Periodontics, Mark I. Gutt, Miami, Oral Health Care

Bone Loss Treatment

Bone Grafting, Ridge Preservation and Guided Tissue Bone Regeneration

Bone loss in the jawbone is common when one or more teeth have been lost due to injury, decay, or trauma. Without the tooth in place to stimulate the jawbone, the bone around the missing tooth will begin to deteriorate. Over time, the jawbone may deteriorate to such an extent that there may not be enough bone to place dental implants. In cases such as these, Dr. Gutt may recommend having a bone grafting procedure.

Bone grafting is the replacement or augmentation of missing bone around the teeth and the deteriorated jawbone defect.

There are three types of bone graft procedures: autogenous, allograft, and xenograft.

Autogenous grafts take bone from one area of the patient’s body and transplant it to the location in the mouth being restored. The bone is usually taken from non-essential bones such as the chin and upper and lower posterior areas. The benefit of an autogenous bone graft is that the bone used comes solely from the patient thus reducing the likelihood of rejection and infection. The bone is also still “live”, meaning it still has active cellular material.
Allografts also use human bone transplanted to the area in the mouth being restored. However, allografts do not use the patient’s own bone. Instead, the bone usually comes from cadavers who have donated their bone to bone-banks. All allograft bone material is carefully screened and is considered very safe. Xenografts also replace bone in the area requiring treatment, however the bone comes from a non-human source. Usually the non-human source is bovine (cow), porcine (pig), or equine (horse).
Allografts and Xenografts are used because they do not require a second surgical site to harvest bone and ample amounts of bone can be easily attained.

The Procedure

Local anesthesia is used to numb the area where the bone will be removed as well as the location where the bone will be augmented. An incision is made in the gums around where the bone will be augmented. This is done so that Dr. Gutt can see exactly how much bone will be need before harvesting it from the patient (if an autogenous graft is being performed).

Next, Dr. Gutt will make a cut in the gums below the lower front teeth in order to expose the jawbone. Dr. Gutt will then remove a part of the bone along with any bone marrow. This incision is then closed with stitches.

The bone removed from the jawbone will be anchored in place in the area to be augmented with small titanium screws. Dr. Gutt may place a mixture of your bone marrow and some bone-grafting material around the bone graft to help speed healing. The incision is then closed with stitches.

After the procedure, Dr. Gutt will prescribe you the appropriate antibiotics, anti-inflammatory medication, and pain medication as needed. You’ll be asked to follow a restricted diet of soft foods such as pastas and Jell-O. Bone grafts usually take about three to nine months to heal completely. Dental implants will not be placed until your mouth has healed completely.

When one or more teeth are extracted from the mouth, soft tissue and bone can begin to collapse. Without the tooth root to stimulate it, the surrounding jawbone will almost immediately begin to collapse and shrink. If there is too much bone loss, it may be impossible to place dental implants and it may become more expensive, more invasive, more time consuming, and more uncomfortable to replace the lost bone. Ridge (or Socket) preservation is a type of bone grafting procedure that rebuilds and stabilizes bone where an extraction has left an empty, weakened socket.

The Procedure

Ridge preservation procedures begin with the removal of the tooth. Dr. Gutt will do so carefully so as to not disturb existing bone in the socket. Next, Dr. Gutt will insert a specialized bone-grafting product. This product can be an autogenous graft, allograft, or alloplast/xenograft. The bone-grafting material is designed to build and regrow bone in the socket. After it has been placed, the grafting material will be stabilized with stitches and/or a membrane. Healing time is approximately 3-5 months before a dental implant can be placed.

The Benefits

Ridge preservation can essentially minimize the amount of bone loss that occurs after the removal of one or more teeth. Leaving the socket empty after an extraction is sure to lead to deteriorating bone in the jaw, making it more difficult to place an implant later.

Ridge preservation is also:

Minimally invasive with minimal discomfort
Prepares the site for future placement of a dental implant without additional grafting
More cost effective and less painful than waiting to have the grafting procedure later
Preserves a natural looking smile

Periodontal disease causes bone loss around teeth, which can increase the chances for tooth loss. Once a tooth has been lost, the supporting jaw bone will disappear over time. This can make wearing dentures uncomfortable. However, simple techniques are now available to regrow lost bone, provide support for dental implants, or to improve esthetics beneath a fixed bridge.

Guided tissue bone regeneration does not always require the removal of bone from any other part of the body. Instead, many options use membrane barriers, tissue stimulating proteins, or bioactive growth factor gels. Occasionally bone grafting procedures are required; bone grafts can be from your own bone, tissue banks, or synthetic materials. The goal of each of these treatment options is to stimulate the body to grow new bone or to hold the space for the bone to regenerate into.

The Benefits

The bone and gum tissue should fit together like a turtleneck around your neck. But when periodontal disease is present, this supporting tissue and bone is destroyed and pockets in the gums develop. Eventually, if too much bone is lost, the tooth will need to be extracted.

Guided tissue bone regeneration helps the body to regenerate lost bone. By repairing the damage done by periodontal disease, this procedure will increase the chances of keeping your natural teeth and will decrease the odds of serious health problems associated with periodontal disease.

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