a portion of your jaw may have to be removed. If you have a malignant mouth tumor, it almost always spreads into your jaw.
In both cases, you may need reconstructive bone grafting to help restore function to the jaw. If you have a malignant tumor, grafting is usually more challenging because you may need surrounding soft tissue removed to treat the tumor.
Some birth defects are characterized by missing portions of the teeth, facial bones, jaw or skull. The surgeons at CVOS Oral Surgery may be able to perform a bone graft procedure to restore bone function and growth where it may be absent.
Removing molars from your upper jaw means that the bone that used to help keep the teeth in place breaks down and the sinuses become enlarged. This condition usually develops over several years. It may result in insufficient bone for the placement of dental implants. We can perform a procedure called a “sinus lift” that can treat enlarged sinuses.
Autogenous Bone Grafts:
Autogenous bone grafts are made from your own bone, taken from somewhere else in your body. It typically comes from your chin, jaw, lower leg bone, hip, or the skull.
The advantage of Autogenous bone grafts is that the graft material is live bone. It contains living cellular elements that enhance bone growth.
A disadvantage is that you need a second procedure to harvest bone from elsewhere in your body. In certain cases, a second procedure may not be in your best interests.
Allogenic Bone Graft:
Allogenic bone, or allograft, is dead bone harvested from a cadaver. A freeze-dry method is used to extract water.
An allograft can’t produce new bone on its own. Rather, it acts as a framework or scaffold over which bone from the surrounding bony walls can grow to fill the defect or void.
Xenogenic Bone Graft:
Xenogenic bone comes from non-living bone of another species, usually a cow. The bone is processed at very high temperatures to avoid the potential for immune rejection and contamination. These grafts also serve as a framework for bone from the surrounding area to grow and fill the void.
Both allogenic and xenogenic bone grafting doesn’t require a second procedure to harvest a patient’s own bone. However, as they lack bone-forming properties, bone regeneration may take longer and the outcome is less predictable.
As a substitute for using real bone, many synthetic materials are available as a safe and proven alternative, including:
Demineralized Bone Matrix (DBM)/Demineralized Freeze-Dried Bone Allograft (DFDBA):
This product is processed allograft bone, containing collagen, proteins, and growth factors. It is available in the form of powder, putty, chips, or as a gel that can be injected through a syringe.
Graft composites consist of other bone graft materials and growth factors to achieve the benefits of a variety of substances. Some combinations may include:
Bone Morphogenetic Proteins:
Bone morphogenetic proteins (BMPs) are proteins naturally produced in your body that promote and regulate bone formation and healing.
Synthetic materials also have the advantage of not requiring a second procedure to harvest bone. This means pain and risk are reduced. Each bone grafting option has its own risks and benefits.
The surgeons at CVOS Oral Surgery can determine which type of bone graft material is right for you.
To receive your initial consultation with one of our oral surgeons, please contact your family dentist and ask to be referred.