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The Science Behind Bone Preservation and Dental Implants

Why is bone so important to dental implants?

People who are looking into the 3 on 6™ see right away that bone is preserved by the procedure because bone removal isn’t required for the prosthetic to fit, like can be the case with the All-On-4 or All-on-X. What many people aren’t aware of though is that the 3 on 6™ is also better for preventing future deterioration of the bone after the teeth are restored.

Bone health is a really big deal with dental implants. It’s the first thing your dentist will look at when determining the appropriate course of action for replacing your teeth. You may not even qualify for dental implants to begin with if you don’t have enough bone or if it isn’t healthy enough. Bone health is also essential to the longevity of your dental implants. You want to do everything possible to promote healthy bone in your mouth and to prevent any bone removal or deterioration.

Jaw bone decay and deterioration

How are bone and muscle related?

Our muscles were designed to be used to maintain their health. Too much pressure and muscles can tear. But if we frequently use our muscles with an adequate amount of weight, or pressure, they get stronger. This is because our muscles will adapt to the loads and stresses placed on them. Alternatively, if we stop using our muscles they will slowly deteriorate. This is evident in anyone who has ever had an arm or leg put into a cast.

muscle deterioration after cast removed
Muscle deterioration after six weeks in a cast

Our bones react the same way. If bones receive too little pressure, they deteriorate. This is why astronauts lose 1-2% of their bone density for each month they spend in zero gravity. Of course, too much pressure can cause a break. When adequate pressure is applied, it increases blood flow to the bones. This blood flow supplies important oxygen and nutrients and eliminates carbon dioxide, acid, and metabolic waste products from the bone. In short, our bones require pressure to maintain their health. [Research on bone stimulation]

The bones in our jaw receive the most stimulation when chewing. Each tooth has a root attached to our bone which conducts this stimulation into the bone. When teeth are replaced by an implant, the implant serves as the root and stimulates the bone.

What are the consequences of limited bone stimulation?

The unfortunate truth is that people who use dentures will always be experiencing bone recession because there is insufficient bone stimulation. This is true for several reasons:

  • Denture wearers generally avoid eating harder foods

  • There are no roots or implants in the bone to transfer stimulation

  • Dentures distribute the pressure of each bite across the whole arch

Eating a banana doesn’t put much pressure on your jawbone, but eating an almond does. Although chewing on an almond would generally be a decent amount of stimulation for the jawbone, most denture wearers wouldn’t attempt to eat an almond. If they did, no single part of the jaw would receive significant bone stimulation as the pressures would be spread across the entire mouth. While an All-on-X patient would feel comfortable eating almonds, this same stimulation reduction phenomenon occurs. Biting forces are distributed across the surface of the jaw, decreasing the necessary pressures for the bone to stay healthy. For this reason, bone recession is very common among All-On-4, All-on-6, and All-on-X patients.

Another important element of natural teeth is the ability to receive feedback from biting pressures. With natural teeth, when we chew, we can gauge how hard we are chewing because of the stimulation into our bone. Unfortunately, All-on-X patients report that they have a hard time knowing how hard they are biting because of the lack of bone feedback. In fact, many All-on-X fractures come from patients biting too hard because they can't properly judge their biting pressure.

All-On-4 or All-on-X
All-On-4 or All-on-X

Cosmetically, an All-on-X patient may not notice or care at first about their bone recession because the recession occurs underneath the lips. It may not be visible to them or even be noticeable at first. Given time though, it can create a hygiene problem and make the implants less stable and more susceptible to failure. That being said, the All-On-4 or X may still be the correct option for patients who already have experienced significant bone loss.

How does the 3 on 6™ promote healthy bone?

With 3 on 6™ treatment, the final teeth are composed of three separate bridges on two implants each. This means that the pressure from biting an almond is absorbed by two implants or roots instead of the entire surface of your jaw, similar to chewing with your natural teeth. Receiving that stimulation creates blood flow to the bone around those implants, which means bone recession is less likely to occur.

3 on 6™ with segmented bridges and implants
3 on 6™ with segmented bridges

Patients who receive 3 on 6™ treatment report that they can sense isolated pressures when they chew and that it feels almost identical to chewing with their natural teeth. 3 on 6™ patients have improved eating habits after their 3 on 6™ is placed and there is evidence of additional bone growth around the implants over time.

Maintaining good bone health is essential for a long-term full mouth restoration. Visit one of our 3 on 6 providers for a free consultation and more information.

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