BONE LOSS AND PATTERN OF BONE DESTRUCTION

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BONE LOSS AND PATTERN OF BONE DESTRUCTION:

Dr. Shafaq Salim BONE LOSS AND PATTERN OF BONE DESTRUCTION Prepared by: Dr. Batool Mohsin Khan

Acknowledgment:

Prepared by: Dr. Batool Mohsin Khan Acknowledgment Dr. Batool Mohsin Khan

PowerPoint Presentation:

Osseous defects are those defects which are formed as a result of destruction of alveolar bone due to periodontal diseases. The normal height of the alveolar bone is at cemento -enamel junction and is maintained by equilibrium between bone formation by ‘ osteoblasts ’ and bone loss by ‘ osteoclasts ’ . Prepared by: Dr. Batool Mohsin Khan

NORMAL ANATOMY OF ALVEOLAR BONE:

NORMAL ANATOMY OF ALVEOLAR BONE Alveolar bone is the part of jaw bone that surrounds and supports the teeth. It is composed of two parts: Alveolar bone proper (compact bone) Supporting bone ( cancellous bone) The shape, size and thickness varies in different region of same oral cavity. It is partially tooth dependent hence it is resorbed once the tooth is extracted. Prepared by: Dr. Batool Mohsin Khan

CAUSES OF BONE DESTRUCTION:

CAUSES OF BONE DESTRUCTION EXTENSION OF GINGIVAL INFLAMMMATION TRAUMA FROM OCCLUSION SYSTEMIC DISORDERS Prepared by: Dr. Batool Mohsin Khan

EXTENSION OF GINGIVAL INFALMMATION:

EXTENSION OF GINGIVAL INFALMMATION The most common cause of bone destruction in periodontal disease is the extension of inflammation from marginal gingiva into supporting periodontal tissues. The inflammatory invasion of the bone surface and the initial bone loss is followed by transition from gingivitis to periodontitis . Periodontitis is always preceded by gingivitis but not all gingivitis progress to periodontitis . The transition from gingivitis to periodontitis is associated with changes in the bacterial plaque composition and cellular composition. Prepared by: Dr. Batool Mohsin Khan

THE PATHWAY OF SPREAD OF INFLAMMATION:

THE PATHWAY OF SPREAD OF INFLAMMATION Prepared by: Dr. Batool Mohsin Khan

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Prepared by: Dr. Batool Mohsin Khan

BONE DESTRUCTION CAUSES BY TRAUMA FROM OCCLUSION:

BONE DESTRUCTION CAUSES BY TRAUMA FROM OCCLUSION Trauma from occlusion can produce bone destruction in the absence or presence of inflammation. The trauma from occlusion in the absence of inflammation can cause following changes: Increase compression and tension of periodontal ligament. Increases osteoclasis of alveolar bone and necrosis of periodontal ligaments. Resorption of bone and tooth structure. Prepared by: Dr. Batool Mohsin Khan

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The changes are reversible if the offending forces are removed . Persistent trauma from occlusion results in funnel shape widening of the crestal portion of periodontal ligaments with resorption of adjacent bone. Modified bone shape weaken tooth support and mobility occurs. Trauma from occulusion with inflammation results in bizarre bone pattern. Prepared by: Dr. Batool Mohsin Khan

PowerPoint Presentation:

Prepared by: Dr. Batool Mohsin Khan

BONE DESTRUCTION CAUSED BY SYSTEMIC DISORDERS:

BONE DESTRUCTION CAUSED BY SYSTEMIC DISORDERS ‘ OSTEEOPOROSIS is a physiologic condition of post menopausal women, resulting in loss of bone mineral content and structural bone changes’. Periodontitis is not caused by osteoporosis, but it can make bone loss from periodontal disease more severe. Inadequate intake of Vitamin D and calcium, physical inactivity, smoking and certain medications and family history are also known risk factors. Prepared by: Dr. Batool Mohsin Khan

BONE DESTRUCTION PATTERNS IN PERIODONTAL DISEASE:

BONE DESTRUCTION PATTERNS IN PERIODONTAL DISEASE Periodontal disease alters the morphology of bone in addition to reducing bone height. Various bone destruction patterns are as follow: HORIZONTAL BONE LOSS VERTICAL OR ANGULAR DEFECTS OSSEOUS CRATERS BULBOUS BONE CONTOUR LEDGES Prepared by: Dr. Batool Mohsin Khan

HORIZONTAL BONE LOSS:

HORIZONTAL BONE LOSS Most common pattern of bone loss in periodontal disease. ‘The bone is reduced in height, but the bone margins remain approximately perpendicular to the tooth surface’. The inter dental septa and facial and lingual plates are affected but not to equal degree around the same tooth. Prepared by: Dr. Batool Mohsin Khan

PowerPoint Presentation:

Prepared by: Dr. Batool Mohsin Khan

VERTICAL OR ANGULAR DEFECTS:

VERTICAL OR ANGULAR DEFECTS ‘Vertical or angular defects are those defects that occur in an oblique direction , leaving a hollow-out trough in the bone along side of the root, the base of the defect is located apical to the surrounding bone ’. Angular defects in most situations are accompanied by infra bony pockets. Prepared by: Dr. Batool Mohsin Khan

PowerPoint Presentation:

Angular defects are classified on the basis of number of walls present: One walled / hemiseptum Two walled Three walled / intrabony defect Combine osseous defect/spiral ( Number of walls in apical portion defect are greater then that in its occlusal portion. Surgical exposure is the only way to determine the presence of vertical osseous defects. Vertical defects increases with age. Prepared by: Dr. Batool Mohsin Khan

PowerPoint Presentation:

Prepared by: Dr. Batool Mohsin Khan

OSSEOUS CRATERS:

OSSEOUS CRATERS ‘Osseous craters are concavities in the crest of the inter dental bone confined within the facial and lingual walls’. Prepared by: Dr. Batool Mohsin Khan

BULBOUS BONE CONTOUR:

BULBOUS BONE CONTOUR ‘Bulbous bone contours are bony enlargements caused by exostosis , adaptation to function or buttressing bone formation’. More common in maxilla than in mandible. Reverse architecture! Prepared by: Dr. Batool Mohsin Khan

LEDGES:

LEDGES ‘Ledges are plateau like bone margins caused by resorption of thickened bony plates’. Prepared by: Dr. Batool Mohsin Khan

FURCATION INVOLVEMENT:

FURCATION INVOLVEMENT ‘The term furcation involvement refers to the invasion of the bifurcation and trifurcation of multi rooted teeth in periodontal disease’. Furcation may be visible clinically or covered by the wall of the pocket. Extend of the involvement is determined by the blunt probe. Prepared by: Dr. Batool Mohsin Khan

GRADING OF FURACTION:

GRADING OF FURACTION • Grade 0: No involvement of the furcation . • Grade I: The furcation is detectable with a probe, but no more than 1/3 is exposed. • Grade II: The probe can penetrate more than 1/3 of the furcation , but not pass right through the tooth. • Grade III: The probe passes from one side of the furcation to the other. Prepared by: Dr. Batool Mohsin Khan

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