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    Patterns of Bone Loss

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    Mashal Fatima
    There are several patterns of bone loss that can occur due to periodontal disease. The most common is horizontal bone loss, which reduces the height of the bone but keeps the bone margin at a 90 degree angle to the tooth. Vertical bone loss occurs at an angle and creates a hollowed out trough along the root surface. Osseous craters are concave defects within the interdental bone and are the most common type of bone defect. Different classification systems have been developed to categorize bone defects based on parameters such as number of surrounding bone walls.

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    Patterns of Bone Loss

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    Mashal Fatima
    121 views4 pages
    There are several patterns of bone loss that can occur due to periodontal disease. The most common is horizontal bone loss, which reduces the height of the bone but keeps the bone margin at a 90 degree angle to the tooth. Vertical bone loss occurs at an angle and creates a hollowed out trough along the root surface. Osseous craters are concave defects within the interdental bone and are the most common type of bone defect. Different classification systems have been developed to categorize bone defects based on parameters such as number of surrounding bone walls.

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    Patterns of bone loss

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    There are several patterns of bone loss that can occur due to periodontal disease. The most common is horizontal bone loss, which reduces the height of the bone but keeps the bone margin at a 90 degree angle to the tooth. Vertical bone loss occurs at an angle and creates a hollowed out trough along the root surface. Osseous craters are concave defects within the interdental bone and are the most common type of bone defect. Different classification systems have been developed to categorize bone defects based on parameters such as number of surrounding bone walls.

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    121 views4 pages

    Patterns of Bone Loss

    Uploaded by

    Mashal Fatima
    There are several patterns of bone loss that can occur due to periodontal disease. The most common is horizontal bone loss, which reduces the height of the bone but keeps the bone margin at a 90 degree angle to the tooth. Vertical bone loss occurs at an angle and creates a hollowed out trough along the root surface. Osseous craters are concave defects within the interdental bone and are the most common type of bone defect. Different classification systems have been developed to categorize bone defects based on parameters such as number of surrounding bone walls.

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    of 4

    Patterns of bone loss

     The normal morphology and dimensions of the supporting bone of the teeth are
    altered during periodontal disease. Different types of bone deformities can result
    from periodontal disease.

    Horizontal Bone Loss


     The most common pattern of bone loss in periodontal disease.
     Height of the bone is reduced but the angle of the bone margin and the tooth
    remains at 90 degrees.
     The buccal/facial, lingual plates and the interdental septum are affected, but not
    necessarily to the same degree.

    Vertical Bone Loss


     Occur in oblique direction.
     This creates a hollowed-out trough in the bone along the root surface.
     The base of the defect is located apical to the surrounding bone.
     Angular defects are mostly accompanied by intrabony periodontal pockets.

    Classified based on the number of walls present:

     One walled defect or Hemiseptum


     Two walled defect
     Three walled defect – more common on the mesial surfaces of molars
     Combined – The number of walls in the apical portion of the defect is greater than in the occlusal
    portion

     Angular defects occurring on the buccal/lingual surfaces are not readily seen in
    the radiographs. Surgical exposure is the only certain way to determine the
    presence and configuration of angular defects.
     Prevalence increases with age.
    Osseous Craters
     Concavities in the crest of the interdental bone confined within the facial and
    lingual walls.
     Most common of all osseous defects (1/3rd of all bone defects and 2/3rd of all
    mandibular bone defects).
     Occurs twice most frequently in the posterior teeth than in the anterior teeth.

    Bulbous Bone Contours


     They are bony enlargements caused by exostoses, adaptation to function or
    buttressing bone formation.
     Found more frequently in the maxilla than in the mandible.

    Reversed Architecture
     They are produced by loss of interdental bone including lingual and facial plates
    without concomitant loss of radicular bone, resulting in a reversal of normal
    architecture.
     More common in the maxilla.

    Ledges
     They are plateau like bone margins caused by resorption of thickened bony
    plates.

    Furcation Involvement
     "Furcation involvement" refers to the invasion of the bifurcation and trifurcation
    of multirooted teeth by periodontal disease (For more details refer topic
    ‘FURCATION’, in chapter periodontal pathology).
    Classification of Bone Defects
    1) Goldman and Cohen (1958)

     One-walled defect
     Two-walled defect
     Three-walled defect
     Combined

    2) Glickman (1964)

     Osseous/interdental craters
     Hemiseptal defects
     Infrabony defects
     Bulbous bone contours
     Inconsistent margins and ledges
     Reversed architecture

    3) Prichard (1967)

     Expansion of Glickman’s classification by including


     Furcation involvement
     Anatomic aberrations of the alveolar process (thick marginal ledges, exostoses,
    tori, dehiscence and fenestrations).

    Highlights
     Horizontal bone loss is the most common pattern of bone loss in periodontal disease.
     Angular defects occurring on the buccal/lingual surfaces are not readily seen in the radiographs.
    Surgical exposure is the only certain way to determine the presence and configuration of angular
    defects.
     Osseous craters are concavities in the crest of the interdental bone confined within the facial and lingual
    walls. They are the most common of all osseous defects (1/3rd of all bone defects and 2/3rd of all
    mandibular bone defects).
     Bulbous bone contours are found more frequently in the maxilla than in the mandible.
     Ledges are plateau like bone margins caused by resorption of thickened bony plates.

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