Jaw Bone Loss And Deterioration
Below are the most common causes for jaw bone deterioration and loss that may require a bone grafting procedure:
When an adult tooth is removed and not replaced by a denture or implant, jaw bone deterioration will happen naturally over time. While our natural teeth are embedded in the jaw bone and stimulate it through activities such as chewing and biting, the opposite occurs when teeth are missing; this is because the alveolar bone or the portion of the jaw bone that anchors the teeth into the mouth, is unable to receive the stimulation it needs. As a result, the jaw bone begins to break down and since the body no longer uses or needs it, it deteriorates. The rate at which the bone deteriorates, as well as the amount of bone loss that occurs differs among individuals, the first 18 months after the extraction is when individuals are the most susceptible.
Periodontal disease is a term used to describe ongoing infections of the gums that prevent your teeth from being healthy because your gums and tissues in the mouth help to support natural teeth. Periodontal diseases affect one or more of the periodontal tissues: alveolar bone, periodontal ligament, cementum, or gingiva. There are many diseases that affect the tooth-supporting structures, however, plaque-induced inflammatory lesions make up many periodontal issues and are divided into 2 categories:
- Gingivitis (which always precedes periodontitis) and
Gingivitis is caused primarily by dental plaque in genetically-susceptible individuals. Plaque is a colorless film, composed of food particles and various types of bacteria, that adhere to your teeth at and below the gum line. Plaque is always forming on your teeth, even after cleaning. It is the bacteria found in plaque which produces toxins that can irritate the gums which in turn show signs of infection when they are inflamed, red, swollen or bleed easily. If irritation is prolonged, the gums will separate from the teeth causing pockets or spaces to form. If you do not brush or floss your teeth regularly enough plaque hardens into a rough, porous substance known as calculus (tartar).
Periodontitis is affected by bacteria that adheres 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 the loosening and subsequent loss of teeth.
Bridges are otherwise known as fixed partial dentures that are essentially dentures that are affected to the adjacent teeth dentures rely on the bone to hold them in place, and as a result, people experience loose dentures and problems when they are eating or speaking. When bone loss is so severe that dentures cannot be held in place with strong adhesives, a new set of dentures might be needed.
Proper denture care, repair, and refitting is essential to maintaining oral health. Some dentures are supported by anchors which stimulate and help to preserve the bone. With bridgework, the teeth on either side of the appliance provide enough stimulation to the bone, but the portion of the bridge that spans the gap where the teeth are missing receives no direct stimulation and that is when bone loss can occur. When this happens, our oral surgeons will be able to restore function and growth preventing any additional damage.
When a tooth is knocked out or broken to the extent that no biting surface is left below the gum line, bone stimulation stops, resulting in jaw bone loss. Common forms of tooth and jaw trauma include:
- Knocked out teeth following an injury or accident
- Fractures of the jawbone
- Any teeth that have had a history of trauma that die 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 situations in the mouth where teeth no longer have an opposing tooth structure. The unopposed teeth can over-erupt causing deterioration of the underlying bone. Issues such as TMJ, wear-and-tear, and a lack of routine dental health care can create abnormal physical forces that interfere with the teeth’s ability to grind or chew properly and over time, bone deterioration can occur.
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. A course of antibiotics is required to treat osteomyelitis as well as surgery to remove the affected bone. A bone graft procedure may be required to restore bone function and growth lost during removal.
Benign facial tumors can grow large and require surgery to remove a portion of the jaw. Malignant tumors within the mouth generally always spread into the jaw, requiring the removal of the affected section of the jaw. In both cases, reconstructive bone grafting is required to help restore normal function to the jaw. Grafting in patients with malignant tumors may be more challenging because treatment of the cancerous tumor generally requires removal of the surrounding soft tissues as well.
Developmental deformities are conditions characterized by missing teeth, facial bones, or parts of the jaw or skull. Our oral surgeons can perform a bone graft procedure to restore bone function as well as any type of growth that could be missing.
There are numerous sinus deficiencies, but the most common type occurs when the molar teeth are removed from the upper jaw and air pressure from the air cavity in the maxilla (maxillary sinus) causes resorption of the bone (that previously kept the teeth in place). As a result, sinuses become enlarged, causing hyper pneumatized sinus. This condition takes time to develop but it can result in insufficient bone from the placement of dental implants. Our oral surgeons can perform a procedure called a ‘sinus lift’ to treat enlarged sinuses.