Bone morphology and bone loss in periodontal disease

Abstract

A clinical study of the distribution of different types of bone defects in chronic periodontitis was carried out on 30 patients. An analysis of 176 defects suggests that their distribution reflects the original morphology of the alveolar bone. The role of function as a determinant of that morphology is examined. While there appears to be a relationship between functional stress and the phylogenesis of the bone, there is no direct relationship between function and ontogenesis. A study of growth remodelling of the mandible in several animals indicates that the pattern of activity is dictated by a drive to achieve a mature form which is the expression of the genetic endowment. Normal function and normal muscle stress are part of the environment in which complete growth can take place, but they do not appear to play a more active role in determining the form of growth; abnormal function does not allow normal growth to take place. The relationship between functional stress and the morphology and activity of the mature bone is not clear. Osteoporosis of age, as measured by the metacarpal index in 101 patients with chronic periodontitis, did not appear to be significantly related to the bone loss score. However, in 54 females patients, aged 35-45 years, a significant correlation was found between the metacarpal index and a "rapidity of bone loss" score.

Sex Steroid Hormones and Cell Dynamics in the Periodontium

“…Several cross-sectional studies have demonstrated decreased bone mass and density (Kribbs, 1990;Moshchil' etal, 1991), as well as reduced bone mineral content (von Wopwern, 1988) in edentulous mandibles of postmenopausal females. A variety of studies have attempted to provide insight into the relationship of osteoporosis to periodontitis, but the results of these studies have been equivocal (Groen et al, 1968;Phillips and Ashley, 1973;Ward and Manson, 1973;Manson, 1976;Baum, 1981;Daniell, 1983;Kribbs, 1990). To ascertain if osteoporosis is a risk factor for periodontal attachment loss in postmenopausal women, well-designed, long-term longitudinal investigations controlling for temporal period following the menopause, plaque levels, medications used (e.g., hormones, etc.…”

A study of the periodontal state of a late Medieval United Kingdom population

“…Alveolar crest bone loss may occur throughout life as a consequence of chronic inflammatory periodontal disease, resulting in root exposure and gingival recession (Manson, 1976). The distance from the cement enamel junction (CEJ) to alveolar crest (AC) has been widely used in order to measure the degree of alveolar bone loss.…”

Post-Extraction Remodeling of the Adult Mandible

“…(3.4.4) Periodontal disease Several workers have found a weak, sometimes indirect, correlation between skeletal bone status and periodontal disease (Phillips and Ashley, 1973;Manson, 1976;von Wowern et al, 1994). For example, patients who had suffered an osteoporotic fracture were found to have 0.8 mm more attachment loss per site (von Wowern et al, 1994), a small difference to be detected clinically.…”