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Osteoporosis is a disease of bones that leads to a decreased density of bone and subsequent increase in risk of fracture. Osteoporosis causes bones to become weak and brittle. Osteoporosis-related fractures most commonly occur in the hip, wrist or spine.

Osteoporosis affects millions of people all over the world. It affects men and women of all races. Women are 4x more likely to develop osteoporosis. Research has shown that post-menopausal white and Asian women are at highest risk. Medications, healthy diet and weight-bearing exercise can help prevent bone loss and strengthen already weak bones. There is recent research showing that women who drink wine in moderation tend to have higher bone density than those who abstain from alcohol.

How Do I Know If Dental Implants Are An Option?

The first step is to get your osteoporosis under control and limit the further effects of the disease. This includes seeing a physician to prescribe the proper medications, diet, and exercise routine. The next step is to see your implant dentist for a full evaluation. This evaluation will include your overall health, your oral health, as well as the degree of your osteoporosis.

Some considerations before having dental implants placed include:

-State Of Oral Health. A major factor in the failure of dental implants is the presence of periodontal disease. With a patient already being compromised with osteoporosis this becomes doubly important that the patient be periodontal disease free.

-Strength, Density, And Volume Of Bone Tissue. You need to have some good quality bone left to have an implant last, healing will be prolonged, so volume of bone is extremely important.

-Medications. This includes medications you are taking for osteoporosis as well as other medications which could counteract those medications. Bisphosphanates have been long known to keep the body from reabsorbing bone tissue, but they also appear to affect your ability to heal after a dental implant procedure. Biphosphonates can increase the risk of biphosphonate-induced osteonecrosis of the jaw (also called BONJ). When BONJ occurs, the bone tissue actually begins to die due to inadequate blood supply.

-Is The Patient A Smoker? Smoking has long been a failure factor in dental implants as well as bone loss. Nicotine is a vaso constrictor so blood supply to the bones in the jaw can be compromised.

-Presence Of Systemic Disease. This can include a decreased immune system or diabetes. Good health is important for good healing.

If you have been diagnosed with osteoporosis, dental implants may still be an option. If osteoporosis has affected other parts of your body, it might not necessarily have caused decrease in jawbone mass or breakdown of these tissues. Recent research (International Journal of Oral and Maxillofacial Implants, Vol 21: 349) has shown a lowered success rate in patients with osteoporosis but the difference was less than 2%. The general success rate for dental implants is about 97% whereas the success rate in this limited study was 95%. The study also showed that bone grafting was successful as well.

Conclusion

Dental implants have long been the treatment of choice for tooth loss. For those who have been told it is not an option the effects can be devastating. The recent research gives hope to those who previously were told that it was not an option. Each individual needs to be evaluated on a case by case basis taking all factors into account before delving into placement of dental implants. If you are missing teeth or about to lose them, contact your dentist for a dental implant evaluation.

We don’t often give much regard to the importance of the bone our teeth sit in until there is a problem. The bone not only serves as the foundation for our teeth but it also plays a big part in our visual aesthetic appearance. Bone can be lost by tooth removal or periodontal disease. If a tooth is missing or removed, the bone may collapse into the empty socket and cause a sunken appearance to our cheeks or jawbone. A bone graft can restore these problems caused by dental disease or those that result from an accident. One of the main reasons for bone grafts in modern dentistry is to form a good foundation for dental implants.

What is a Bone Graft?

A bone graft is the replacement or augmentation of the bone around the teeth. Bone grafting is a term used to describe a variety of procedures used to add or build bone so that dental implants can be placed.
Dental Bone Grafting
A bone graft typically involves adding bone or bone like materials to the jaw. The bone graft can be your own bone (also called Autologous  bone), synthetic bone, be processed bone obtained from a cadaver (also called Allograft), or can even come from bovine/cow sources (these types are also called Xenografts). After grafting, you generally have to wait several months for the grafted material to fuse or become one with the existing bone structure.  Processed bone grafted materials either cause surrounding bone to grow into the graft or cause cells around the graft to change into bone. Autologous bone transplants bone cells or a block of bone that fuses to the jaw.

Implant Dentistry

It is often used to augment bone to allow for a more successful implant placement. A few reasons for bone grafting in implant dentistry include:
1) Augmenting bone in the sinus area to allow for implant placement.
2) Augmenting bone to enhance the fit and comfort of removable prostheses (dentures)
3) To enhance aesthetics of a missing tooth site in the smile or aesthetic zone. This zone is generally defined as the visible area seen upon full smile, including the teeth, gingiva, and lips.
For a dental implants to be a success, the patient must have sufficient bone in the jaw to place the implant into.
Assumptions were once made that if a patient did not have sufficient quality or quantity of bone in their jaw they would not be suitable candidates for dental implants. Today, thanks to the exponential advances in dental techniques, materials, and technology, patients with insufficient bone in their jaws can have the bone rebuilt using bone grafting.

Bone Grafting Procedure

The actual bone grafting procedure is quite straightforward. A dentist will assess the quantity and quality of your bone during the treatment planning stages. It will be at this time that he/she will determine if there is a need for bone grafting. Then your dentist will review the different types of bone grafts with you and decide which will be the most suitable for your individual case.

Once this has been decided the bone graft procedure can be performed. The actual procedure requires the dentist to place bone under the gum tissue at the site where the bone graft is needed. The dentist will then be able to place the bone to be grafted onto the site and then cover it with a membrane for protection. Membranes are often used to help stabilize the bone graft as well as keep the gum tissue from invading the healing bone graft. The gum tissue will grow at a much faster rate than bone, therefore, membranes are used to prevent gum tissue from growing in and displacing the bone graft before it fully matures.This membrane is also used to protect the boneDental Bone Grafting from any germs found in the oral cavity and ensure that the area is perfectly clean to allow the healing process to take place. Finally, the area is closed and the tissue is stitched into place. Bone graft healing time is usually right around 4-6 months. But this can vary from patient to patient. Patients are given a prescription for antibiotics to take following their bone graft. Antibiotic mouthwashes can also be prescribed to preserve the health of the gum covering the bone graft.

On follow up visits the dentist will check on the success of the bone graft by taking x-rays to determine the height and width of the new bone. Once this has been verified as satisfactory, and the site of the bone graft is completely healed, the next stage of the dental implant process can begin.

Dental bone grafts for the purpose of dental implants has a very high success rate. But there is always a possibility that the bone graft will not work as planned, even if your own bone was used. Bone grafts are not rejected by the body like organ transplants. There is still some mystery as to why some bone grafts fail. We do know that certain people (for example, smokers, diabetics, patients with poor dental hygiene) have higher risks of graft failure.

A failed graft will need to be removed. Once healed properly, you and your dentist may choose to place a second graft.

A bone graft gives the implant dentist and patient one more tool to achieve a successful outcome to just about any implant treatment.

Dental Bone Graft