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Bone Loss Perio
Bone Loss Perio
Bone Loss Perio
•INTRODUCTION
•ETIOLOGY
SYSTEMIC DISORDERS
EXTENSION OF GINGIVAL INFLAMMATION
Periods of destruction
• bursts of destructive activity associated with sub
gingival ulceration and acute inflammatory reaction,
resulting in rapid bone loss.
•Bursts of destructive activity coincide with the
conversion of T-lymphocyte lesion to B-lymphocyte
•Exacerbation are associated with loose ,
unattached ,motile gram negative ,anaerobic
pocket flora and period of remission coincide
with the formation of dense ,unattached
,nonmotile, grame positive flora with tendency to
mineralize.
•Tissue invasion by one or several bacterial
species is followed by an advanced local host
defense that controls the attack.
Mechanisms of bone destruction
The factors involved in bone destruction in
periodontal disease are bacteria and host mediated
And they produced osteoclasts and also direct
effect by bacterial colonies
Several host factors released by inflammatory cells
are prostaglandins , interleukin 1-alpha and beta
,and tumor necrosis factor
Bone formation in periodontal disease
Reversed architecture
They are produced by loss of
interdental bone including the
facial plates, lingual plates
Or both without concomitant
loss of radicularbone.
More in maxilla
ledges
Ledges are plateau like bone margins caused by
resorption of thickened bony plates.
Furcation involvement
Furcation refers to the invasion of the bifurcatoin
and trifurcation of multirooted teeth by
periodontal disease.
Mandibular 1st molars are most common site and
maxillary premolar are least common.
Grade 1 – incipient bone loss
Grade 2 – partial bone loss
Grade 3 – total bone loss ( through & through
opening of furcation
Grade 4 – similar to grade 3 but with gingival
recession
Microscopically –
It is simply a phase of rootward extension of
periodontal pocket
In its early stage , widening of the periodontal
space with cellular and fluid exudates
Extension of the inflammation into the bone leads
to bone resorption and reduction in height.
Bone destruction pattern may produced horizontal
or angular , and very frequently crater develop
in interradicular area.