Your natural teeth are surrounded by your jawbone, a type of bone called alveolar bone, and like all bone, it is continually remodeling.
As your jawbone remodels, old bone cells that are dying are replaced, ensuring the bone stays healthy and strong and can support your teeth. However, changes to your oral health can cause alveolar bone loss.
The jawbone can be destroyed because of trauma but is most frequently lost because of periodontal disease. Periodontal disease (gum disease) is a bacterial infection that inflames and destroys gums, and if it worsens, it will destroy other structures around your teeth, including your jawbone and periodontal ligaments.
Your jawbone helps hold your teeth firmly in place, along with stretchy pieces of tissue called periodontal ligaments.
When alveolar bone around your teeth and these periodontal ligaments are destroyed, your teeth will gradually loosen and may fall out or will need removing. Because alveolar bone is quite fragile, it’s also possible for it to become damaged when you have teeth removed. Your dentist removes teeth by carefully rocking them side to side until they loosen entirely and are easily removable. It is a technique which can damage the bony socket around the tooth, no matter how carefully the tooth is extracted.
Once you lose teeth, it can cause bone resorption because normally, your bone receives stimulation when you bite and chew. Whenever you bite into food or chew something, the forces created are transmitted through your natural tooth root and into the surrounding bone. The stimulation tells your body it must continue renewing old bone cells as they die off.
When you have teeth removed, this stimulation is lost, and without it, old bone cells are no longer automatically replaced.
Consequently, your jawbone begins to remodel so that the bony ridge made from alveolar bone and which used to support your teeth gradually loses height or width or both. Unfortunately, this type of jawbone loss is inevitable when you lose natural teeth, and much of the bone resorption occurs during the first year of tooth loss and continues afterward at a slower rate. Loss of height or width in your jawbone can change your facial dimensions, and there is less support for your facial muscles so your cheeks and lips can begin to collapse inward.
Losing alveolar bone is highly undesirable, not least because it can affect dental implant treatment.
Dental implants must be surrounded with a specific amount of strong, healthy bone that they can gradually fuse with and which will hold them firmly in place. Without enough healthy bone, there is a risk your dental implants won’t be able to bond with your jawbone and instead could fail. When you visit any of our LuxDen dental implant clinics, Dr. Leonard Umanoff analyzes the quality and quantity of your bone using an advanced cone beam CT scan. Luckily, tooth bone loss is reversible.
Bone grafting can rebuild tooth bone loss, restoring the missing bone, creating a strong and stable platform for the dentist Dr. Umanoff to restore a missing tooth.
There are different types of bone grafts, and which include:
An autograft uses bone removed from another site in your body, typically from your chin or jaw, or possibly from your hip or leg. The advantage of an autograft is that it eliminates any small risk of rejection or other adverse reactions, and the bone used is alive, so it enhances the production of new bone. But it does mean you will need another surgical procedure to remove the bone graft.
A xenograft uses bone taken from another species, and which is normally bovine. The bone is extensively processed and sterilized and is rigorously tested to make sure it is safe for use. A xenograft provides a scaffold or framework for your bone, encouraging it to grow in areas where it is needed for dental implants.
An allograft also uses donor bone but which is human. It is rigorously tested and is sterilized and highly processed to ensure it is safe for use. An allograft also provides a scaffold on which new bone cells can grow, as the material is inert and won’t produce bone cells of its own.
An alloplast consists of entirely synthetic materials and is a sophisticated type of graft that may contain growth factors, proteins, and collagen designed to promote new bone growth and healing.
If you do need a bone graft, Dr. Umanoff can discuss all these solutions with you to determine which type of bone graft is most suitable for your preferences and needs. There are different types of bone grafting techniques that are used depending on the areas requiring additional bone.
These bone grafting techniques include:
When you have a tooth removed, the bony socket around it can become damaged during the removal process or by disease or infection. Socket preservation is a technique where the empty socket is filled with suitable bone grafting material immediately after removing the natural tooth. Afterward, the material is covered up with an artificial membrane containing special growth proteins, helping to stimulate your body to repair the empty socket.
The membrane also prevents gum tissue from growing in the socket. Once the membrane is in place, it is covered with gum to protect it during healing.
Socket preservation is a highly successful technique that can eliminate the collapse and shrinkage of bone and gum tissue and which creates a strong foundation for the dental implant.
It also helps to enhance the appearance of your dental implant by ensuring it is surrounded by the right amount of healthy bone and gum, creating a more aesthetically pleasing outcome. We may suggest socket preservation when replacing front teeth and where aesthetics are important or when using mini dental implants.
When we remove a natural tooth, it leaves an empty socket in the alveolar ridge, which is the raised bony ridge that used to support your teeth and which helps to protect tooth sockets. Usually, after a tooth extraction, the empty socket will heal well without additional treatment, as new bone and gum tissue are created. However, sometimes, the alveolar bone surrounding the empty socket will break down, creating a loss of height and width in the alveolar ridge.
A ridge augmentation restores the ridge to its original width and height, ensuring there is plenty of bone to support dental implants. A ridge augmentation also helps to ensure good aesthetics once restored with implant teeth.
Sometimes ridge augmentation is carried out at the same time as tooth removal, and we insert bone grafting material into the empty socket. It is a process that can also be carried out later when empty sockets have healed, and undesirable bone loss has occurred. Usually, a ridge augmentation must heal for 4 to 6 months, but sometimes it is possible to insert the implant at the same time as the bone graft.
Many people will need a sinus lift when replacing upper back teeth as the maxillary sinuses are located just above these teeth. Maxillary sinuses are air-filled cavities, and often the bone in this area is thinner and more fragile naturally, and sometimes natural tooth roots extend into the maxillary sinuses. When we take out natural teeth, there is often only a thin wall of bone between the mouth and sinuses and which isn’t adequate to support dental implants.
A sinus lift strengthens and builds up the bone around the sinuses, creating enough healthy bone to support dental implants.
During this procedure, an incision is made into the gums to expose the bone underneath. A small opening is cut into the bone, so top dental implant dentist Dr. Umanoff can see the membrane separating the bone from your sinuses. The membrane is carefully pushed upward or ‘lifted,’ creating a space between the jawbone and membrane, which we fill with bone grafting material.
Once in place, your gums are stitched, and the graft is left to heal. When only a small amount of bone is needed, it’s sometimes possible to have a sinus augmentation at the same time as your dental implant. If you need a greater amount of bone, a sinus lift will be more successful when completed as a stand-alone procedure and must be left to heal for several months before implant surgery.
Bone grafting ensures dental implant treatment is more successful and more aesthetically pleasing. We only use the very latest bone grafting techniques combined with the most sophisticated grafting materials. Although a bone graft may delay implant treatment slightly, it’s important to remember that many people will enjoy dental implants for decades to come, or potentially for life. Spending a little longer on treatment is well worth the additional effort and time.