Replacing Bone For Dental Implants
Bone structure is vital to the support and success of dental implants. Periodontal disease can lead to a number of dental issues including gum recession and bone loss in the jaw. When the jaw bone begins to deteriorate, teeth can become loose and even fall out and patients may even notice a change in their facial structure. In order to restore lost bone structure, a patient may require a bone graft before a dental implant can be placed.
Periodontal Disease and Bone Loss
Gum disease develops in stages starting with gingivitis and progressing into periodontitis. Periodontitis is a chronic bacterial infection in the gum tissue and gum pockets around the teeth which can develop from poor oral hygiene, certain medications, or even medical conditions. Patients may have a genetic predisposition for periodontal disease and may require more frequent cleanings by their dental office than the standard twice a year in order to keep everything healthy and prevent gingivitis from developing in the first place.
Once periodontitis has developed, the infection in the gum pockets will cause the gum tissue to pull away from the root of the tooth, causing the root surface to become exposed and extremely sensitive which can be very painful and could require a gum graft 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 surgeries available to help heal the different areas of deterioration in the mouth.
There are a few symptoms of gum disease that you should be aware of. Addressing symptoms as soon as they arise will help to keep your mouth as healthy as possible! Symptoms of gum disease include:
- Tooth sensitivity to hot or cold items
- Pain while eating
- Halitosis, or chronic bad breath
- Loose teeth
- Swollen and puffy gums that bleed upon flossing and brushing
Bone Graft For Periodontal Disease
A dental implant requires sufficient bone structure for proper support. For patients who lack appropriate 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 another area of the patient’s body or even from a cadaver.
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. They will also remove any infection in the gum tissue as they go. The bone graft is then placed and sutured into place and the gum tissue is closed. The bone graft will integrate with existing bone structure and help rebuild the jaw bone and will be able to better support the teeth or any restorative dental prosthesis that may be set.
A couple of months of healing time will be allowed to ensure that the new bone material is fully integrated with the natural bone before any other restorative work can be done. 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.
Types of Bone Grafts
There are a few different types of bone grafts available and your doctor will decide which option to use. Types of and grafts include:
- Autograft: Sometimes your doctor can take a piece of bone from the patient's hip or the back of their jaw.
- Allograft: This type of graft utilizes a piece of bone harvested from a human donor.
- Xenograft: Another type of donor bone graft, this one uses bone harvested from an animal, usually a cow.
- Alloplast: This bone graft uses synthetic material that contains calcium, phosphorus, and hydroxylapatite which is a natural mineral that is chemically similar to hard tissue.
Regenerating Gum Tissue in Patients With Periodontal Disease
A bone graft may not be the only surgery required before an implant can be placed. Periodontal disease can have a great impact on the gum tissue so a gum graft may be required 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.
Preventing Bone Loss
Prevention is the best way to avoid periodontal disease and it's negative affects on your 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. 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.
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.