Bone Loss and patterns of bone

destruction
Fahad Al-Dabbagh
BDS, MSc (Clin) Periodontics, LDS RCS (Eng.), PhD (Res) Periodontology

Outline

• Causes of bone destruction in periodontium

• Factors determining bone morphology in PDD
• Patterns of bone destruction in PDD
• Summary
Causes of bone • Extension of gingival inflammation
• Trauma from occlusion
destruction in • Systemic disorders
periodontium

Extension of gingival inflammation

Extension of gingival inflammation

Extension of gingival inflammation

Factors determining bone morphology in PDD
• Thickness, width and angulation of interdental septa
• Thickness of facial and lingual alveolar plates
• Fenestration and dehiscence
• Alignment of the teeth
• Root position and anatomy
• Proximity to another teeth and location within the alveolar process.

Fenestration and dehiscence

Alignment of the teeth

Root position and anatomy

Proximity to another teeth and location within the
alveolar process
Patterns of bone destruction in PDD
• Horizontal
• Vertical or angular

• Osseous crater
• Bulbous bone contour
• Reversed architecture
• Ledges
• Furcation involvement

Horizontal bone loss

Vertical bone loss

Vertical bone loss

Bulbous bone contour

Reversed architecture
Ledges

Furcation involvement
Summary
• Bone destruction in periodontal disease is not a necrosis
• Periodontitis pass through period of active destruction followed by
period of remission depending on several factors.
• Several factors determine the pattern and extent of periodontal
disease.

Thank you
References:
• Newman, M.G., Takei, H., Klokkevold, P.R. and Carranza, F.A., 2011
(2018). Newman and Carranza's Clinical Periodontology. Elsevier
Health Sciences.