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What is bone buttressing?

Published in Dental Anatomy 2 mins read

Bone buttressing refers to the development of thickened or exostotic buccal alveolar bone, typically as a response to excessive occlusal forces. In simpler terms, it's the body's way of reinforcing the jawbone when it's experiencing too much stress from chewing or other oral activities.

Understanding Bone Buttressing

When the teeth experience abnormally high forces, the alveolar bone (the bone surrounding the teeth) can react by increasing in density and volume in specific areas. This reinforced bone acts like a "buttress," providing additional support to the teeth and distributing the load more effectively.

Causes of Bone Buttressing

The primary cause is excessive occlusal force, which can arise from:

  • Bruxism (teeth grinding): Habitual grinding or clenching of the teeth puts immense pressure on the jawbone.
  • Malocclusion (bad bite): Misalignment of the teeth can lead to uneven force distribution, stressing certain areas of the bone.
  • Missing Teeth: Remaining teeth may bear excessive force if adjacent teeth are missing, causing bone stress and buttressing.
  • Parafunctional Habits: Activities like nail-biting or pencil-chewing can also contribute.

Characteristics of Bone Buttressing

  • Thickened Alveolar Bone: Clinically, it appears as a noticeable thickening of the bone, usually on the buccal (cheek) side of the alveolar ridge.
  • Exostosis: In some cases, the buttressing can manifest as an exostosis, a benign bony growth projecting outwards.
  • Location: It is most commonly observed in areas where the occlusal forces are concentrated.

Clinical Significance

While bone buttressing itself isn't necessarily a disease, it signifies an underlying problem: excessive occlusal forces. Left unaddressed, this can lead to:

  • Tooth Mobility: Excessive force can loosen the teeth over time.
  • Gingival Recession: The gums can recede due to the increased pressure.
  • Temporomandibular Joint (TMJ) Disorders: Imbalance in bite forces can strain the TMJ.

Treatment

Treatment focuses on addressing the underlying cause of the excessive force:

  • Occlusal Adjustment: Re-shaping the biting surfaces of the teeth to distribute forces more evenly.
  • Night Guard: A custom-made appliance worn at night to protect the teeth from grinding and clenching.
  • Orthodontic Treatment: Correcting misaligned teeth to improve bite alignment.
  • Stress Management: Techniques to reduce stress and anxiety, which can contribute to bruxism.

In conclusion, bone buttressing is a compensatory mechanism where the alveolar bone thickens in response to excessive occlusal forces, highlighting a potential underlying issue that needs to be addressed to prevent further dental problems.