Published June 17, 2023 | Version online

Bone Loss, Its Patterns & Rationale of Bone Grafting

  • 1. Professor & Head,
  • 2. Principal, Professor & Head

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The final and most severe effect of the inflammatory process seen in periodontitis is bone loss.  In periodontitis, the inflammatory reaction to the bacterial biofilm insult damages the periodontal unit and causes bone loss as well as the breakdown of periodontal ligament fibres. As a result of previous pathologic episodes, the bone loss takes place but  soft tissue changes may or may not correspond to it. Therefore, the depth of periodontal pockets, the severity of pocket wall ulceration, or the presence or absence of suppuration do not always correspond with the degree of bone loss.

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References

  • References: 1. Löe, H et al. "Natural history of periodontal disease in man. Rapid, moderate and no loss of attachment in Sri Lankan laborers 14 to 46 years of age." Journal of clinical periodontology vol. 13,5 (1986): 431-45. doi:10.1111/ j.1600-051x.1986.tb01487.x 2. Papapanou P N, Tonetti M S. Diagnosis and epidemiology of periodontal osseous lesions.P 2000;2000:22:8–21. 3. Manson J D. Bone morphology and bone loss in periodontal disease. J Clinc Periodont;1976:3:14-22. 4. Glickman I, Smulow J B. Alterations in the pathway of gingival inflammation into the underlying tissue including excessive occlusal forces. J Periodontol;1962:33:7-13 5. Prichard JF. Advanced Periodontal Disease.Philadelphia:WB Saunders 6. Polson AM, Zander HA. Effect of periodontal trauma upon intrabony pockets.J Periodontol.1983;54(10):586-91. 7. Jin L, Cao C. Clinical diagnosis of trauma from occlusion and its relation with severity of periodontitis. J Clin Periodontol 1992;19:92-97 8. Shefter G, McFall W. Occlusal relations and periodontal status in human adults. J Periodontal 1984;55:368-374 9. Pihlstrom B, Anderson K, Aeppli D, Schaffer E. Association between signs of trauma from occlusion and periodontitis. J Periodontol 1986;57:1-6 10. Wang H, Burgett F, Shyr Y, Ramfjord S. The influence of molar furcation involvement and mobility on future clinical periodontal attachment loss. J Periodontol. 1994;65:25-29 11. Burgett F, Ramfjord S, Nissle R et al. A randomized trial of occlusal adjustment in the treatment of periodontitis patients. J Clin Periodontol. 1992;19:381-387 12. Goldman H M, Cohen W D. The infrabony pocket: Classification and treatment. J Periodontol.1958;29:272-291. 13. Carranza FA, Takei H A. Bone loss and patterns of bone destruction. Clinical Periodontology.10th ed. St. Louis, Saunders, Elsevier. 14. Weinberg M A, Eskow R N. Osseous Defects: Proper Terminology Revisited. J Periodontol.2000;71:1928 15. Glickman I. Clinical Periodontology.3rd ed. W B Saunders. Philadelphia.1964 16. Prichard J F. The etiology, diagnosis and treatment of the intrabony defect. J Periodontol. 1967;38:455-65 17. Karn KW, Schockett HP, William C, Moffitt, Jonathan LG. Topographic Classification of deformities of the alveolar process. J Periodontol. 1984; 55: 336 -340. 18. Orban B J. Oral Histology and Embryology. 4th ed. St. Louis, Mo., 210,1957. 19. Wheeler R C. A text book of Dental Anatomy and Physiology. 3rd Ed. Philadelphia, W B Saunders Co, 300-301,1958. 20. Bradin M. Precautions & Hazards in periodontal surgery. J Periodontol. 1962; 33:154. 21. Wade B A. The Flap Operation. J Periodontol 1966;37:9 22. Klingsberg J. The Circumferential Aspect of Periodontal Deformities: A Proposal for Classification. J Periodontol. 1973;44:145-149. 23. Hamp SE, Nyman S and Lindhe J. Periodontal treatment of multirooted teeth. Results after 5 years. J Clinic Periodontol1975; 2:126-135. 24. Tarnow D and Fletcher P. Classification of the vertical component of furcation involvement. J Periodontol1984; 55:283-284. 25. Glickman I. Clinical Periodontology, 2nd ed. Philadelphia:W. B. Saunders, 1958; 694-696. 26. GoldmanHM. Therapy of the incipient bifurcation involvement. J Periodontology 1958; 29:112. 27. Tal H and Lemmer J. Furcal defects in dry mandibles part II: Severity of furcal defects. J Periodontol1982; 53:364-367. 28. Fedi PF Jr. The Periodontal Syllabus, 2nd ed. Philadelphia: Lea and Febiger, 1985; 169-170. 29. Walter C, Kaner D, Berndt DC, Weiger R and Zitzmann NU. Three-dimensional imaging as a pre-operative tool in decision making for furcation surgery. Journal of Clinical Periodontology 2009; 36:250-257 30. Spiekermann H: Implantologie. Stuttgart: Thieme; 1984. 31. Spiekerman, H. Atlas de Implantología. Barcelona: Editorial Masson; 1995 32. Vanden Bogaerde L. A proposal for the classification of bony defects adjacent to dental implants.Int J Periodontics Restorative Dent. 2004;24:264-71. 33. Schwarz F, Sahm N, Becker J: Aktuelle Aspektezur Therapie periimplantärer Entzündungen. Quintessenz 2008,59 34. Nielsen IM, Glavind L, Karring T. Interproximal periodontal intrabony defects. Prevalence, localization and etiological factors. J Clin Periodontol 1980: 7: 187–198. 35. Wouters FR, Salonen LE, Helldén LB, Frithiof L. Prevalence of interproximal periodontal intrabony defects in an adult population in Sweden. A radiographic study. J Clin Periodontol. 1989;16:144-9 36. Persson RE, Hollender LG, Laurell L, Persson GR. Horizontal alveolar bone loss and vertical bone defects in an adult patient population. J Periodontol.1998;69:348-56. 37. Soder B, Jin LJ, Soder PO, Wikner S. Clinical characteristics of destructive periodontitis in a risk group of Swedish urban adults. Swed Dent J 1995: 19: 9–15 38. Ainamo A, Soikkonen K, Wolf J, Siukosaari P, Erkinjuntti T, Tilvis R, Valuanne J. Dental radiographic findings in the elderly in Helsinki, Finland. Acta OdontolScand 1994: 52: 243–249. 39. Manson JD, Nicholson K. The distribution of bony defects in chronic Periodontitis. J Periodontol.1974;45:88-92 40. Saari J T, Hurt WC, Biggs N L. Periodontal bony defects in the dry skull. J Periodontol 1968;39:278-283 41. Papapanou PN, Wennstro¨m JL, Grondahl K. Periodontal status in relation to age and tooth type. A cross-sectional radiographic study. J Clin Periodontol 1988: 15: 469–478. 42. Wouters FR, Salonen LE, Hellde´n LB, Frithiof L. Prevalence of interproximal periodontal intrabony defects in an adult population in Sweden. A radiographic study. J Clin Periodontol 1989: 16: 144–149. 43. Gilmore, N D. An epidemioiogkal investigation of vertical nsseous defects in penodoniat disease. Thesis, Ann Arbor, Michigan.1970 44. Larato DC. Intrabony defects in the dry human skull. J Periodontol.1970;41:496-498. 45. Haim Tal. The Prevalence and Distribution of Intrabony Defects in Dry Mandibles. J Periodontol.1984;55:149-154. 46. Rupprecht RD, Horning GM, Nicoll BK, Cohen MEPrevalence of dehiscences and fenestrations in modern American skulls. J periodontal 2001;72:722-729. 47. Svardstrom G, Wennstrom JL. Prevalence of furcation involvements in patients referred for periodontal treatment. J Clin Periodontol 1996: 23: 1093–1099. 48. Papapanou PN, Wennström JL. The angular bony defect as indicator of further alveolar bone loss. J Clin Periodontol. 1991;18:317-22. 49. Goldman H, Stallard R. Limitations of the radiograph in diagnosis of osseous defects in periodontal disease. J Periodontol 1973;44:626. 50. Prichard, J.: Interpretation of radiographs in periodontics. Int J Periodontics Rest Dent 3: 9, 1983. 51. Ramadan, Mitchell D. A roentgenographic study of experimental bone destruction. Oral Surg 1962;15:934 52. Revesz, G, Kundel, H, and Graber, M. The influence of structured noise on the detection of radiographic abnormalities. Invest Radiol 1974; 9: 479. 53. Jeffcoat M K. Radiographic Methods for the detectionof progressive alveolar bone loss. J Periodontol. 1992;63:367-372 54. Hausmann E, Allen K, Christersson L, Genco RJ. Effect of x-ray beam vertical angulation on radiographic alveolar crest level measurement. J Periodontal Res. 1989;24:8-19. 55. Stoner J E. An Investigation into the Accuracy of Measurements made on Radiographs of the Alveolar Crests of Dried Mandibles. J Periodontol 1972;43:699-701. 56. Gonalez L, Vano E, Fernandez R. Reference doses in dental radiodiagnostic facilities. Br J Radiol 2001;74:153-156 57. Mol A. Imaging methods in periodontology. Periodontol 2000. 2004;34:34-48 58. Kim T, Obst C, Zehanczek, Geenen C. Detection of bone loss with different X-ray techniques in periodontal patients. J Periodontol. 2008; 79:1141-1149. 59. Rethmann M, Ruttiman U, O'Neal R, Webber R et al. Diagnosis of bone lesion by substraction radiography. J Periodontol. 1985;56:324-329 60. Young SJ, Chaibi MS, Graves DT, et al. Quantitative analysis of periodontal defects in a skull model by subtraction radiography using a digital imaging device. J Periodontol 1996; 67:763-769. 61. Braegger U, Pasquali L, Weber H, Kornman KS. Computerised denstitometric image analysis (CADIA) for the assessment of alveolar bone density changes in furcation. J Clin Periodontol. 1989;16:46-52 62. Misch KA, Yi ES, Sarment DP. Accuracy of cone beam computed tomography for periodontal defect measurements. J Periodontol. 2006;77:1261-6 63. Arai Y, Tammisalo E, Iwai K, Hashimoto K, Shinoda K. Development of a compact computed tomographic apparatus for dental use. DentomaxillofacRadiol 1999; 28:245-248. 64. Danforth RA. Cone beam volume tomography: A new digital imaging option for dentistry. J Calif Dent Assoc 2003;31:814-815. 65. Sukovic P. Cone beam computed tomography in craniofacial imaging. OrthodCraniofac Res 2003; 6(Suppl. 1):31-36. 66. Ludlow JB, Davies-Ludlow LE, Brooks SL. Dosimetry of two extraoral direct digital imaging devices: NewTom cone beam CT and Orthophos Plus DS panoramic unit. DentomaxillofacRadiol 2003;32:229-234. 67. Ozawa T, Tsuchida M, Yamazaki Y, Arai T and Nakamura J. Clinical application of a fiberscope for periodontal lesions: Case reports. Quintessence International 1999; 30:615-622. 68. Otis LL, Everett MJ, Sathyam US and Colston BW. Optical coherence tomography: a new imaging technology for dentistry. Journal of the American Dental Association 2000; 131:511-514. 69. Chandrashekhar KT, Vandana KL and Mehta DS. Comparative evaluation of ultrasonography, clinical and surgical measurements of furcation involvement: A clinical study. JIDA 2014; 269. 70. Reynolds, Mark A et al. "The efficacy of bone replacement grafts in the treatment of periodontal osseous defects. A systematic review." Annals of periodontology vol. 8,1 (2003): 227-65. doi:10.1902/annals.2003.8.1.227