Alan J. Kossman, DDS
916 Belvidere Road
Belvidere, IL 61008
815-544-3111

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Posts for: May, 2018

UsingSinusSurgerytoStimulateBoneGrowthforImplants

For a predictable outcome, a dental implant should be placed as soon as the bone and gum tissues following a tooth extraction have healed. But what happens if the tooth has been missing for months or years? You might then run the risk of not having enough bone to properly place an implant.

This can happen because of a disruption in the growth cycle of living bone tissue. As older bone cells dissolve (resorption), new bone develops to take its place. This is a dynamic process, as the amount and exact location of the new growth is in response to changes in the mouth, particularly from forces generated by the teeth as we chew. If, however, this stimulation transmitted to the bone no longer occurs because the tooth is missing, the bone will tend to dissolve over time.

In fact, within the first year after a tooth loss the associated bone can lose as much as a quarter of its normal width. This is why we typically place bone grafting material in an empty socket at the same time as we extract the tooth. This encourages bone growth during the healing period in anticipation of installing a dental implant or a fixed bridge. If, however, the bone has diminished to less than required for a dental implant, we must then use techniques to encourage new bone growth to support a future implant.

One such technique for restoring bone in the back of the upper jaw is to surgically access the area through the maxillary sinus (a membrane-lined air space within the bone structure of the face) positioned just over the jawbone to place grafting material. During surgery performed usually with local anesthesia, the surgeon accesses the sinus cavity, lifts the tissue membrane up from the sinus floor and applies the grafting material on top of the bone. Eventually, the new bone growth will replace the grafting material.

If successful, the new bone growth will be sufficient to support an implant. Thanks to this renewed growth, you’ll soon be able to enjoy better function and a transformed smile provided by your new implant.

If you would like more information on forming new bone for implants through sinus surgery, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Sinus Surgery.”


Implant-SupportedDenturesCouldContributetoBetterBoneHealth

For generations, dentures have helped people avoid the dire consequences of total teeth loss. Now, implant technology is making them even better.

Composed of life-like prosthetic teeth fixed within a plastic or resin gum-colored base, dentures are manufactured to fit an individual patient’s mouth for maximum fit, comfort and performance. But dentures also have a critical drawback—they can’t stop bone loss in the jaw.

Bone is constantly regenerating as older cells dissolve and then are replaced by newer cells. In the jawbone, the forces generated when we chew travel through the teeth to the bone and help stimulate this new cell growth. When teeth are missing, though, the bone doesn’t receive this stimulus and may not regenerate at a healthy rate, resulting in gradual bone loss.

Dentures can’t transmit this chewing stimulus to the bone. In fact, the pressure they produce as they rest on top of the gums may actually accelerate bone loss. Over time then, a denture’s once secure and comfortable fit becomes loose.

In the past, most patients with loose dentures have had them relined with new dental material to improve fit, or have new dentures created to conform to the changed contours of the jaws. But implant technology now offers another alternative.

Implants are in essence a tooth root replacement. Dentists surgically implant a titanium metal post directly into the jawbone that naturally attracts bone cells to grow and adhere to it over time (a process called osseointegration). This not only creates a secure and lasting hold, it can also stop or even reverse bone loss.

Most people know implants as single tooth replacements with a porcelain crown attached to the titanium post. But a few strategically placed implants can also support either removable or fixed dentures. Removable dentures (also called overdentures) usually need only 3 or 4 implants on the top jaw and 2 on the bottom jaw for support through built-in connectors in the dentures that attach to the implants. A fixed bridge may require 4-6 implants to which they are permanently attached.

There are pros and cons for each of these options and they’re both more expensive than traditional dentures. In the long run, though, implant-supported dentures could be more beneficial for your bone health and hold their fit longer.

If you would like more information on implant-supported dental work, please contact us or schedule an appointment for a consultation.


By Belvidere Dental
May 04, 2018
Category: Oral Health
Tags: bone loss  
BoneLossattheRootscanPutYourToothinDangerofLoss

There’s more to teeth than meets the eye. Hidden beneath the visible crown are the tooth’s roots set within the jawbone, secured and protected by the gums from bacteria and infection. But if the gums shrink back (recede), the roots become exposed and susceptible to disease, especially at the points where multiple roots branch from each other, areas called furcations.

It all begins with periodontal (gum) disease caused by built-up bacterial plaque from insufficient brushing and flossing. The infection triggers inflammation that over time weakens gum tissues. They begin to detach from the teeth, which can eventually lead to gum recession and root exposure.

This also causes bone loss, especially at the furcations. We can detect any loss (known as a furcation invasion) and how far along it may be with x-ray imaging or by manually probing with an instrument called a periodontal probe.

There are three general classes measuring furcation invasions. In the earliest, Class I, we can feel the invasion as a slight groove; in Class II, it increases to two or more millimeters across. In Class III the bone loss extends from one side of the root all the way to the other (a “through and through”).

At this stage a patient is in danger of losing the tooth, so we’ll have to act promptly. This means first removing accumulated dental plaque and calculus (tartar) to stop the infection and allow the gums to heal. With severe damage, we may need to assist healing with bone and gum tissue grafting, in which we place donor grafts to serve as scaffolding for the appropriate tissue to grow upon.

You can help prevent this situation by practicing effective daily hygiene and visiting your dentist for thorough cleanings at least twice a year (or more if recommended). And at the first signs of a gum infection—swollen, reddened or bleeding gums—make an appointment as soon as possible to have it checked. The sooner we can detect and treat gum disease, the less likely a furcation invasion or worse will be in your future.

If you would like more information on gum disease diagnosis and treatment, please contact us or schedule an appointment for a consultation.