Abstract

Under normal physiological conditions, bone undergoes a constant, balanced and well- regulated process of renewal and remodelling. This is needed for growth, remodelling and maintenance of skeletal form, as well as for homeostasis of skeletal and plasma calcium levels. The alveolar bone grows along with tooth eruption, and thereafter its shape and volume are influenced by local mechanical as well as systemic factors. It is maintained by forces exerted on it via the periodontal ligaments, thus teeth are mandatory for its preservation and renewal. Following tooth loss, the socket becomes filled with a blood coagulum, which is later replaced by fibrous tissue. This healing process is associated with sizeable reduction in ridge height within the first two months that continues at a slower and variable rate throughout life. There are countless examples of patients who have lost teeth at an early age, presenting with severe alveolar bone loss bone in that area / jaw. The extent is even more dramatic if the edentulous space has been opposed by natural teeth. The cases illustrated in this paper serve to remind clinicians of the need to help patients maintain as many of their natural teeth as possible, while still being cognisant of their aesthetic and functional demands, and the possible health implications.

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