Gum disease and bone loss

Posted on 13th December 2020

Gum recession is a common feature of many people’s mouth. In many cases, this is a consequence of bone loss which is termed periodontal disease. With over 60% of the adult population suffering from periodontal disease, it is the main cause of tooth loss in the UK today.

Periodontal disease is often symptom free with very few signs of pain. This is one of the main reasons that the disease can go undetected for years before the effects of bone loss start to become symptomatic. We often find that patients come to see us for the first time with loose teeth because it is only at that point they become aware of the problem.

In this case, the patient had 2 teeth which were very loose and beyond the point of being able to save them. However, the adjacent teeth, which were the lateral incisors, were also starting to become affected by the bone loss as can be seen in the radiograph images.

It is not possible to successfully contain the periodontal disease unless the most severely affected central incisors are removed. By removing the central incisors we were able to maximise the chances of saving the lateral incisors. We replaced the central incisors with strong Dental Implant supported teeth and a bone grafting procedure that replaced the deficient bone. The bone grafting procedure not only allowed us to replace the central incisors BUT it improved the bone volume around the patient’s own lateral incisor teeth as well. This helped to improve the long term prognosis of the adjacent teeth and limit the number of teeth lost to the periodontal disease to just 2 teeth.

Bone regenration
Cross sectional CBCT 3d Xray showing the increase in bone volume achieved using bone augmentation and the placement of a dental implant

The pictures below show the stages involved in restoring this patient’s incisors with Dental Implants. As can be seen by the occlusal image, the implants are placed in the middle of the prosthetic zone in every plane to ensure that we are able to regenerate the maximum amount of bone following treatment. There is plenty of evidence demonstrating that implants in the middle of the prosthetic zone will evade peri-implant disease in the future more so than implants placed too far buccal or palatal.

Smile view of central incisor implants Infinity Dental ClinicLateral view of anterior implant restorations Dr mohsin PatelOcclusal view of central implant Dr mohsin Patel

Our patient is enrolled onto a long term periodontal therapy programme with our hygienist to minimise his risk of developing this severe form of periodontal disease in the future. Therefore, we have successfully contained his periodontal disease and helped to restore his confidence in his smile and dental health.

In this case, as with most cases, the most important outcome of early treatment is to prevent the loss of more teeth for this patient. The earlier we treat periodontal disease, the less bone will be lost and ultimately, this means our patients can keep their own teeth for longer.

Thank you for reading

Mohsin Patel BDS MJDF RCS (Eng)

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