How do dental implants help with bone loss and gum diseases?

Ad Min - Monday, January 18, 2021

Bone loss can occur in bones of a person leading to many orthopaedic diseases, prominent among them being osteo porosis where bone density decreases, making the bones brittle and porous which in turn make them susceptible for fractures.

What is bone loss?

When teeth are lost for whatever reasons, the bone which was supporting it gets absorbed in the body again, this process of bone being reabsorbed by the body is called resorption in dental and oral care parlance.

Causes of bone loss

There are numerous reasons for bone loss among which periodontist is the main reason and most common. Bone loss occurs because teeth are lost or missed. The main reason for losing teeth is periodontitis. When you do not take good care of your mouth and teeth, you end up having periodontitis which is a disease of the teeth and gums.

What is periodontitis?

Periodontitis is a disease caused by bacteria in the mouth. Lack of dental hygiene causes these bacteria to grow and multiply in the mouth feeding on the sugar left behind in the mouth. These bacteria eat away at the roots of the teeth and the jawbone, and then eats the ligaments that connects the tooth to the bone. This causes the teeth to fall out, creating gaps in the line of teeth. When the teeth are lost, the bone underneath the teeth have no pressure of chewing, which makes them get reabsorbed in the body, because chewing pressure is the motivation for the bone to grow and stay put. Slowly major portion of the supporting bone gets reabsorbed and bone from the jaw gets lost. The bone loss occurs very fast after the tooth is lost. About 25% of bone loss occurs in the first year itself after a tooth is lost.

The most common reason for bone loss is when this place, created by tooth loss is left alone, without taking any steps to keep the bone in place. When multiple teeth are lost, the bone loss is greater through resorption process.

The loss of bone occurs in alveolar bone which is surrounding and supporting the teeth. Alveolar bone is responsible for the ridges that imbeds the teeth in them. When teeth are lost, these ridges waste away from all sides leaving the surface flat.

Dentures as a replacement of the natural teeth do not help in getting back the lost bone because they do not exert pressure on the bone with chewing. Compared to natural teeth, the pressure applied on jawbone by dentures is less than 10%.

Sinus cavity that lies above the jawbone of upper molars is another reason for the resorption of the jawbone when upper molars are lost. With no teeth, the air pressure in the sinus cavity induces the resorption of the bone that lines the sinuses. Infection in bones is another cause of bone loss.

Dental implants and bone loss

Dental implants can prevent bone loss after teeth loss if the procedure can be done in time. Dental implants are a procedure where a metal (Titanium) screw is implanted in the jawbone and allowed to remain there till bone tissues grow around it making it secure in the bone. Then a crown is placed on it with the help of abutment which holds it in place. The implants can prevent further bone loss because the tooth exerts enough pressure on the jawbone to stimulate it and let it grow. When many teeth are lost, the implants can support a bridge built on them. Since implants are inserted in the jawbone, they take the pressure of chewing and help getting the bone remain in place and grow. When two implants support a bridge of 4 teeth, the pressure provided by the implants can equal of about 70 to 90 % of natural teeth. This helps prevent bone loss to quite an extent.

Bone grafting

When bone loss severe in some individuals, the option of bone grafting is still open. Bone grafting is needed to provide enough bone to get ridges on the jawbone so that crowns can be fitted snugly on them after dental implants have been inserted. When bone loss has occurred for missing molars, the dentist will require enough width to place them on. Bone grafting can be useful in such cases.

In cases with severe gum disease, the bone loss is acute. Bone grafting can come to the rescue for dental implants in restoring the lost bone and repair the damaged surrounding bone around the teeth.
When bone grafting technique is used for dental implant, in severe bone loss incidents, the grafting not only helps replace the lost bone, but also provides motivation and stimulation to the jawbone to regrow and develop so that eventually it replaces the bone graft with the individuals own replenished bone.

The material used for bone graft is varied depending upon the need of the patient. The new technology used for bone grafting is dynamic and make uses of cutting age materials that requires minimum period of healing.

In many dentistry practices, the technology used is minimally invasive which is explained in detail to the satisfaction of the patient.

Many times, if the bone loss is not extensive, then the bone graft and implant can be placed during one surgery procedure without having to go through the procedure twice. In severe bone loss, the dentist prefers to call the patients twice for the surgery, once for bone graft and the other for placing the implant, depending on how well the bone graft is healing and new bone is surfacing.

When sinuses have slid down quite a bit, the surgeon has to lift the membrane separating the jawbone and sinuses.

There are instances when there is no need for bone graft even in a severe bone loss case.  The 3D CT scanner gives a 360degree view which allows the dental team to see and measure the exact amount of bone needed for the place where implants are going to be placed, and in many cases the enough bone can be found for use. In this technology, with 4 implants, the surgeons can make the bridge for the entire mouth with enough bone available without separate surgery in another area of the body.

Different teeth replacement options to choose from

Ad Min - Friday, January 08, 2021

There are several reasons are behind missing teeth. Age, accidents, trauma to the mouth and oral region, tooth decay, diseases, hygiene habits or even genetics. Whatever be the reason for losing teeth, replacing the lost teeth is possible. This helps to maintain and promote oral health, not to forget the support it gives to self-confidence and speech.

Dental clinics provide different treatment options, one can choose these treatment procedures based on their need, suitability and also costs. The major options that one can opt for in teeth replacement is discussed.

Dental Implants - This is one of the most reliable tooth replacement options that one can go for. They are almost similar to the natural teeth. They are anchored in the jawbone like a natural tooth. A single tooth or multiple teeth replacements are possible using this procedure. The procedure is a bit lengthy as it involves cutting the jawbone and inserting the ‘root’ of the replacement tooth into it. This procedure is durable and lasting almost close to a natural tooth that one can get. It does not require any additional care, following normal oral hygiene practices will be sufficient. Neighbouring teeth are not affected by this procedure and are cost effective if taken care of. The only downside to this procedure is that jawbone health needs to be good to go for this treatment as the root needs to be supported in the jaw bone.

Dentures - A simpler option to replacing teeth is dentures. These dentures are replacement teeth that are removable and can be used for people who have lost some of their teeth. If a replacement is required for the whole set of teeth then complete dentures are recommended by dentists. The replacement teeth are placed in areas where teeth are lost. They can be removed and cleaned and slipped on with ease. Clasps are available to hold the removable dentures in place. Dentists made these dentures by obtaining a mould of the lost teeth and making exact replicas of the natural teeth, if metal supporters are visible then that is a sure give-away sign. But now, one can also avail the clasps made of gum coloured material that help to merge with the colour of the gums. They are not as costly as dental implants and can be repaired easily. They might feel a bit uncomfortable to wear and are not that sturdy as other dental prosthetics and hence one needs to be careful in handling them.

Implant supported bridge - If there are missing teeth in a row, then implant supported bridge is best suited. This helps to tide over the issue of having dental implants for each teeth. This will be able to support missing teeth in a row, the teeth at the end will be secured. So the teeth in the middle do have to be rooted in the jawline. This is a better option for those who have lost teeth in a row and serves as well as dental implants and are long lasting. This might need to be replaced at a later time for a healthier option, of course depending on the recommendation from the dentist. This is also a good option when looked at from the aesthetic side, the replaced teeth look like natural teeth and provide the same structural and functional support. Cleaning the teeth is similar to cleaning natural teeth and does not require any specific care. They are long lasting if even proper care and does not usually require replacement.

Tooth supported bridge - A similar procedure when there is a single tooth missing is achieved by tooth supported bridge. This bridge is placed supported by the neighbouring tooth. This device will have two crowns which are placed on the natural teeth and abutment crowns are placed on the replaced teeth. For providing lasting support they are usually cemented in place using metals or alloys like silver, gold or amalgams etc. The advantage is that the procedures are less when compared to dental implants. The bridge helps in reducing individual implants. This procedure does not require much time at the dental clinic and will be over in a few visits. Once the device is placed, it requires proper attention while cleaning. Food particles can get under the bridge. This is a small area and cleaning it requires greater focus as it is difficult to remove the food. Tooth decay or other gum diseases can happen if unchecked.

Resin bonded bridge - Often used as a temporary measure, the procedure helps teeth in the front. The front teeth are usually very delicate and are not as strong as the molars and their chewing strength. This non-invasive treatment helps in replacing front teeth. The neighbouring teeth are not shaped too much, dentists will remove only a small amount of enamel for fixing the abutment teeth. The wings are attachment to the replacement teeth. As it is fragile, it can pop off sometimes when hard food is chewed on and will require replacement from the dentist. But this is often a better option than removable dentures. It provides the person with continued support in speech and also oral function such as keeping the other teeth in their position and not shifting.

Flipper - A temporary structure that helps when one or two teeth need replacement. As the names suggest they can be flipped in and out of position. They help to give confidence to the wearer by removing the embarrassing situation of losing teeth and this procedure does not require much time. This is often chosen by many as a stop-gap arrangement when they are thinking of more durable solutions. They are useful as they can be slipped in after tooth extraction. Keeping the remaining tooth in position after tooth removal as other teeth tend to slip from their position when there is a gap in the teeth row. This procedure is not costly but as the device is delicate it needs care in handling.

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