Periodontal Disease Horizontal and vertical bone loss localized

Periodontal Disease: Horizontal and vertical bone loss; localized & generalized, moderate & advanced (severe) By Liling Zhang DEN 1218/D 232 Prof: Childs http: //www. free-powerpoint-templates-design. com

Introduction-What is bone loss? Alveolar bone forms the ridges in which the teeth are embedded. Bacteria and the body’s own immune system constantly battled with each other to maintain equilibrium. When bone resorption exceed formation, both bone height and density is reduced. Teeth may eventually become loose, fall out, or have to be removed.

Etiology/Causes: Extension of Gingiva inflammation/ginivitis • Extension of inflammation from marginal gingiva to supporting tissues. • Most common cause of bone loss. Trauma from occlusion • Periodontal response to external force. • Occurs in presence or absence of inflammation. Systemic disorders • Osteoporosis: loss of bone mineral content and structural bone changes. • Osteopenia, Hyperparathyroidism leukopenia.

Horizontal Bone Loss Even degree of bone resorption that the height of the bone in relation to the teeth has been uniformly decreased. (more than 2 mm apical to CEJ is considered bone loss) AKA: suprabony defect

Vertical Bone Loss/Infrabony defect one-sided bone resorption of the interdental marginal bone has a angulation towards either the mesial or distal aspect of the root(more than 2 mm).

Radiographs: vertical and horizontal bone loss Pic 1 Pic 2 Pic 3 Pic 1 shows horizontal and vertical bone loss Pic 2 shows horizontal bone loss with furcation involvement. Pic 3 shows horizontal and vertical bone loss

Periodontal disease: Gingivitis: Infectious bacteria from plaque get into the sulcus around he teeth and start infecting the gums. It’s manifested by inflammation of the gingiva; it is reversible. Periodontitis: As chronic gingivitis continues the infectious process and starts to infect the supporting structure around the teeth, periodontitis develops. Periodontitis is always preceded by gingivitis, but not all gingivitis progress to periodontitis; and it is not reversible. • Slight periodontitis: few signs and symptoms, redness/inflammation of gingiva, bleeding and PD of 4 -5 mm. • Moderate periodontitis: absence of pain, deeper infection, bad breath, bone loss and PD of 6 -7 mm • Advanced periodontitis: Redness/swelling gums, cold sensitivity, tooth mobility worsens with furcation involvement, Pain when chewing, Severe bad breath and PD of 7+mm

• Localized means less than 30% of the tooth involvement. • Generalized is more than 30% of the tooth involvement. Pic shows horizonal bone loss in a Panoramic. Localized & Generalized Periodontitis

Periapical radiograph Pic shows severe bone loss in a Periapical radiograph Pic shows localized bone loss in a

Severe Bone Loss with furcation involvement

Severe Bone Loss with +3 mobility

Reference of the pictures. : • • • https: //www. researchgate. net/figure/Pretreatment-radiograph-of-case-2 -Generalized-horizontal-alveolarbone-loss-and-multiple_fig 7_315934386 https: //www. researchgate. net/figure/Severe-angular-alveolar-bone-loss-and-furcation-defect-degree-IIat-36 -Probing-depth_fig 2_282862369 https: //www. researchgate. net/figure/Pretreatment-radiograph-of-case-2 -Although-vertical-bone-defect-of -left-lower-second_fig 5_282459090 http: //www. jisponline. com/viewimage. asp? img=JIndian. Soc. Periodontol_2014_18_4_482_138701_u 1. jpg https: //www. google. com/url? sa=i&source=images&cd=&ved=2 ah. UKEwilg_y. Ey. KXh. Ah. WMMd 8 KHZTLC 5 MQj. Rx 6 BAg. BEAU&url=https%3 A%2 F%2 Fwww. epicstudyclub. com%2 F 20162017&psig=AOv. Vaw 0 WFIYMdk 5 Tgw 5 e 6 q 9 V 56 UI&ust=1553887412888883 http: //www. jisponline. com/viewimage. asp? img=JIndian. Soc. Periodontol_2011_15_4_414_92583_f 5. jpg https: //www. omicsonline. org/open-access/different-radiographic-modalities-used-for-detection-ofcommon-periodontal-and-periapical-lesions-encountered-in-routine-dental-practice-23320702. 1000163. php? aid=32340 https: //pocketdentistry. com/disease-entities-and-diagnosis/ http: //www. jisponline. com/viewimage. asp? img=JIndian. Soc. Periodontol_2013_17_4_527_118330_f 5. jpg https: //www. nature. com/vital/journal/v 6/n 4/fig_tab/vital 1035_F 3. html https: //www. google. com/url? sa=i&source=imgres&cd=&ved=2 ah. UKEwj 2 h 4_L 4 q. Xh. Ah. Vv. ZN 8 KHRFb. Av. I Qj. Rx 6 BAg. BEAU&url=https%3 A%2 F%2 Fwww. efp. org%2 Fpatients%2 Fwhat-isperiodontitis. html&psig=AOv. Vaw 2 c. ZBxg. Srl. M_IQv 4 hktg 9 Cb&ust=1553894592587462