Tooth Loss and Replacement Options

Because looking and feeling good are important to us all, it is wise to maintain a healthy and attractive smile throughout life.

Over 35 million Americans are missing all their teeth and 178 million people in the US are missing at least one tooth. Regular dental visits and early intervention significantly reduce the need to extract teeth.

 Loss of teeth happens from dental decay, gum or periodontal disease, result of injury or excessive wear from habits like grinding and teeth clenching.

All teeth work together to help you chew, speak and smile. When teeth are missing, it is difficult to do these things. Fortunately, missing teeth can be replaced to restore function and smiles.

 

A Dental implant is much like a natural tooth where a metal post in placed into the bone beneath the gum. It fuses to the bone and acts like the root of a tooth. When the metal post is secure in the bone, a crown is designed and fabricated to blend with the other teeth in the mouth. Dental implants also can be used to anchor loose dentures. Dental implants are safe, predictable and secure but not an option for everyone.

Fixed  Bridge is a restoration of one or more adjoining teeth by anchoring onto  the teeth  adjacent to the space.  These restorations are cemented or bonded and therefore remain in the mouth permanently without the need to remove and clean them. This option involves tooth preparation and reduction of the  anchor teeth.

Removable partials and dentures are the least invasive  and  are readily taken out of the mouth for cleaning. Removables usually have replacement teeth attached to gum colored plastic bases connected by a metal framework and are either supported by embracing natural teeth or by simply resting over the gum tissue. Over time, with age and bone changes, the removable may no longer fit well and may need periodic modifications.

How best to replace missing teeth is an important decision. 

For a thorough evaluation and discussion on choices, call 909 627 6699 or visit www.mydentistchino.com

Grafting Following Tooth Extraction

In the United States alone, thousands of teeth are extracted annually, primarily because of decay, severe periodontal disease, infection, or trauma. The jaw bone that supports the teeth, "alveolar" bone, which is generally soft and vascular, often melts away or resorbs following tooth removal. Such bone resorption can result in significant cosmetic or functional defects, including loss of surrounding gum tissue.

Bioengineering has led to simple but effective surgical techniques that can either totally prevent or greatly reduce the bone and soft tissue loss that normally occurs following tooth extraction.

What generally occurs to the surrounding bone and tissue following tooth extraction?

Even with the most atraumatic extraction and completely normal healing, there is often some resorption or melting away of the surrounding bone, resulting in less height and width that were present prior to tooth extraction. In addition, as bone resorbs the overlying gum tissue also tends to lose both volume and its normal anatomic form. These changes can occur anywhere but the most severe loss of bone and gum tissue tends to occur following removal of incisor teeth located in the front of the mouth.

Why is preserving bone and surrounding gum tissue important?

Loss of bone and gum tissue following tooth extraction often results in both functional and cosmetic defects. Such tissue loss often results in an unsightly collapsed appearance, especially in the front of the mouth where proper maintenance of tissue health is critical to normal esthetics. In addition, loss of bone and gum tissue often compromise the dentist's ability to adequately replace the missing tooth or teeth with either conventional removable or fixed bridgework or with a dental implant supported restoration. Sometimes the loss of bone is so severe that additional surgical procedures are required prior to replacing the missing tooth with either a conventional or implant supported restoration.

How can bone and gum tissue be preserved following tooth extraction?

Today, because of advances in dental surgical procedures and bioengineering, bone and gum tissue loss following tooth removal can either be greatly reduced or completely eliminated. Following removal of the tooth a specially bioengineered graft material that helps support bone formation is placed within the extraction socket. This bone graft material, with structure similar to human bone, not only supports new bone growth but also has been shown to preserve bone and overlying soft tissue following tooth removal..  Visit www.chinosmiles for more information.

Dental Bone Grafting

Bone Grafting is the replacement or augmentation of the portion of the jaw bone that anchors the teeth. It's a surgical procedure that's often done to reverse the loss or resorption of bone that may have occurred due to tooth loss, trauma, disease or ill-fitting dentures, and to rebuild the bone structure beneath the gums in preparation for the placement of dental implants or other tooth replacements.

When bone graft is implanted in the jaw, it doesn't just simply fill a void in the bone; it may also help promote new bone growth in that location. When successful, bone grafting can restore both the height and width of your jaw bone
.
There are several bone graft options, and they differ in how they help promote bone formation. They include:
Autogenous Bone Grafts. Also called autografts, these types of grafts are made from the patient's own bone, harvested from elsewhere in the body. Typical harvest sites include the chin, jaw, bone of the lower leg (tibia), hip (iliac crest) or the skull (cranium).
Autogenous bone graft has traditionally been considered the "gold standard" as a graft material because it is "live bone" complete with the living cellular elements that enhance bone growth.
A potential downside of autogenous bone grafting, however, is that it involves a second procedure to harvest the bone, which may be painful and not in some patients' best interest, depending on their condition. It also may not be a viable option in instances where the patient's overall bone quality and/or density is poor, or when a large volume of graft material is required.

Allogeneic Bone. Allogeneic bone, also called allograft, is bone derived from a genetically unrelated member of the same species. It's typically non-vital (dead) bone harvested from a cadaver, then processed using a freeze-drying method that extracts all the water via a vacuum.
Allogeneic bone cannot produce new bone on its own – Its primary mechanism of action is that it is osteoconductive, and serves as a framework or scaffold over which bone from the surrounding bony walls can grow to fill the defect or void.

Xenogenic Bone. Similar to allogeneic bone, xenogenic bone is non-vital bone derived from another species, usually a cow. Because the potential for immune rejection and contamination by viral proteins is higher in bovine bone than in human cadaver bone, xenograft material is processed at very high temperatures (600-1,000 degrees Celsius). Xenograft's mechanism of action is similar to that of allograft – it serves as an osteoconductive framework on which bone from the surrounding area can grow to fill the void.
These grafting options are preferred by many patients and dental professionals alike because they eliminate the potentially painful second harvesting procedure. However, because allograft and xenograft lack autograft's bone forming properties, bone regeneration may take somewhat longer than it does when using the patient's own bone and the outcome may be less predictable.

Bone Graft Substitutes

Bone graft substitutes are commercially produced synthetic products that have many of the same bone forming properties as human bone, and are a safe and proven alternative to autograft and allograft.
One of the advantages of using a bone graft substitute instead of autogenous bone is that it eliminates the need to harvest the patient's own bone, thus potentially reducing the risk and pain associated with the harvest procedure.

Contact Dr Cherukuri for more information on dental bone grafting or visit www.chinosmiles.com  for more information.