Bone loss, bone growth and sinus lifts…

Posted on 7th October 2022

So often we talk about Dental Implants as being the solution to teeth that have had to be removed or are missing. In this case we also demonstrate how treatment with Dental Implants can also help to prevent further tooth loss in the future.

For most of our patients, the main reason for their tooth loss is chronic periodontal disease. Periodontal disease results in the gradual loss of bone support for teeth. This can eventually lead to the teeth becoming ‘weaker’ and mobile.

When we are planning to replace the missing teeth with dental implants, we should consider how we can improve the structure of the bone in the mouth at the same time. In most cases this is necessary to somewhat ‘reverse’ the bone loss caused by the periodontal disease affecting the preceding teeth. By rebuilding the bone structure, the implants will have a much higher long term success rate and the treatment outcomes are significantly improved.

2 of the main contributing factors to periodontal disease are poor plaque control and smoking. This results in the gradual progression of bone loss around teeth. Periodontal disease can also affect the bone around dental implants therefore, we provide our patients with the tools and techniques they require to manage their dental hygiene thoroughly at home with ease. Studies have shown that visiting the hygienist regularly and maintaining excellent oral hygiene on a daily basis will stabilise periodontal disease and prevent it from affecting any more of the mouth.

Our patients have shown significant improvements in the health of their gums and teeth as a result of the periodontal care they continue to receive and also compliment themselves using their daily techniques. A combination of team work between our dental team and the patient themselves can stabilise dental disease and provide us with beautiful results like those shown in the radiographic images below:

The dark spaces around the teeth show the vast amounts of bone loss in these areas. These patients were provided with a treatment to combine the regeneration of the missing bone volume and dental implants to replace the loose and failing teeth. By maintaining their future periodontal health we have a much better prognosis for both the success of their dental implants and also the long term health of the other teeth in their mouth.

What about a sinus lift?

We often find that the upper molar area (posterior maxilla) of the mouth has insufficient bone available for a dental implant to be fitted. This may be due to a previous infection that affected the failed tooth or teeth. It could also be because the tooth may have been removed some time ago and this is because in most patients the bone shrinks following tooth loss. One of the main reasons we recommend replacing teeth soon after having them removed is to prevent this unwanted healing process which results in bone loss.

The lack of bone in the upper right molar space is seen on the first xray image. The image below shows the growth of ‘new’ bone which has enabled the placement of a permanent fixed implant in the upper right molar space.

If bone loss has occurred, we can still consider providing our patients with dental implants. In the upper molar regions we can utilise the space available in the maxillary sinuses to provide the patient with additional bone volume that will make it possible for them to have dental implants. The maxillary sinuses are large air spaces that everyone has around the region of the upper molar teeth. The large anatomical space in the sinuses is much larger than is needed for the healthy function of the airways and sinuses. For this reason, we can use some of this ‘extra’ space to increase the bone volume in patients who may lack sufficient bone in this part of their mouth. In most patients this is possible and it allows us to successfully provide patients with the treatment they need. The procedure is pain free and we have provided this successfully to many patients at our clinic.

 

Not all patients require sinus lifts, in fact very few patients actually need this dental procedure. For those patients who need a sinus lift, it is certainly nothing to be concerned about and it is a useful procedure to enable the provision of dental implants in patients who would otherwise not be able to have this treatment.

The new bone matures to become as strong as the patient’s existing bone therefore, these new implant supported teeth are some of the strongest teeth in their mouths.

 

Mohsin Patel BDS MJDF RCE (Eng)

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