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Bone loss & patterns of bone loss / /certified fixed orthodontic courses by Indian dental academy
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Bone loss & patterns of bone loss / /certified fixed orthodontic courses by Indian dental academy



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Welcome to Indian Dental Academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.

Indian dental academy has a unique training program & curriculum that provides students with exceptional clinical skills and enabling them to return to their office with high level confidence and start treating patients

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Bone loss & patterns of bone loss / /certified fixed orthodontic courses by Indian dental academy Bone loss & patterns of bone loss / /certified fixed orthodontic courses by Indian dental academy Presentation Transcript

  • Bone loss & patterns of bone loss INDIAN DENTAL ACADEMY Leader in Continuing Dental Education www.indiandentalacademy.com www.indiandentalacademy.com
  • Periodontitis is always preceded by thegingivitis , but not all gingivitis progressesto periodontitisThe transition of gingivitis to peridontitis isassociated with changes in the plaqueT lymphocytes are predominant in thegingivitis, as the lesion becomes Blymphocytic it becomes more destructive www.indiandentalacademy.com
  • The recurrent episodes of acute destructionover time may be lead to progressive boneloss in marginal periodontitisPathway of inflammation Inflammation bone PDL www.indiandentalacademy.com
  • Radius of action Locally produced bone resorption factors have to be present in the proximity of bone surface to be able to exert their action Range of 1.5mm- 2.5mm within bacterial plaque can induce loss of bone Interproximal angular defects can appear only in spaces that are wider than 2.5mm www.indiandentalacademy.com
  •  Large defects far exceeding 2.5mm from the tooth surface may be caused by presence of bacteria in the tissuesRate of bone loss8 % --- 0.1 mm –1mm/yr 81% --- 0.05mm-0.5mm/yr 11% --- 0.05-0.09mm/yr www.indiandentalacademy.com
  • Mechanisms of bone destruction  Plaque bone progenitor cells noncellular mechanismGingival cells osteoclasts mediators Bone resorption www.indiandentalacademy.com
  • Plaque direct action bone resorptionPGE2,IL-1 & TNF, IL-6 bone resorptionNSAIDs such as flubiprofen , ibuprofeninhibit PGE2, slowing bone loss. www.indiandentalacademy.com
  • Bone destruction caused by systemicdisases Bone factor concept ---systemic component is present in all forms of periodontitis. Nature of systemic component influences the severity of disease. Osteoporosis Hyperparathyroidism, leukemia. www.indiandentalacademy.com
  • Factors that determine the bone morphologyin the alveolar bone Anatomic factors  Thickness , width, & crest angulation of interdental septa  Thickness of facial & lingual alveolar bone  Presence of fenestration, dehiscence or both  Alignment of teeth  Root position within the alveolar process  Proximity with another tooth surface www.indiandentalacademy.com
  •  Exostoses Lipping – Bone formation occurs in an attempt to buttress bony trabeculae weakened by resorption. When it occurs within the jaw it is called central buttressing bone formation.when it occurs in the external surface , it is reffred as peripheral buttressing bone formation. www.indiandentalacademy.com
  •  TFO --- funnel shaped widening of crestal portion of PDL, with resorption of alveolar bone.Angular shape bony crest represent adaptation of PDL tissues to “cushion” increased occlusal force. www.indiandentalacademy.com
  •  Food impaction --- it is complicating factor rather than cause of bone defect JPBone destructionpatterns Horizontal bone loss  Most common pattern  Bone margin remains perpendicular to the tooth surface Horizontal bone loss www.indiandentalacademy.com
  •  Angular or vertical defects  They occur in an oblique direction leaving an hollowed trough in the bone along side the root  Base of the defect located apical to surronding bone  They accompany infrabony defects  They classified on number of osseous walls present  One wall  Two wall  www.indiandentalacademy.com Three wall
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  •  The number of walls in the apical portion of the defect may be greater than that in its occlusal portion, combined osseous defects Surgical exposure is the only sure way to determine the configuration of osseous walls Vertical defects increases with age Intrabony defects are more frequently found on the mesial surfaces of upper & lower molars About 60% of persons with interdental angular defects have only a single defect www.indiandentalacademy.com
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  • Osseous craters These are the concavities in the crest of the interdental bone confined within the facial & lingual walls They form about 1/3 of all defects & 2/3 of mandibular defects They are twice as common in posterior segments as in anterior segments www.indiandentalacademy.com
  •  Reasons for high frequency of interdental craters  Interdental area collects plaque & is difficult to clean  Vascular patterns from the gingiva to the centre of the crest may provide a pathway of inflammation www.indiandentalacademy.com
  • Bulbous bone contours bony enlargements caused by exotoses, buttressing bone formation. Found more frequently in the maxilla than in the mandibleReversed architecture More common in the maxilla Reversed architecture www.indiandentalacademy.com
  • Ledges Plateu like bone margins caused by resorption of thickened bony platesF.I. www.indiandentalacademy.com