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.