Oct
According to the American Dental Association, five million dental implants are placed each year in this country alone. In skilled, experienced hands, the procedure has an excellent success rate. How can this be the case, when so many people have oral challenges? Dr. Mark Cruz explains how he addresses special cases at his Dana Point, CA practice, so that most patients can be candidates for this beneficial treatment.
Adequate bone is an essential element of a successful dental
implant. When periodontal disease is present, a tooth has been missing
for a long time, or due to other causes such as menopause, alcoholism,
or certain medical conditions, jawbone diminishes. The process is called
bone resorption.
Though you are unaware of it, bone throughout the body is in a
constant state of remodeling. The mechanism for this function is truly
amazing.
Osteoblasts are a derivative of stem cells. They secrete a matrix of collagen protein fibers, calcium, and phosphate that revitalizes old bone. Most people are aware that weight-bearing exercise – lifting, walking, or running – helps to keep long bones in arms and legs thick and strong. Why? Because the body senses this extra demand for strength and fortifies bone to withstand it. The same thing happens in your mouth. Each time you bite or chew, roots of teeth send signals telling your body, “Hard work is going on here and we need more osteoblasts.
Call: (949) 661-1006 OR Request An Appointment Today
Osteoclasts are continuously working against
osteoblasts. These cells reside on the outer layer of bone. When a tooth
is missing, calcium-sensing receptors detect the lack of need for bone
in that area. Osteoclasts are activated to resorb calcium and phosphate,
releasing it into blood, so that osteoblasts may send the minerals to
areas where bone is more acutely needed.
The rate of resorption is unique to each patient, but most
bone is lost during the first 18 months after a tooth is lost or
extracted and continues throughout life. Eventually bone becomes too
fragile to support a dental implant. This presents a potential
complication for an implant in the upper arch – it could pierce the
sinus cavity.
Building bone is not as simple as drinking milk or taking a mineral supplement. However, modern bone grafting techniques now make dental implants a possibility for most reasonably healthy patients.
In the past, bone graft options were:
Today, most oral bone grafting can be completed with biocompatible synthetic Alloplast grafting material. The formulation is molded into the desired shape and surgically placed where needed to accelerate bone formation with natural growth factors. The graft supplements volume, until it is gradually replaced with natural bone over the course of several months. At this point, planning for placement of the dental implant can begin.
The American Sleep Association reports that about ten percent
of adults and up to 15 percent of children are bruxers – they
chronically clench and grind their teeth. This unconscious habit has
many serious oral health implications. Bruxing can wear, loosen, or
fracture a dental implant restoration (the visible crown). The excessive
pressure may also inhibit osseointegration – jawbone fusing with the
implant to mimic a tooth root.
A prescription occlusal splint dramatically reduces the impact of bruxism on dental implants. This custom-fitted acrylic guard spreads the bite force of nocturnal bruxing more evenly across the entire arch.
It also cushions direct force on teeth and implant restorations.
Patients who wear a night guard to preserve implant success often derive
ancillary benefits – improvement in TMJ problems, reduction in morning
headaches and jaw pain, and less wear on natural teeth.
Have you been told you are not a candidate for dental implants due to bone loss or bruxism? Call (949) 661-1006 to schedule a consultation at Mark A. Cruz DDS in Dana Point, CA for solutions.
Mark A Cruz graduated from the UCLA School of Dentistry in 1986 and started a dental practice in Monarch Beach, CA upon graduation. He has lectured nationally and internationally and is a member of various dental organizations. He was a part-time lecturer at UCLA and a member of the faculty group practice and was past assistant director of the UCLA Center for Esthetic Dentistry. He has served on the National Institute of Health/NIDCR (National Institute of Dental & Craniofacial Research) Grant review Committee in Washington D.C. as well as on the editorial board for the Journal of Evidence-Based Dental Practice (Elsevier) and is currently serving on the DSMB (data safety management board) for the NPBRN (national practice-based research network.
