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Understanding Bone Health in Dentistry

Apr 27, 2025

Lecture on Bone Health and Loss in Dentistry

Overview

  • Focus on understanding bone health in relation to the gums and periodontal disease.
  • Examines gingivitis and periodontitis effects on bone structure.

Bone Health in the Mouth

  • Healthy Mouth
    • Bone level is intact, two millimeters below the CEJ (cementoenamel junction).
    • In gingivitis (inflammation of gums), bone remains intact.
    • Gingivitis is reversible with proper dental care.
  • Periodontitis
    • Inflammation affects the periodontium, leading to bone loss.
    • Severe periodontitis can result in significant bone resorption, tooth mobility, and potential tooth loss.

Types of Bone Loss

  • Horizontal Bone Loss

    • Most common type.
    • Bone between teeth forms a horizontal line.
    • Normal bone should be two millimeters below the CEJ.
    • With bone loss, this level decreases, forming a slightly fuzzy, straight line.
  • Vertical Bone Loss

    • Less common, more severe.
    • Bone loss progresses rapidly in a diagonal pattern.
    • Inflammation pathway differs from horizontal loss.

Inflammation Pathways

  • Horizontal Bone Loss Pathway

    • Inflammation spreads through connective tissue to bone and periodontal ligament (PDL).
    • Results in a horizontal pattern of bone loss.
  • Vertical Bone Loss Pathway

    • Inflammation spreads differently, through weakened periodontal ligament fibers.
    • Associated with occlusal trauma (e.g., grinding, clenching).
    • Progressive and less favorable due to pre-existing PDL weakness.
    • Leads to a diagonal pattern of bone loss.

Conclusion

  • Maintaining bone health is crucial to prevent tooth loss.
  • Regular dental hygiene and addressing habits like grinding are vital to prevent progression of bone loss.