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When a tooth is removed, the bone which previously housed it may begin to
dissolve away or "resorb" almost immediately.
The process can be accelerated by a soft- tissue supported partial denture and
other factors.
If the resorption is severe, there may be inadequate bone to replace the missing
tooth with a dental implant unless bone grafting procedures are performed
in advance, or specially modified implants are used.
Bone resorption can compromise the dentist's ability to place an aesthetic
dental implant with normal contours.
An unnaturally long or tapered implant crown may result, which creates
large triangular food traps and poor esthetics.
A fixed bridge may be an option, but would require tooth removal on the
adjacent teeth,
and the use of special oral hygiene aides for effective plaque removal.
Although aesthetics may not be a concern in every part of the mouth,
bone resorption at an area that is visible in the smile can lead to
significant compromises in the cosmetic treatment result.
Here, a fixed bridge with a normal sized replacement tooth or pontiac
would leave a sizable gap between the tooth and gums.
Closing the gap with a bridge would require an abnormally long pontic.
Restoring an area of untreated bone resorption in the front part of the
mouth with the dental implant
may not be possible without bone grafting first -
and even if the implant CAN be placed, its position may also lead to a
non-ideal esthetic result.
When an upper back tooth is lost, bone resorbs from two directions - the
maxillary sinus, and the mouth.
This is known as "sinus pneumatization."
Without placing a bone graft into the sinus, there may be insufficient bone to
stabilize dental implants.
Fortunately, effective techniques for treating bone resorption prior to
replacing the teeth have been developed and are commonly performed in dentistry.
Here a block of cortical bone has been specially shaped and is being held in
place with removable fixation screws.
Techniques for avoiding bone resorption following tooth extraction are also
commonly used.
If you're facing the loss and replacement of a tooth, ask your dentist
whether bone grafting may be appropriate for you.