Extraction gap closing slowly and do I have bone loss?

[JohnnyS]

Hello I am new here

I have had braces for a year now and my extraction gap has only closed half way as well as this does it look like I have bone loss and once the teeth are closed will there be a black triangle between the teeth or should bone build up as the gap continues to close, the gap is about 2mm big, can someone please give me some advice? Thanks

Here is an image:

[img]https://i.imgur.com/BTPWcP6.jpg[/img]

[JohnnyS]

Sorry I couldn’t get the image to work, here is the link to the image https://i.imgur.com/BTPWcP6.jpg

[FlyByNight]

It doesn’t look like you have much bone loss, just some mild recession. It’s the shape of your teeth. They’re thinner at the bottom, like mine. My orthodontist did some IPR and made it a little better. Munch black triangles are very very small now. I would ask about it

[JohnnyS]

[quote="FlyByNight"]It doesn’t look like you have much bone loss, just some mild recession. It’s the shape of your teeth. They’re thinner at the bottom, like mine. My orthodontist did some IPR and made it a little better. Munch black triangles are very very small now. I would ask about it[/quote]

Thanks for your reply

The tooth I had extracted had severe recession as it was crooked and the one next to it looks low but luckily the gum is all nicely sealed around that tooth, do you think it’s normal for them to be taking this long to close? Thanks again!

[djspeece]

The number cited most frequently around here is that teeth should move a maximum of 1mm per month, and that rate is variable depending on your age, bone density, and underlying biology. I don't think bone loss can be accurately assessed by laymen looking at a photo, to be blunt.
I had a couple of gaps, one due to an extraction, that took an extra year to close -- apparently I have very dense bones, and long roots as well. My two year plan morphed into three as a result. Discuss it with your ortho at your next visit and best of luck to you.

[FlyByNight]

It doesn’t look like you have much bone loss, just some mild recession. It’s the shape of your teeth. They’re thinner at the bottom, like mine. My orthodontist did some IPR and made it a little better. Munch black triangles are very very small now. I would ask about it

Thanks for your reply

The tooth I had extracted had severe recession as it was crooked and the one next to it looks low but luckily the gum is all nicely sealed around that tooth, do you think it’s normal for them to be taking this long to close? Thanks again!

I think it’s normal. I had 1mm gaps around each lower incisor and they took a month to fill in completely. So I think you’re fine.

[JohnnyS]

I asked the orphodontist today and they said they won’t leave me with any gaps. Anyway I’m kinda worried because I’m always putting my tongue between the gap could this be causing the space not to close also why is it that the gap should be closing 1mm per tightening and it’s only closing 0.01 mm I just cannot see any change to the gap between the teeth, with braces is it sometimes impossible to close a gap like mine? Thanks

[djspeece]

I asked the orphodontist today and they said they won’t leave me with any gaps. Anyway I’m kinda worried because I’m always putting my tongue between the gap could this be causing the space not to close also why is it that the gap should be closing 1mm per tightening and it’s only closing 0.01 mm I just cannot see any change to the gap between the teeth, with braces is it sometimes impossible to close a gap like mine? Thanks

1mm per month is the maximum and it is going to be very difficult to visually assess. Putting your tongue in the gap won't slow anything down, don't sweat it. For my slow-closing gaps my orthodontist employed powerchains of course, and nearer to the end closing coils which are applied to brackets on two adjoining teeth and add a bit more "pull" across the gaps. But it was all very slow. Nature has her own timetable so you'll need to be patient.

[JohnnyS]

Hi where the tooth was extracted the gum is really indented as though there is hardly any bone there, do you think bone will form as the gap closes, thanks for all your reply’s I really appreciate them! Also if I do have severe bone loss what is the worst case scenario will I need another tooth extracted?

[djspeece]

The crater you are looking at after an extraction is mainly due to the temporary absence of soft tissue, i.e., gum tissue. The areas in the jaw that were vacated due to the extraction will fill in, but those are relatively small and are where the roots penetrated. And you (or probably any layman) can't tell simply by looking at the jaw. Worst case, if there is actual bone loss, is likely a bone graft which is not a big deal. The dentist/oral surgeon creates a small incision on the side of the jaw and implants a small piece of bone which becomes incorporated into the jaw over the span of a couple of months.

[JohnnyS]

[quote="djspeece"]The crater you are looking at after an extraction is mainly due to the temporary absence of soft tissue, i.e., gum tissue. The areas in the jaw that were vacated due to the extraction will fill in, but those are relatively small and are where the roots penetrated. And you (or probably any layman) can't tell simply by looking at the jaw. Worst case, if there is actual bone loss, is likely a bone graft which is not a big deal. The dentist/oral surgeon creates a small incision on the side of the jaw and implants a small piece of bone which becomes incorporated into the jaw over the span of a couple of months.[/quote]

Hi,

Thanks for your reply, it’s been a year since my extraction do you think it could still fill in? Also I can see white under the gum, is this bone? Thanks again!

[djspeece]

The crater you are looking at after an extraction is mainly due to the temporary absence of soft tissue, i.e., gum tissue. The areas in the jaw that were vacated due to the extraction will fill in, but those are relatively small and are where the roots penetrated. And you (or probably any layman) can't tell simply by looking at the jaw. Worst case, if there is actual bone loss, is likely a bone graft which is not a big deal. The dentist/oral surgeon creates a small incision on the side of the jaw and implants a small piece of bone which becomes incorporated into the jaw over the span of a couple of months.

Hi,

Thanks for your reply, it’s been a year since my extraction do you think it could still fill in? Also I can see white under the gum, is this bone? Thanks again!

Not sure, but I'm sure a dentist could quickly answer your question.

[JohnnyS]

[quote="djspeece"][quote="JohnnyS"][quote="djspeece"]The crater you are looking at after an extraction is mainly due to the temporary absence of soft tissue, i.e., gum tissue. The areas in the jaw that were vacated due to the extraction will fill in, but those are relatively small and are where the roots penetrated. And you (or probably any layman) can't tell simply by looking at the jaw. Worst case, if there is actual bone loss, is likely a bone graft which is not a big deal. The dentist/oral surgeon creates a small incision on the side of the jaw and implants a small piece of bone which becomes incorporated into the jaw over the span of a couple of months.[/quote]

Hi,

Thanks for your reply, it’s been a year since my extraction do you think it could still fill in? Also I can see white under the gum, is this bone? Thanks again![/quote]

Not sure, but I'm sure a dentist could quickly answer your question.[/quote]

Hi, just got back from the dentist, they said the tooth is being stubborn but there is slight bone loss and recomended I have the middle lower incisor extracted, Have a bone graft then have an implant, but I would have all this done once I gets my braces off, what do you guys think, its going to cost me a fortune but I’m sure it will be worth it.

[assertives]

Not sure why your dentist recommends extracting the lower incisor. Is anything wrong with it? (e.g. decay, root resorption, alot of dental work done, etc). Otherwise, if it is just loose, why can't a bone graft be done in that area to save that tooth?

Extracting then bone graft then implant sounds very invasive to me. Have you considered a second opinion?

[JohnnyS]

[quote="assertives"]Not sure why your dentist recommends extracting the lower incisor. Is anything wrong with it? (e.g. decay, root resorption, alot of dental work done, etc). Otherwise, if it is just loose, why can't a bone graft be done in that area to save that tooth?

Extracting then bone graft then implant sounds very invasive to me. Have you considered a second opinion?[/quote]

Ok I thought this never sounded right so I booked an appointment with another dentist and they said I have mild bone loss in the extraction gap he said that as long as I don’t mind having a small black gap once the gap has closed then I should be ok and they can do ipr if the gap is really big.