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Dental implants are a highly popular dental procedure for replacing lost teeth. Dental implants are able to restore the mouth back to full function with a highly predictive, strong, long

Dental Implants Marielaina Perrone DDS

Dental Implants – The Perfect Solution For Tooth Loss

lasting restoration. However, for many, dental implants are not even an option due to poor bone density and quality of their bone.  What if dental implants were possible for these patients? Well, new research says that is possible.

Bone Break = Stronger Bone?

A recent article in the Journal of Oral Implantology suggests that the introduction of micro cracks in the jaw bones can stimulate bone growth. This would be especially helpful in patients with compromised bone density and bone quality. In theory, micro cracks can be developed in these patients and then following healing they would be able to receive their dental implants allowing for full restoration when otherwise they would not be able to.

Currently, the only way to improve bone density in patients lacking it would be the use of a dental bone graft and/or a sinus lift. These procedures require extra steps as well as extra cost. They also come with potential pitfalls such as the bone graft not taking on the first attempt.

What Did The Research Show?

The researchers used an instrument called an Osteotensor. This instrument was designed specifically for this Dental Implants Marielaina Perrone DDSdental implants study. This instrument is able to make a series of micro cracks in the jawbone in the area of the desired dental implant placement. Researchers found that, following placement of these micro cracks, there was biological response. Proteins, stem cells, and other growth factors began work to heal and regenerate the bone. The healing process is completed in about 45-90 days. At this time, the patient would be ready for dental implant placement.

The research followed the progress of a 74 year old woman who was treated with this technique. 45 days after the initial formation of micro cracks, the osteotensor instrument was unable to penetrate the bone at 23 of 42 impact sites. After 90 days, none of the sites were able to be penetrated. Softer type IV bone had been transformed into harder type II bone and it was then deemed safe to proceed with the dental implants surgery.

Dental Implant Success Is The Goal

Dental implants are currently successful over 95% of the time but for many patients their bone density and quality do not allow them to even have the option offered to them. With this new research it opens doors to allow for even more dental implant successes in the future, as well as opening the procedure up to entire new populations.

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