Causes of Jawbone Loss and Degradation
The most frequent reasons for jawbone deterioration and loss that may necessitate a bone grafting procedure are as follows:
Tooth Extractions
When an adult tooth is extracted and not replaced, it can lead to jawbone deterioration. Natural teeth play a crucial role in stimulating the jawbone through activities like chewing and biting. Without this stimulation, the alveolar bone, which supports the teeth, can begin to break down and resorb. As a result, the jawbone may deteriorate over time.
The rate and extent of bone loss can vary from person to person, but most of the deterioration typically occurs within the first eighteen months after the tooth extraction. This process of gradual bone loss may continue throughout a person's life.
Periodontal Disease
Periodontal diseases are chronic infections of the gums that gradually deteriorate the support of natural teeth. These diseases affect the periodontal tissues, including the alveolar bone, periodontal ligament, cementum, and gingiva. The majority of periodontal issues are caused by plaque-induced inflammatory lesions, which are categorized as gingivitis and periodontitis. Gingivitis, the less severe form, can progress into periodontitis if left untreated.
Dental plaque, a sticky film made up of food particles and bacteria, is the main culprit behind gingivitis, especially in individuals with a genetic predisposition. Plaque forms on and below the gum line and can harden into calculus if not removed through proper oral hygiene practices. The bacteria in plaque release toxins that irritate the gums, leading to inflammation, redness, swelling, and bleeding. Prolonged irritation can cause the gums to pull away from the teeth, creating pockets where more bacteria can thrive.
Periodontitis occurs when bacteria on the tooth's surface trigger an aggressive immune response, resulting in the deterioration of the gum tissue and bone that support the teeth. As the alveolar bone is lost, teeth may become loose and eventually fall out. Proper oral hygiene, including regular brushing and flossing, is essential in preventing and managing periodontal diseases.
Dentures/Bridgework
Unanchored dentures are placed on top of the gum line, but they do not provide any direct stimulation to the underlying alveolar bone. Over time the lack of stimulation causes the bone to resorb and deteriorate. Because this type of denture relies on the bone to hold them in place, people often experience loosening of their dentures and problems eating and speaking. Eventually, bone loss may become so severe that dentures cannot be held in place with strong adhesives, and a new set of dentures may be required. Proper denture care, repair, and refitting are essential to maintaining oral health.
Some dentures are supported by anchors, which do help adequately stimulate, and therefore preserve bone.
With bridgework, the teeth on either side of the appliance provide sufficient stimulation to the bone, but the portion of the bridge that spans the gap where the teeth are missing receives no direct stimulation. Bone loss can occur in this area.
By completing a bone graft procedure, Dr. Khayat is now able to restore bone function and growth, thereby halting the effects of poor denture care.
Trauma
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 jawbone 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.
To reverse the effects of bone deterioration, restore function, and promote new bone growth in traumatized areas, a bone grafting procedure would be necessary.
Misalignment
When there are misalignment issues in the mouth, it can lead to a situation where certain teeth do not have a corresponding opposing tooth structure. This can result in the unopposed tooth over-erupting, which can cause damage to the underlying bone.
Other factors such as TMJ problems, regular wear and tear, and lack of treatment can also contribute to abnormal physical forces that disrupt the teeth's ability to grind and chew effectively. As a result, bone deterioration may occur over time due to lack of stimulation.
Osteomyelitis
Osteomyelitis is a bacterial infection that affects the bone and bone marrow in the jaw, causing inflammation and reduced blood supply. Treatment typically involves antibiotics and removal of the infected bone. In some cases, a bone graft may be necessary to restore lost bone function and growth.
Tumors
Facial tumors, whether benign or malignant, can sometimes grow large enough to necessitate the removal of a portion of the jaw. Malignant mouth tumors typically spread into the jaw, leading to the removal of the affected section. Reconstructive bone grafting is often necessary in both cases to help restore normal jaw function. Patients with malignant tumors may face additional challenges with grafting due to the need to remove surrounding soft tissues during cancer treatment.
Developmental Deformities
Certain conditions or syndromes may involve the absence of portions of the teeth, facial bones, jaw, or skull. Dr. Khayat has the expertise to conduct a bone graft procedure to help restore bone function and growth in areas where it is lacking.
Sinus Deficiencies
When molars are extracted from the upper jaw, the air pressure from the air cavity in the maxilla (maxillary sinus) can lead to resorption of the bone that previously supported the teeth. This can cause the sinuses to become enlarged, a condition known as hyperpneumatized sinus.
Over time, this condition can develop and may eventually result in inadequate bone for the successful placement of dental implants. Dr. Khayat specializes in performing a procedure called a “sinus lift” to address enlarged sinuses and restore proper bone structure for dental implant placement.
