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Alveolar bone loss

alveolar bone loss; gum recession; dental health

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#1 Leni

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Posted 03 February 2017 - 12:06 PM


Is anyone dealing with alveolar bone loss and (admittedly I kind of suspect what the answer will be but:) would there currently be any way to regenerate the lost alveolar bone (through whatever dental surgery/treatment)? 

I suffered from periodontitis when I neglected my dental health during a challenging time in my life, and the result is alveolar bone loss with exposed teeth roots (since of course the gums receded too). 

 

The periodontitis has been under control, but the bone loss is quite evident. Any input would be appreciated: thanks!


Edited by Lenie, 03 February 2017 - 12:07 PM.


#2 seivtcho

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Posted 03 February 2017 - 12:25 PM

Parodontologysts and oral surgeons deal with that. If I were you, I would go to an oral surgeon. 

 

Augmentive alveolar surgery is the procedure you are asking for. 

 

The procedure takes bone from you (other places from your body), or from corpses - bone fragment or a chopped lyopfilisiedd bone from tissue banks depending on what exactly plastics you need. 

 

The results are a chance - relatively high chance of getting a new bone. But there ia also a chance you to end up with money thrown from the window. I am not sure about the official success rate, but it is not 100% 


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#3 aconita

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Posted 03 February 2017 - 11:35 PM

I underwent surgical alveolar bone augmentation prior to implants, bone was lost because trauma.

 

Procedure done in the largest university hospital in my country under direct supervision of an international renown professor specialized in bone regeneration.

 

I think I am in the position to tell what works and it is worth trying and what is better left alone, not only because my direct experience with it and my inquisitive relationship with the above mentioned professor and its team but because my extensive research on the subject too.

 

The procedure that guarantees the best results and the highest rate of success consists in a surgical intervention which exposes the alveolar bone, a paste made of autogenous/equine (or bovine or corpse) powdered bone is applied on the area, a goretex/titanium membrane is nailed by micro-implants (4 of them) to the bone in order to keep the paste in place and shape, the gums are stitched back in place to completely cover the whole thing (which is easier said than done), after 6 months the scaffold provided by the "artificial" bone is replaced by your real bone, the whole thing opened again, the goretex/titanium membrane and the micro-implants removed, the gums stitched again back in place.

 

Not an easy and pleasurable experience but results are amazingly good and reliable, everything else at the time being is not worth.

 

Nice...but this requires NO TEETH in the area of the bone augmentation and the gain doesn't go past the ridge of the alveolar crests!

 

Augmenting alveolar bone around existing teeth at the time being is just not officially possible, whom proposes this kind of intervention is just after your money and some kind of result is just pure luck, possibly a worsening of the situation is more likely.

 

At clinical research level some results have been achieved by stem cells therapy,  I personally know the professor who did that and I have been his patient, the stem cells therapy anyway wasn't and isn't available and the professor is now inquired for fraud and fired from his position (for other reasons than the clinical research on stem cells but still not an index of great professionalism), my experience with him has been very bad (and expensive).

 

Possibly the stem cells therapy is promising anyway but as far as I know not available yet.

 

The only other option worth a try could be the LIPUS but it would be a try without any guarantee, at least relatively inexpensive, no side effects and not unpleasant.

 

https://benthamopen....T/TODENTJ-6-220

 

Keep in mind that alveolar bone augmentation around existing teeth would be the greatest odontoiatric revolution ever since it would mean basically never a lost teeth anymore (which doesn't make most dentists very happy about the idea).

 

If something like that was really available you can be sure everybody will know.

 


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#4 seivtcho

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Posted 04 February 2017 - 05:48 PM

.... 

 

Nice...but this requires NO TEETH in the area of the bone augmentation and the gain doesn't go past the ridge of the alveolar crests!

 

Augmenting alveolar bone around existing teeth at the time being is just not officially possible, .... 

 

.... 

 

If something like that was really available you can be sure everybody will know.

 

I have seen several patients with this. Bone in dust that you describe can be held also with a resorbable membrane, that is soft and easy to shape. Replacing fine regions of bone also has been done so far - many times - at least in Bulgaria 

 

kostozamestvane.jpg

 

vodena-kostna-regeneracia.jpg


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#5 aconita

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Posted 05 February 2017 - 02:42 AM

I know about the procedure you describe, I underwent it and I know of friends too but I never heard of a successful outcome, this has been confirmed to me by the professor I mentioned and by others.

 

Since the "bone paste" is very soft a rigid membrane needs to cover it entirely in order to keep shape and position absolutely still for months (usually 6 but at least about 3), a resorbable membrane is too soft, movable and doesn't last long enough to achieve that.

 

Sealing from bacteria has to be perfect or the scaffold just doesn't work, around an existing teeth that kind of sealing isn't achievable.

 

There are liquid resorbable membranes too but those issues aren't solved anyway.

 

When one looks at theory or dental suppliers' brochures it's all easy and wonderful but reality is different.

 

I don't deny that in some rare lucky instance some might have achieved a positive result but success percentages are so low and luck plays such a fundamental role.

 

And we are talking about one or two teeth at best, imagine to apply it to the entire denture...

 

 


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#6 seivtcho

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Posted 05 February 2017 - 06:05 PM

When I wrote "I have seen several patients with this" I meaned several successufull (with new bone recovered).

 

As for why it happened with them is another question. That kind of plastics are relatively new, and still (2016 - 2017) many questions remain unanswered. As general you are correct, that  "a resorbable membrane is too soft, movable" and the long time needed is a nice argument. However, I have seen patients done different successfull bone augmentations - arround the maxillar sinuses, filled defects after cysys removal, interdental parodontal defects, even recoveries of the alveolar bone arround teeth that the topic is about. Perhaps for one reason or another the bone dust has remained fit in place lol. The soft membrane if well reshaped and if placed in a perfectly designed soft tissues bed. Now when I think about that I wonder why I dont do this in my practice.

 

Sealing from bacteria is also a nice argument. Not allowing plaque formation, regular risings and control exams may help.

 

Another issue I have seen is about the quality of the bone. Augmented bone that was made 6 months after bone dust augmentation showed new bone on x-ray and it is really a new bone but even after 6 months it still is not the strong good bone. It is still soft and inperfect.



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#7 aconita

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Posted 06 February 2017 - 03:35 AM

Another issue I have seen is about the quality of the bone. Augmented bone that was made 6 months after bone dust augmentation showed new bone on x-ray and it is really a new bone but even after 6 months it still is not the strong good bone. It is still soft and inperfect.

 

What I know is that bone formation is a long process, it may take 2 years for osteoblasts to fully develop and arrange as in perfectly developed bone.

 

In my case after 1 year I had the implants positioned and the bone was so hard to drill to create difficulties, maybe a few supplements I used and the training helped in that regard, anyway even if it takes quite a long time the bone quality achievable is top notch.

 

For me powder was equine mixed with some of my own bone taken from the spot (powder from the mini-implants drillings and some scraping here and there) at the time of surgery.

 

The scaffold is very soft and slowly hardens, the first 2-3 months are critical since it is still too soft, after that it is hard enough to guarantee good chances of positive outcomes.

 


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