Bone loss often shows up as a black space on a dental x-ray. The amount of bone loss determines how much space is shown. On a normal x-ray, the bone and gums will be level with the bottom of the teeth, between the crown and the root. A very small amount of black space may be present, but this typically does not indicate bone loss. When there is a large amount of black space and the bone and gum line is below the bottom of the tooth and in line with the root of the tooth, this indicates significant bone loss. In some cases of very severe bone loss, the black space on a dental x-ray will extend beyond the roots of the tooth and potentially even below them. For patients with bone loss indicated by black space on an x-ray, bone grafting may be recommended, especially in cases where a dental implant is being considered.
A black triangle in between the teeth can indicate a number of issues. While it may start out small at first, it can widen into a larger triangle shaped gap if not treated. This black triangle most likely indicates that the gums are starting to recede, which is often due to periodontal disease. A deep cleaning, or a scale and root planing, may be necessary to remove plaque and debris far up underneath the gum line. A black triangle in between the teeth can also be an indicator that bone loss is beginning to occur, which may go hand in hand with periodontal disease. Advanced periodontal disease can cause bone loss, which in turn weakens the entire structure of the jaw and teeth. Patients that notice black triangles in between their teeth should see a dentist promptly, particularly if it appears that the black triangles started out small and are beginning to get larger in size.
A blade implant is a laminar endosseous dental implant that is designed to be placed within the bone. Blade implants were developed for use in the alveolar crest but are especially suited to being placed in thin alveolar bone. This type of implant could allow some patients to avoid alveolar bone grafting procedures by utilizing tricortical anchorage. While titanium blade implants do show a high rate of osseointegration and can help patients avoid receiving bone grafts, they are also subject to higher rates of failure when placed by a surgeon who does not have sufficient experience with blade implant procedures. The success of the blade implant depends upon several factors which must be carefully evaluated prior to its placement. These factors include use in atrophic crestal bone, failure to consider the patient’s tongue movements, and failure to accurately evaluate the patient’s alveolar crest anatomy. For a blade implant to be successful, the practitioner must have experience in selecting the proper patient.