What Causes Bone Loss?
There are many known causes of bone loss in the jaw, namely, periodontal disease and missing teeth.
Periodontal disease attacks the tissues supporting the tooth
Periodontal disease takes different forms depending on the stage of infection. The first stage is a common disease called gingivitis. Due to an accumulation of dental plaque resulting from poor oral hygiene, this infection attacks the gums surrounding the tooth. Although benign and easy to treat, it can become more and more extensive if not properly treated and reach the stage of periodontitis.
Periodontitis is a generalized infection of the periodontium. At this stage of the disease, it is no longer the gums, but the entire periodontium that is affected, i.e. all the tissues supporting the tooth - bone + gums -. The infection creates cavities between the teeth, creating pockets in which dental plaque accumulates, further aggravating the disease. At the most advanced stage, the pockets are so deep that the tissues no longer support the tooth, which then ends up loosening its roots and falling out.
Periodontitis that has not been treated in time therefore leads to significant bone loss. In the event that one wishes to have implants placed, it will then be necessary, depending on the sector of bone loss, to proceed with a graft.
Bone loss due to an unreplaced missing tooth
When a tooth is lost, following an accident, an illness or an extraction, it should be replaced as soon as possible in order to avoid the phenomenon of bone resorption.
Bone resorption is bone loss that results from the lack of stimulation of the bone. We must not forget that our teeth are directly connected to the bone of our jaw. Thus, when we chew, our bone is indirectly solicited through our teeth. When you lose a tooth, the bone is no longer stimulated, and the body deduces that it is useless to have bone at this level. In a few months, we then witness the phenomenon of bone resorption.
Extraction of teeth without replacement of missing teeth
In some cases, your dental surgeon may have to extract one or more teeth from your mouth. This may be due to a fracture during an accident, an oral infection that can become widespread if we do not intervene, or even poor positioning that interferes with the general balance of your teeth.
Following this extraction, the jawbone can shrink more or less quickly at the level of the extracted teeth. At the extraction site, a blood clot forms, and white blood cells flow in to neutralize bacteria and destroy damaged tissue. Subsequently, cells of the immune system continue to be solicited for several weeks on the location of the missing teeth. If these teeth are not replaced, there will be bone resorption, i.e. bone loss due to the fact that the bone no longer receives any stimulation. Most of this stimulation is usually caused by chewing forces, but in the absence of these forces exerted on the tooth (and therefore indirectly on the bone supporting the tooth), the body does not see the point of maintaining a bone volume according to him useless. The logic is the same as with a muscle: if you don't work your muscles, they tend to decrease in volume because the body sees no reason to retain mass.
Coming back to the jawbone, it is therefore essential to find a replacement solution for missing teeth to avoid resorption, and the dental implant remains the best solution to date. Otherwise, the lack of bone volume may represent a contraindication to the direct placement of an implant, and it will therefore be necessary to resort to a bone graft before the placement.
Traumatic tooth extraction
Dental trauma refers to damage to one or more parts of the tooth. The trauma can therefore concern the enamel, the dentin, the pulp, the root, the periodontal ligament which holds the tooth in the alveolus, the cementum which covers the roots, or even the alveolar bone. Regarding this last bone that surrounds the tooth, it is very important to respect it and take care not to damage it during the extraction. Indeed the bone walls are thin and fragile and if a section of bone fractures, the bone crest will remain mutilated and the establishment of the implant compromised because it is in this alveolar bone, very vascularized, that comes integrate the implant. Indeed, its great vascularization allows what is called osseointegration of the implant (i.e. the integration of the implant into the bone) as well as new bone formation.