Horizontal Alveolar Bone Loss and Vertical Bone Defects in an Adult Patient Population

Abstract

The objectives of the present investigation were to analyze intraoral radiographs and to study 1) the distribution of the distance between the cemento-enamel junction (CEJ) and the alveolar bone level (BL) and 2) the prevalence and severity of vertical defects, and furcation lesions in 416 individuals seeking dental care. Full mouth radiographs were enlarged 7.5 times and the mesial and distal distances between CEJ and bone level were measured. The extent of interradicular molar radiolucencies was also measured. Images of 10,282 teeth were studied. Subjects were between 15 to 94 years (mean age: 47.2, S.D.+/-15.2). On average they had 24.8 teeth (S.D.+/-5.5). The mean distance CEJ-BL increased significantly up to age 45 (r2=0.07; beta=0.29; P < 0.0001) and remained stable thereafter r2=0.09, beta=-0.02, N.S.). The mean distance CEJ-bone level was 1.4 mm (S.D.+/-0.7) in the 15 to 24 age group; 3.0 (S.D.+/-1.5) in the 45 to 54 age group; and 3.02 (S.D.+/-1.4) in the 75 to 94 age group. No vertical defects were found in 163 participants (39.3%); vertical defects > or = 3.0 mm were found in 30.2% (126). Mesial defects were significantly more common that distal defects (P < 0.001). The extent of horizontal bone loss was correlated to extent of vertical defects (r2=0.88; P < 0.0001). The number of remaining teeth was not associated with horizontal or vertical bone loss. In conclusion, the study indicated that few of the individuals had extensive horizontal bone loss. Vertical defects suitable for guided tissue regeneration procedures however, were found in many patients.

Cone beam computed tomography evaluation of distance from cementoenamel junction to alveolar crest before and after nonextraction orthodontic treatment

“…5 The same procedures were repeated to measure the CBCT scans obtained after orthodontic treatment, using axial, sagittal, and coronal sections and the criteria described above.…”

“…1 Increased distances from the cementoenamel junction to the bone crest may be indicative of alveolar bone dehiscence, [2][3][4] and Persson et al 5 and Baysal et al 6 adopted this classification when this distance is greater than 2 mm. Alveolar bone dehiscence that results from orthodontic movement may be either not clinically evident or clearly identified as extensive gingival recession that compromises esthetics and tooth sensitivity.…”

“…7,8 The thicker the periodontium, the less likely that clinical changes will be found in the alveolar bone. 5,8 Size and position of the teeth, alveolar bone thickness, and orthodontic movement may affect the onset of dehiscence. 9,10 Movement direction, as well as frequency and magnitude of forces applied during orthodontic treatment, may also contribute to its occurrence.…”

“…9,10 Movement direction, as well as frequency and magnitude of forces applied during orthodontic treatment, may also contribute to its occurrence. 2,5,7,8,11 According to several authors, 2,12,13 the morphology of the lingual and buccal bone plates should be determined before orthodontic treatment using radiographs to carefully plan treatment and to avoid the appearance of alveolar bone dehiscence or to minimize its frequency.…”

“…It provides images in which anatomical structures do not overlap, which ensures greater accuracy than two-dimensional radiographic images. [14][15][16] CBCT also provides buccal and lingual views of teeth in high resolution using less radiation and at a lower cost than conventional and multislice CT. 2,4,5,8,16 The high demand for orthodontic treatment in adult patients with periodontal disease has greatly stimulated research about periodontal health before treatment. 14,15 Alveolar bone dehiscence should be diagnosed before orthodontic treatment to minimize possible deterioration due to expansion, retraction, and buccolingual tooth inclination.…”