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"Why do teeth need to be extracted?"
Teeth need to be extracted due to unrestorable damage occurring to either the top of the tooth (the crown), the root of the tooth, or the surrounding bone. Common causes are severe tooth decay, failing root canals, root and tooth fractures, and periodontal disease. Fortunately extracted teeth can almost always be replaced with dental implants, which can restore oral function.
"Why do we lose bone?"
When a tooth has been extracted it is common to lose the volume of bone that supported the tooth. This is because bone volume is maintained due to stimulation from chewing, either on a tooth or dental implant. Chewing stimulates the bone and keeps it strong similar to how weight lifting keeps our bone more dense.
"Why do we graft bone?"
Lost bone volume needs to be replaced so that dental implants can be placed. A certain volume of bone is required for long-term success of the dental implant. Bone can be added to widen the jaw (horizontal grafting), make the jaw taller (vertical grafting), or to replace lost bone in the sinus (sinus grafting). The most difficult type of graft to have succeed is vertical grafting. The larger the amount of graft needed, the lesser the chance of the graft succeeding, so it is important to have dental implants placed as soon as possible after extraction or to have a socket preservation graft.
"What is a socket preservation graft?"
When a tooth is lost and an implant is not immediately placed it is possible to lose bone volume. Immediately after an extraction the chance of retaining this bone can be increased by having a socket preservation graft, which fills the hole made from the missing tooth. The most common types of bone graft material are from cadaver donors or cows. Synthetic materials exist, but they typically result in less successful grafts.
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