What causes bone loss in the jaw?
Teeth may be lost due to injury, trauma, decay or periodontal (gum) disease. With periodontal disease, the bacteria gradually eats away at the underlying jawbone and at the periodontal ligaments that connect the tooth to the bone.
When a tooth is missing and not quickly replaced, the area of jawbone beneath the tooth shrinks due to lack of stimulation from chewing and biting. Dentures and dental bridges do not provide this stimulation, and dentures can actually accelerate bone loss.
As a periodontist, Dr. Greenberg is an expert in the bone and gum surrounding teeth, and in bone regeneration to repair depleted bone.
Bone grafting to replace lost bone
Bone grafting is a frequent component of periodontal surgical procedures. It is used to augment the volume of the ridge in order to properly support a dental implant, to restore tooth strength by giving teeth a scaffolding, and to repair defects in ridges.
The material used for grafting can be your own bone, bone from a tissue bank, or synthetic materials. Dr. Greenberg prefers to use bone from a tissue bank for good integration with your jaw bone without the need for extra surgery. He uses bone that has been completely disinfected and has been treated to improve its ability to stimulate bone regrowth.
The bone graft doesn’t actually replace the bone, but stimulates new bone growth. As the new bone grows, it replaces the bone graft, which breaks down and is passed out through the blood stream.
Dr. Greenberg has equipped his practice with leading-edge technology to make bone grafting procedures more expedient and more comfortable.
Dental Microscope for precision grafting
An illuminated dental microscope provides a highly magnified view that allows for precision surgical procedures using small instruments for less invasive treatment.
Ultrasonic Piezosurgery for gentle cutting
Piezosurgery uses high frequency ultrasonic sound waves to cut bone in a gentle way. The vibrations are set to cut only the targeted bone and not the surrounding tissue. It also cauterizes while it cuts, eliminating bleeding and improving healing.
Dr. Greenberg also uses laser dentistry for some procedures. The laser is fast, gentle and cauterizes blood vessels in the surgical area, resulting in less swelling and bleeding.
Platelet Rich Fibrin (PRF) for fast healing
Platelet Rich Fibrin accelerates growth and healing in soft and hard tissue, and Dr. Greenberg frequently uses this technique when placing bone grafts. It also improves the quality of the regenerated tissue.
One of the best methods to do this to utilize growth proteins that are already available in the patient’s bloodstream. The gel-like substance is obtained by spinning a small sample of your own blood in a medical centrifuge to separate out the growth factors.
When is bone grafting needed?
Saving a tooth
When a tooth has a hole in the bone supporting it, or bone loss at the point where a tooth root branches (known as “furcation involvement”), usually due to periodontal disease, Dr. Greenberg has to work to regenerate the lost bone.
After disinfecting the area, Dr. Greenberg places a “scaffolding” of bone grafting material that provides support while the bone regenerates and reattaches to the tooth. Grafting bone can add years of life to a compromised tooth or even completely reverse the damage.
Preparing for dental implants
Jawbone that has shrunk and become too thin to support a dental implant can be augmented with bone grafts. After a few months, the bone regenerates sufficiently for Dr. Greenberg to securely place implant posts.
Dr. Greenberg anesthetizes the area and makes a small incision to lift the gum. He cleans out any infection and places the bone graft material. He sometimes places a membrane to contain the bone graft so that gum tissue is prevented from growing into the bone cavity.
Lifting expanded sinuses
When molars are removed from the upper jaw, pressure from the air cavity in the sinus causes bone resorption, or shrinkage. As a result, the sinus expands to fill the space left by the loss of bone, and there is frequently insufficient bone for placement of dental implants.
In this case, Dr. Greenberg can perform a procedure called a “sinus lift” to gently push the sinus upward and fill the area it had encroached upon with bone grafting material. He uses a minimally invasive approach for low impact on the surrounding tissues, and faster healing.
Ridge preservation after tooth extraction
Dr. Greenberg always tries to save your natural teeth. However, in situations where a tooth must be extracted to maintain oral health, he takes preventative measures to preserve the natural ridge contour and maintain bone density.
To keep the portion of bone beneath the missing tooth from shrinking, Dr. Greenberg can place bone grafts in the empty socket and suture the site. Over time, the grafting material will be absorbed and replaced with your natural bone.
Aesthetic ridge augmentation
The procedure for aesthetic ridge augmentation is the same as for ridge augmentation done for the purpose of placing implants. Dr. Greenberg will use it to augment bone for patients with dental bridges.
Over time, patients with dental bridges experience bone loss below the missing tooth or teeth, leaving a gap beneath the restoration. Dr. Greenberg uses bone grafts to rebuild this area and level out any discrepancies.
To make an appointment, call (717) 775-7576 or click here to request an appointment online.