Reasons for Bone Loss and Deterioration
Jacks Oral Surgery & Dental Implants – Piqua & Dayton OH
The following are the most common causes for bone deterioration and loss that may require a bone grafting procedure:
When an adult tooth is removed and not replaced, bone deterioration may occur. Natural teeth are embedded in the bone, and stimulate the bone through activities such as chewing and biting. When teeth are missing, the portion of the bone that anchors the teeth in the mouth, no longer receives the necessary stimulation, and begins to break down, or resorb. The body no longer uses or “needs” the bone, so it deteriorates and goes away. Wearing dentures or partials can accelerate the bone loss. This bone loss is why patient’s dentures and partials become “loose” over time until enough bone is lost that they can no longer wear their denture or partial.
The rate the bone deteriorates, as well as the amount of bone loss that occurs, varies greatly among individuals. However, most lost occurs within the first eighteen months following the extraction, and continues throughout life.
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Periodontal diseases are ongoing infections of the gums that gradually destroy the bone around your natural teeth. Periodontal disease affects one or more of the periodontal tissues: alveolar bone, periodontal ligament, cementum, 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 in genetically-susceptible individuals. 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 toxins or poisons that irritate the gums. Gums may become inflamed, red, swollen, and bleed easily. If this irritation is prolonged, the gums separate from the teeth causing pockets (spaces) to form. If daily brushing and flossing is neglected, plaque can also harden into a rough, porous substance known as calculus (or 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 overly aggressive 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 this bone, the alveolar, can lead to loosening and subsequent loss of teeth.
When a tooth is knocked out or broken to the extent that no biting surface is left below the gum line, bone stimulation stops, which results in bone loss. Some common forms of tooth and jaw trauma include: teeth knocked out from injury or accident, jaw fractures, or teeth with a history of trauma that may die and lead to bone loss years after the initial trauma.
A bone grafting procedure would be necessary to reverse the effects of bone deterioration, restoring function and promoting new bone growth in traumatized areas.
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.
Issues such as TMJ problems, normal wear-and-tear, and lack of treatment can also create abnormal physical forces that interfere with the teeth’s ability to grind and chew properly. Over time, bone deterioration can occur where bone is losing stimulation.
Osteomyelitis is a type of bacterial infection in the bone and bone marrow of the jaw. The infection leads to inflammation, which can cause a reduction of 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, though generally non-threateningly, 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.
Some conditions or syndromes known as birth defects are characterized by missing portions of the teeth, facial bones, jaw or skull. Dr. Jacks may be able to perform a bone graft procedure to restore bone function and growth where it may be absent.
When molars are removed from the upper jaw, air pressure from the air cavity in the maxilla (maxillary sinus), causes resorption of the bone that formerly helped the teeth in place. As a result, the sinuses become enlarged, a condition called hyperneumatized sinus.
This condition usually develops over several years, and may result in insufficient bone for the placement of dental implants. Dr. Jacks can perform a procedure called a “sinus lift” that can treat enlarged sinuses.