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What is horizontal bone loss?
Results in a fairly even, overall reduction in the height of bone.
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What is vertical bone loss?
- Results in an uneven reduction in bone height.
- Leaves a trenchlike area of missing bone alongside the root.
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How does the inflammation spread into the bone?
- Pathway in Horizontal Bone Loss G+B+PDL= H
- Pathway in Vertical Bone Loss G+PDL+B=V
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In health, the crest of the alveolar bone is located approximately _____mm apical to (below) the CEJs.
1-2
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In gingivitis, the crest of the alveolar bone is located approximately ____mm apical to (below) the CEJs.
- 2mm
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is the JE is at its normal level in gingivitis?
yes
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In periodontitis, bone destruction may be severe and the crest of the alveolar bone is located approximately ____mm apical to (below) the CEJs.
- More than 3
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Is Pain is considered a symptom of periodontitis?
no
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Alveolar bone loss in periodontitis:
- there is a progressive loss of bone.
- Bone destruction may eventually lead to tooth loss
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What are the two Patterns of Bone Loss?
- Horizontal bone loss
- Vertical bone loss
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Which Is the most common pattern of bone loss?
Horizontal bone loss
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Where is bone loss measure?
Measure from the CEJ(our marker)
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Which Is the less common pattern of bone loss?
vertical bone loss
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what pattern of bone loss is results in more rapid progression?
vertical bone loss
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What is the Pathway in Horizontal Bone Loss?
- G+B+PDL= H
- Into the gingival connective tissue(1)
- Into the alveolar bone(2)
- Into the periodontal ligament(3)
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When does Vertical bone loss occur?
when the crestal periodontal ligament fibers are weakened and no longer act as an effective barrier to inflammation (patient can’t clean it out)
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What is the Pathway in Vertical Bone Loss?
- G+PDL+B=V
- 1. Into the gingival connective tissue
- 2. Directly into the PDL space
- 3. Into the alveolar bone
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How are Infrabony defects classified?
- on the basis of the number of osseous (bony) walls.
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One-Wall Intrabony Defect
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Two-Wall Intrabony Defect
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Three-Wall Intrabony Defect
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Interproximal Osseous Crater:
- Concavities in the crest of the interdental bone confined within the facial and lingual walls.
- High frequency of occurrence is the difficulty to clean plaque and bacteria from these areas
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Contour of Interdental Bone
Normal:
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Contour of Interdental Bone
Osseous Crater:
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Furcation involvement occurs on?
- a multirooted tooth when the periodontal infection invades the area between and around the roots.
- This results in a loss of alveolar bone between the roots of the tooth.
- 1-feel it
- 2-feel it and tip goes in
- 3-tip goes thru and can see it
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There is no bone loss in?
gingivitis
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Bone loss only occurs in?
periodontitis.
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Bone loss in periodontitis can result in the loss of ______.
teeth.
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What is this?
furcation
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what type of bone loss?
horizontal
-
what type of bone loss?
vertical
-
What type of bone loss?
vertical
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What type of bone loss?
vertical
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What is a periodontal pocket?
- a pathologic deepening of the gingival sulcus as a result of:
- Apical migration of the JE
- Destruction of periodontal ligament fibers
- Destruction of the alveolar bone
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Are there different types of periodontal pockets?
- Gingival pocket
- Periodontal pocket
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What is the bone loss like in a periodontal pocket?
Destruction of the alveolar bone
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What is a Gingival pocket?
- a deepening of the gingival sulcus as a result of inflammation.
- NO apical migration of the JE.
- The coronal portion of the JE detaches from the tooth resulting in a slight increase in probing depth.
- In many cases, swelling of the gingival tissue also contributes to an increased probing depth.
- BOP
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in a Healthy Gingival Sulcus:
the JE attaches along its entire length to the enamel of the tooth.
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Gingival pockets are also called?
- pseudopockets
- meaning false pocket: because there is no destruction of PDL fibers or alveolar bone.
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Periodontal pocket:
- a pathologic deepening of the gingival sulcus as a result of:
- Apical migration of the JE
- Destruction of periodontal ligament fibers
- Destruction of the alveolar bone
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Two Types of Periodontal Pockets:
- Suprabony periodontal pocket
- Infrabony periodontal pocket
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Suprabony Pocket occurs when?
- there is horizontal bone loss.
- JE is located coronal to the crest of the alveolar bone (above the crest of bone).
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Infrabony Pocket occur when?
- there is vertical bone loss.
- JE is located apical to the crest of the alveolar bone (below the crest of bone)
- Base of the pocket is located within the cratered-out area of bone alongside the root surface.
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Attachment loss is?
- the destruction of the fibers and alveolar bone that support the teeth.
- The base of a pocket may exhibit a very irregular pattern of tissue destruction.
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What do you see?
There is irregular pattern of tissue destruction.
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A disease site is ?
- an area of tissue destruction.
- may involve only one surface of the tooth, such as the distal surface, or several surfaces, or all four surfaces of the tooth.
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Active disease site is?
- a disease site that shows continued apical migration of the junctional epithelium over time.
- For example, 3 months ago the deepest reading on the distal surface of the mandibular right first molar was 5 mm. Today, it is 6 mm.
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Inactive disease site is?
- a disease site that is stable, with the attachment level of the JE remaining at the same level for a period of time
- For example, the deepest reading on the distal surface of the mandibular right first molar has remained at 5 mm for 12 months.
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How to assess Disease Sites?
Disease activity should be assessed with a periodontal probe at regular intervals and recorded in the patient chart or computerized record.
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______ is an area of tissue destruction left by the periodontal disease process.
Periodontal pocket
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The majority of periodontal pockets in most adult patients with periodontitis are ______.
inactive sites.
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The periodontal pocket is an indicator of
past destruction from periodontitis.
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____ is the destruction of the fibers and alveolar bone that support the teeth.
Attachment loss
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A ______ is an area of tissue destruction.
disease site
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______an area of tissue destruction left by the disease process
Periodontal pocket
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