April 28, 2019
Do Dental Implants Help Preserve Jawbone?
The preservation of jawbone en mass is highly contingent on maintaining good implant health, which is facilitated by positioning of the fixtures in a manner that facilitates hygiene as well as with proper biomechanical considerations.
In my prior article I focused on the causes for bone atrophy, in particular as it relates to Iatrogenic causes and how this can be controlled with timely removal of diseased teeth, avoidance of dentures, and proper positioning of implants.
It was put then to me by a colleague that we are all taught early in our careers that implants preserve the jaw bone, the hard question is: where is the evidence that (well positioned) implants do in-fact preserve jawbone?
If we are talking about alveolar bone that is present around healthy teeth, then as I stated in my prior article on natural atrophy this cannot be stopped, and it cannot be reliably preserved even with implants. What I am talking about in my article is stimulation of deeper basal bone through functional loading.
The picture below illustrates the loss of alveolar bone irrespective of the presence of dental implants …

In the last picture the implants in Quadrant 2 (on the right of the picture) were removed and replaced with new implants in deeper basal bone. Overall this sequence illustrates the difference between placement of implants in alveolar bone, which limits restorative space, hampers hygiene, and does nothing to preserve bone, versus placement in basal bone which allows for improved restorative space, flat and hygienic underside, and involves a bone type that is not naturally predisposed to bundle-bone loss.