Once you have had the mild form of gum disease for some time, it eventually changes and takes on a new form. It becomes periodontitis and the destruction of tissue begins, including gum recession, the support structures for your teeth, and your jawbone. In order to restore your smile after periodontal disease, you will need periodontal bone grafting surgery.
Damage From Periodontal Disease
As the bacteria that cause gum disease gets into your gums, it sets off an immune reaction. Your immune system attacks the bacteria and the toxins they produce, and this leads to the slow destruction of gums, tissue, and bone. It will keep on going and spread. Eventually, if allowed to continue untreated, it will cause your teeth to become loose and they may even fall out.
As the jawbone continues to be destroyed, the height of your jawbone decreases, and this causes your lower jaw to shrink and collapse – making you look older. The width of your jawbone will also decrease under missing teeth by as much as 25 percent within the first year. Gum disease can also weaken the bone, making it too soft to provide implant stability.
Periodontal Disease Treatment
Before you can get a bone graft or dental implant, it is necessary to remove gum disease. This may be a simple application of antibiotics, and/or deep cleaning (also called scaling and root planing). In more serious cases of periodontal disease, you may also need to have surgery to clean out the pockets and to fasten the gums up tight against the teeth to keep the bacteria out.
An alternative to this surgery is laser gum surgery. This alternative has many advantages and is considered to be non-invasive and no scalpels or stitches are involved. It also enables faster healing of the gums because the laser kills bacteria near the site that could cause infection. More tissue is also saved because of selective targeting of the laser beam.
Bone Graft Surgery
The size of your jawbone can be repaired with bone graft surgery. This surgery can restore the size of your jaw, making you look years younger if considerable shrinkage has taken place. You can also get a dental bone graft for the purpose of preparing your jaw to receive dental implants.
Sufficient bone mass is necessary to stabilize the dental implant. If the width and depth are not enough, the implant will most likely fail.
The bone used in the bone grafting procedure may come from one of four possible sources. Although the periodontist may have a preference, some of your own bone may be used. It can be taken from your chin or hip. Other sources include bone from donors (cadavers), animals, or synthetic bone. The bone is processed before using it to ensure that it is sterile.
When it is ready to be applied, it will be made ready for application. This means it will be in the form of granules, a powder, putty, or a gel. The periodontist will form it into the shape desired, or it may simply be put into the cavity after tooth extraction.
The surgery can be expected to last from 45 minutes to about an hour and a half. In most cases, you will only need to have local anesthesia, but some periodontists may want to use stronger doses – possibly even general anesthesia.
After an Extraction
Sometimes a dentist will insert bone graft material into a socket after an extraction. This enables bone loss to be limited and it also prepares the site for a dental implant later.
Healing After Bone Grafting Surgery
Right after the surgery, you can expect some discomfort. You will be given pain medications and antibiotics to prevent infection. You may expect some swelling on your gums and face with bruising, some pain, and some bleeding. You can place ice packs on the side of your face if needed to reduce swelling.
It is very important that you do not smoke during the healing process. Swallowing may be a little painful for a couple of days.
You should not feel any pain after a couple of days. Your gums will heal after about two weeks, but it will take between 3 to 6 months for the bone graft to heal completely. During that time, your bone cells will replace the bone graft to become solid bone. Once that has occurred, a dental implant may be installed and another 3 to 6 month period of healing will be necessary.
Some situations may require a longer healing period. This may include the size of the bone graft, the location, and the kind of material that was used.
Care After Bone Grafting Surgery
After the periodontal bone grafting surgery and after the implant surgery, you will need to take good care of your teeth. Without it, periodontal disease could reoccur, and it could mean the failure of the dental implant.