Bone loss

Disease, Injury, Deformity and Tooth Extractions may Contribute to Jaw Bone Deterioration and Loss.

Bone Grafts may be one solution to restore the height of the Alveolar Ridge.

Healthy jaw bone structures are critical for tooth retention, good overall oral health and for aesthetic reasons as well. Due to bone loss, or of poor quality, teeth do not function; feel or look as well as they should, and may fall out. With missing teeth and bone loss, the area of the mouth and face will lose its structure. This may be a concern for most patients.

The Reasons Why Teeth or The Bone Structure are Lost or of Poor Quality Include:

• Dental Procedures
• Disease
• Trauma, Sport Injury
• Developmental deformity

Most Common Factors That May Contribute to Jaw Bone Deterioration and Loss:
 

Tooth Extractions:

Natural teeth are embedded in the jaw bone (socket) and attached via a root structure and the ligament. The so called bone tissue is maintained by putting a load on it through the periodontal ligament; activities such as biting and chewing stimulate the root structure, which in turn stimulates the bone that the root is attached to.

When a permanent tooth is removed, bone stimulation stops at that particular site, and the alveolar bone – the portion of the jaw bone that anchors the teeth in the mouth – no longer receives this physical stimulation and starts to resorb (shrink or melt away). Bone resorption is a natural process. Since a natural tooth when extracted can not be replaced with another natural tooth the only option to prevent bone loss is a dental implant.

The most amount of bone loss occurs during the first eighteen months after the tooth is removed, and continues in varying degrees and rate throughout life, it varies greatly between individuals.

Dentures:

Dentures and bridgework are intended to correct the challenge of missing teeth, in terms of appearance and function, but can not be designed to mimic a natural tooth's ability to stimulate the bone within the jaw.

Dentures rest on top of the gums within you mouth and do not provide direct stimulation of the bone (alveolar bone). Dentures rely on the support from the gums and the underlying bone structure to keep them in place this effect is called adhesion (example place water on a glass plate and place a second glass plate on top due to adhesion you can lift the first up by touching only the second plate) The bone resorbtion (shrink or melt) will progress and the denture will become loose and therefore will not fit as well. The denture needs a reline, which in short term, may fix the problem however over the years the resorbtion (shrinkage) can get to a point where a new, relined or denture adhesives can not provide the adequate retention.


This picture shows the bone structure with all the teeth.
(Image provided by Dr. Spiller)

 

This second pic shows the lost of teeth at the age around thirty this is the result of bone loss around 20  years later.
(Image provided by Dr. Spiller)

This third pic shows bone loss around 30 years later. Dentures do not prevent bone loss.
(Image provided by Dr. Spiller)
 

Bridgework:

With bridgework, the anchoring teeth (abutment teeth) on each side of the tooth to be replaced continue to stimulate the underlying bone within the jaw; however, the bone structure under the portion of the bridge that spans the vertical bone defect, similar to what occurs after teeth are removed, but usually more severe.

Fractures:

If a fracture in the jaw bone fails to heal (which requires the formation of a bony union), instead it forms a non-union, or fibrous union. This causes gaps between the broken bone segments and may include a tooth or teeth and the surrounding structures. They are typically 1 mm-1. 5 mm in size.

Post Trauma:

Teeth with a history of trauma may become necrotic, or die, after the trauma acures, sometimes even years after the injury. In some instances, bone loss may also occur, due to the resorption(shrinkage) of bone and tooth structures.

Misalignment:

An environment can be created by misalignment issues within the mouth where certain tooth structures no longer have an opposing tooth structure (antagonist). The unopposed tooth may over-erupt (growing out of the position), leading to deterioration of the underlying bone.