Reasons for Jawbone Loss and Deterioration
Bone grafting is required to correct defects in the jawbone. The most common causes of this deterioration are:
When an adult tooth is removed and not replaced, a defect in the jawbone will occur. Natural teeth are embedded in the jawbone, and stimulate the jawbone through function, such as chewing and biting. When teeth are missing, the alveolar bone (or the portion of the jawbone that anchors the teeth in the mouth), no longer receives the necessary stimulation, and begins to deteriorate, or resorb.
The rate and the amount of bone deterioration, varies greatly amongst individuals. However, most bone loss occurs within the first eighteen months following the extraction.
Periodontal diseases are ongoing infections of the gums that gradually destroy the support of your natural teeth. Periodontal disease affects one or more of the four periodontal tissues: alveolar bone, periodontal ligament, cementum, and gingiva. While there are many diseases which affect the tooth-supporting structures, plaque-induced inflammatory lesions make up the majority of the periodontal diseases, and are divided into two categories: gingivitis and periodontitis. Gingivitis is the less serious of these two conditions. It may never progress into periodontitis, however 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. These organisms 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 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 caused by bacteria that adhere to the tooth’s surface, along with an overly aggressive immune response to these organisms. If gingivitis progresses into periodontitis, the supporting gum tissue and tooth- supporting bone deteriorates. The progressive loss of this alveolar bone can lead to the loosening, and subsequent loss of teeth.
Conventional removable dentures are placed on top of the gums, and therefore provide minimal stimulation to the underlying alveolar bone. Over time, this bone begins to deteriorate or resorb. This results in the loosening of dentures, and problems with eating and speaking. Eventually, the 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 (teeth or implants), which often helps to stimulate, and preserve bone.
With tooth supported bridgework, the abutment teeth on either side of the prosthesis stimulates the bone. The portion of the bridge that spans the gap (where the teeth are missing), receives no direct stimulation, resulting in some bone loss.
In some cases a bone grafting procedure can be performed by Dr. Gainey to recreate the bone volume lost by inactivity.
Bone stimulation stops when a tooth is knocked out or fractured due to trauma. This results in the deterioration of the tooth-supporting jaw bone. A bone grafting procedure may be necessary to reverse this bone damage, and ready this area for prosthetic rehabilitation, possibly with dental implants.
Misalignment issues can create a condition in the mouth where some teeth no longer have an opposing tooth to function upon. This unopposed tooth can overerupt or move out of the bone, resulting in a reduction in tooth support. Conditions such as temporomandibular joint dysfunction (TMD), excessive tooth wear, and orthodontic problems can cause a reduction in function, resulting in bone loss.
Osteomyelitis is a type of bacterial infection in the bone and bone marrow of the jaw. This infection leads to inflammation, which can cause a reduction of blood supply to the bone. The treatment for osteomyelitis generally requires antibiotics and the removal of the affected bone. A bone graft procedure may then be required to restore bone form and function.
Benign facial tumors, may grow large and require the removal of a portion of the jaw. Malignant oral tumors often spread into the jaw, requiring removal of a section of bone. In both cases, reconstructive bone grafting may be required to help restore jaw form and function.
When upper molar teeth are removed, air pressure from the air cavity in the maxilla (maxillary sinus), causes resorption of the bone that formerly held the teeth in place. As a result, the sinus becomes enlarged, a condition called hyperpneumatized.
This condition usually develops over several years, and may result in insufficient bone for the placement of dental implants. Dr. Gainey can perform a procedure called a maxillary sinus lift that can treat the enlarged sinus.