Reasons for Jawbone Loss and Deterioration

The following are the most common causes for jawbone deterioration and loss that may require a bone grafting procedure. By completing a bone graft procedure, Dr. Maranon is able to restore bone function and growth. Dental implants may also be used to preserve jaw structure and improve function. 

Tooth Extractions:

Alveolar bone is the portion of the jaw that supports and anchors the teeth. The alveolar bone is stimulate and remains vital through activities such as chewing and biting.  When an permanent tooth is extracted, loss of alveolar bone can occur.  Since body no longer “needs” bone in the area of the lost tooth, so the bone resorbs or dissolves away.

The rate and the amount of bone loss varies greatly among individuals. Bone loss can start as early as four to six months after tooth extraction.  Most of the bone loss occurs within the first eighteen months following the loss of a tooth but can continue throughout life.

Periodontal Disease:

Periodontal disease can affect the alveolar bone, the tooth root, or gingiva (gums).  Periodontal diseases result from infections or inflammatory responses of the bone or gingival tissues that gradually destroy the support of teeth.  While there are many diseases which affect the tooth-supporting structures, plaque-induced inflammatory lesions make up the majority of periodontal issues, and are divided into two categories: gingivitis and periodontitis. While gingivitis, the less serious of the diseases, may never progress into periodontitis, it always precedes periodontitis.

Dental plaque is the primary cause of gingivitis in genetically-susceptible individuals. Plaque is a sticky film, composed primarily of food particles and various types of bacteria, which adhere to teeth above and below the gum line. Plaque constantly forms on teeth, even minutes after brushing and flossing. Bacteria found in plaque produce toxins that irritate the gums. Gums may become inflamed, red, swollen, and bleed easily. If daily brushing and flossing are neglected, plaque can also harden into a rough, porous substance known as calculus (tartar). This can occur both above and below the gum line.  Calculus increases irritation of the gums and allows plaque to accumulate faster and be more difficult to remove.

Periodontitis is caused by bacterial plaque that adheres to the tooth’s surface resulting in an overly aggressive immune response to these bacteria. If gingivitis progresses into periodontitis, the gums and alveolar bone separate from the teeth causing pockets (spaces) to form. The progressive loss of alveolar bone can lead to loosening and subsequent loss of teeth.

Dentures/Bridgework:

Dentures are usually placed on top of the gums overlying the alveolar bone of the jaw.A denture relies on the bone to hold them in place,  The pressure of a denture on the jaw is different from the stimulation from the function of teeth.  Over time, this abnormal pressure on the underlying alveolar bone causes the bone to resorb and deteriorate. Frequent denture care, repair, refitting or replacement by a dentist is essential and can slow the resorption of bone.  In spite of this bone loss can continue. Because this bone loss, people may experience continued loosening of their dentures and problems eating and speaking. Eventually, bone loss may become so severe that dentures cannot be held in place even with strong adhesives.  Bone grafting may be necessary to restore the architecture of the supporting bone.

Some dentures are supported by teeth (partial dentures).  With bridgework, around the area where teeth were extracted support the replacement teeth.  The teeth supporting the bridges of partial dentures provide sufficient stimulation to the bone that surrounds them, but the are where the teeth are lost receives no direct stimulation. Bone loss can occur in this area.

Trauma:

Teeth can be lost as a result of trauma.  As with the extraction of a tooth, bone stimulation in the area of tooth loss stops. In addition, the trauma itself can cause loss of bone from damage from the event.  Some common forms of tooth and jaw trauma include: teeth lost from injury or accident and jaw fractures.  In order to restore function, bone grafting procedures may be necessary to restore the effects of tooth loss and  bone resorption or traumatic bone loss. 

Sinus Deficiencies:

The maxillary sinus is and air-filled cavity above the posterior teeth in the upper jaw.  If these teeth are lost, air pressure in the sinus causes resorption of the alveolar bone that formerly supported these teeth. As a result, the sinuses become enlarged, a condition called hyper-pneumatized sinus.  This condition usually develops over several years, and may result in insufficient volume of bone for the placement of dental implants. Dr. Maranon can perform a procedure called a “sinus lift” that can treat enlarged sinuses.

Osteomyelitis:

Osteomyelitis is a type of bacterial infection in the bone and bone marrow of the jaw. The infection leads to inflammation, which can cause a reduction of blood supply to the bone. Treatment for osteomyelitis generally requires antibiotics and removal of the affected bone. A bone graft procedure may then be required to restore bone function and growth lost during removal.

Tumors:

Benign facial tumors, though generally non-threatening, may grow large and create a defect in a portion of the jaw. Malignant mouth tumors almost always spread into the jaw, requiring removal of a section of the jaw. In both cases, reconstructive bone grafting is usually required to help restore function to the jaw. Grafting in patients with malignant tumors may be more challenging because treatment of the cancerous tumor generally requires removal of surrounding soft tissue as well.

Developmental Deformities:

Some conditions or syndromes known as birth defects are characterized by missing portions of the teeth, facial bones, jaw or skull.