Horizontal alveolar bone loss: A periodontal orphan

Abstract

Background:Attempts to successfully regenerate lost alveolar bone have always been a clinician’s dream. Angular defects, at least, have a fairer chance, but the same cannot be said about horizontal bone loss. The purpose of the present study was to evaluate the prevalence of horizontal alveolar bone loss and vertical bone defects in periodontal patients; and later, to correlate it with the treatment modalities available in the literature for horizontal and vertical bone defects.Materials and Methods:The study was conducted in two parts. Part I was the radiographic evaluation of 150 orthopantomographs (OPGs) (of patients diagnosed with chronic periodontitis and seeking periodontal care), which were digitized and read using the AutoCAD 2006 software. All the periodontitis-affected teeth were categorized as teeth with vertical defects (if the defect angle was ≤45° and defect depth was ≥3 mm) or as having horizontal bone loss. Part II of the study comprised search of the literature on treatment modalities for horizontal and vertical bone loss in four selected periodontal journals.Results:Out of the 150 OPGs studied, 54 (36%) OPGs showed one or more vertical defects. Totally, 3,371 teeth were studied, out of which horizontal bone loss was found in 3,107 (92.2%) teeth, and vertical defects were found only in 264 (7.8%) of the teeth, which was statistically significant (P<.001). Search of the selected journals revealed 477 papers have addressed the treatment modalities for vertical and horizontal types of bone loss specifically. Out of the 477 papers, 461 (96.3%) have addressed vertical bone loss, and 18 (3.7%) have addressed treatment options for horizontal bone loss. Two papers have addressed both types of bone loss and are included in both categories.Conclusion:Horizontal bone loss is more prevalent than vertical bone loss but has been sidelined by researchers as very few papers have been published on the subject of regenerative treatment modalities for this type of bone loss. This study should be an impetus for greater attention to an otherwise ubiquitous periodontal challenge.

The occurrence of dental caries is associated with atherosclerosis

“…These measurements are inferior to surgical measurements of alveolar bone height and clinical attachment measurements because they underestimate the extent of periodontitis compared with other methods (28). Accordingly, the extent of periodontitis in this study was underestimated (6,29). The sum of the maximum distances from the selected incisal points to the alveolar crest at 10 representative locations for visualizing the horizontal bony defect in the upper and lower jaw (30) and the sum of the bone heights at these locations were significantly correlated with the extent of the atherosclerotic burden.…”

Treatment of Supra‐Alveolar‐Type Defects by a Simplified Papilla Preservation Technique for Access Flap Surgery With or Without Enamel Matrix Proteins

“…In this regard, it should be noted that horizontal alveolar bone loss is a problem that periodontists often face; in fact, in a radiographic study, Jayakumar et al 31 reported that horizontal bone loss represents 92% of the total bone loss from periodontal patients. Conversely, the prevalence of intrabony defects has been shown to be significantly lower, ranging from 8% to 30.2% 32‐34 …”

The relationship between root concavities in first premolars and chronic periodontitis

“…Chronic periodontal disease has been reported to cause structural changes in normal alveolar bone, which results in different forms and varying degrees of alveolar bone defect seen in different parts of the same tooth. In our study, we analyzed the effect of root concavities on defects seen in the first premolar interproximal bone using CBCT scanning.…”