Periodontics is a specialized area of dentistry that focuses on the health of the tissues supporting and surrounding the teeth. A dentist or periodontist works with patients on the prevention, diagnosis, and treatment of the gums, bone, and ligaments in the jaw.
Periodontal disease is mainly caused by plaque, the sticky bacteria that form on the teeth. Without proper oral hygiene, this plaque can cause infection in the gums, bones, and tissues. In addition to poor oral hygiene, periodontal disease may be caused by diseases that suppress the immune system, genetic predisposition, tobacco use, and certain medications. Left untreated, periodontitis can cause tooth loss.
Regular twice yearly visits to your dentist will aid in the early detection and treatment of periodontal disease.
If periodontal disease is severe, tooth loss may occur and eventually lead to bone loss. Before replacing the tooth, the bone may need to be repaired, so that it is at the same height as the rest of the jaw and the new tooth will be aligned correctly with the rest of the natural teeth.
Bone grafting involves using some of the patient’s own bone, usually from the back of the lower jaw or the chin, to restore the affected area. Using the patient’s own bone is always preferable. If there is not enough bone to use in those areas, the dentist may need to take a section of bone from the patient’s hip. This procedure requires a hospital stay and is more intensive and less desirable. Another option is a synthetic bone replacement or bone taken from a donor or animal.
After examination and x-rays, local anesthesia is administered to numb both the area where the bone loss is present as well as the site the bone for the graft will be coming from. The area that will be receiving the graft is examined through an incision in the gum to determine the amount of donor bone needed. Once this is determined, the dentist will make an incision in the gum at the area from which the bone graft will be taken. A section of bone is cut, along with bone marrow. A thin layer of grafting material is placed to allow the gum and bone to regrow, and the area is stitched closed.
The new piece of bone is then screwed into place with very small screws made of titanium. Bone marrow, mixed with grafting material is placed around the piece of bone to facilitate the healing. This area is then covered with a membrane for protection, and the incision is stitched shut.
Post-procedure, the patient will be given a course of antibiotics, pain medications, and an antibacterial rinse. The dentist may provide a temporary bridge or denture to keep the area free of trauma during healing. After 6-9 months, the graft should be healed and the screws will be removed so that a dental implant may be placed.