Chapter 34 Flashcards
Periodontal disease
Affects both hard and soft tissue and includes loss of bone
Gingivitis
Affects only soft tissue
Radiograph of the supporting bone
Allows views of interseptal bone and crystal bone to be assessed
Bone loss is defined as
Horizontal or vertical or a combination of both
Horizontal bone loss
Loss of bone around the teeth in an entire region around several teeth with both buccal and lingual bone lost parallel to the CEJ. Bone has receded fairly evenly like a tide
Vertical bone loss
Loss of bone at an angle to the tooth - it often forms a V next to the tooth with the bone slanted downward creating a pocket next to the tooth
Furcation bone loss or involvement
Loss of bone between the roots of multi-rooted teeth
Predisposing factors
Restoration overhangs Poorly contoured restoratons Poorly contacting natural teeth Plunger cusps Calculus build-up Occlusal trauma
Occlusal trauma
Includes such things as osteosclerosis, hypercementosis, triangulation of bone left between the teeth, widened PDL, and other RO in bone
Anatomical configurations
Root morphology
Relationship of a tooth’s roots to the adjacent tooth
Sinus location
Mandibular canal location
What kind of tissues are not imaged in radiographs
Soft
Radiographs cannot distinguish between
Active periodontal disease vs. periodontally treated surgical procedures
Vertical BW’s
More useful for examining periodontium than horizontal BW’s
Faulty horizontal angulation
The cause of overlap between the teeth and renders the radiograph fairly useless for caries detection
Too much vertical angulation
Does not reveal crestal bone
Too little angulation
Falsely indicates bone loss
Gingivitis
Case Type I
Chronic periodontitis
Case Type II
Moderate chronic or aggressive periodontitis
Case Type III
Advanced Chronic or Aggressive periodontitis
Case Type IV
Case Type I
Should appear normal on radiographs
Lamina dura should be intact and unbroken. The alveolar crest should be 1 to 1 1/2mm apical to CEJ with points between the teeth inter proximally. The PDL should be a thin RL line between tooth and bone
Case Type II
Early bone loss of up to 30%
Radiographs will show a “cupping” out of crestal bone, blunting of the inter proximal points and a triangulation of the PDL
Case Type III
Moderate bone loss of 30-50%
Severe vertical and/or horizontal bone loss with RL in the furcations
Case type IV
More than 50% bone loss
Severe vertical and/or horizontal bone loss with furcation involvement. Thickened periodontal membrane causes changes in tooth position
