2024 BOH1: Radiology and Bone Loss
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Questions and Answers

Which of the following best describes horizontal bone loss?

  • An even reduction in bone height along the tooth root surface. (correct)
  • Localized areas of bone loss around furcations of multi-rooted teeth.
  • Bone loss that affects only the facial aspects of teeth.
  • Bone loss occurring in a vertical plane without changes in the horizontal dimension.

    • What is a key characteristic of vertical bone loss?

  • Causes symmetrical loss of bone around all teeth.
  • Usually leads to more significant tooth mobility. (correct)
  • Only impacts the buccal side of the tooth.
  • Is typically a result of periodontal disease only in the anterior region.

    • Which factor is commonly associated with furcation involvement?

  • Absence of periodontal pockets.
  • Uniform bone loss around the tooth structure.
  • Presence of local irritating factors like plaque or calculus. (correct)
  • Healthy gingival tissue surrounding the tooth.

    • Which of the following is considered a local irritating factor in periodontal disease?

    <p>Presence of calculus and plaque on tooth surfaces.</p> Signup and view all the answers

    What is a recommended diagnostic imaging technique in evaluating bone loss?

    <p>A thorough clinical examination followed by targeted radiographs only if necessary.</p> Signup and view all the answers

    What type of radiograph is indicated if a periodontal/endodontic lesion is suspected?

    <p>A periapical radiograph using a paralleling technique</p> Signup and view all the answers

    Which diagnostic imaging technique is sufficient to assess the periodontal support of all teeth?

    <p>An optimal-quality panoramic radiograph</p> Signup and view all the answers

    What is the main advantage of using a panoramic radiograph with supplementary periapical radiographs?

    <p>To obtain a comprehensive view of lesions not visible in a standard radiograph</p> Signup and view all the answers

    What is often a local irritating factor in periodontal disease?

    <p>Calculus or plaque accumulation</p> Signup and view all the answers

    Which condition can be assessed using a periapical radiograph?

    <p>Furcation involvement</p> Signup and view all the answers

    What characterizes vertical bone loss in periodontal conditions?

    <p>Localized loss of bone along the root of a tooth</p> Signup and view all the answers

    What distinguishes horizontal bone loss from vertical bone loss?

    <p>Horizontal bone loss occurs uniformly across multiple teeth</p> Signup and view all the answers

    What factor is important to consider when deciding on diagnostic imaging methods?

    <p>Patient age and the presence of systemic diseases</p> Signup and view all the answers

    Which type of bone loss is characterized by horizontal patterns at the coronal, mid, and apical thirds of the root length?

    <p>Horizontal bone loss</p> Signup and view all the answers

    What type of vertical bone defect is also referred to as craters?

    <p>Two-walled defects</p> Signup and view all the answers

    Which local irritating factor is commonly associated with periodontal disease?

    <p>Overextended restorations</p> Signup and view all the answers

    When is it recommended to use bitewing radiographs?

    <p>With mild to moderate bone loss</p> Signup and view all the answers

    How is furcation involvement classified at an early stage?

    <p>Early involvement</p> Signup and view all the answers

    What is the maximum extension of horizontal bone loss designated within the coronal third?

    <p>Coronal 1/3 of root length</p> Signup and view all the answers

    What diagnostic imaging technique overcomes the limitations of 2D radiographs in assessing complex periodontal conditions?

    <p>Cone beam CT (CBCT)</p> Signup and view all the answers

    Which classification applies to horizon bone loss measured as up to 6mm or more?

    <p>BPE of 4</p> Signup and view all the answers

    What percentage of root length does vertical bone loss primarily affect?

    <p>33%</p> Signup and view all the answers

    What is a common cause of localized bone loss in periodontal conditions?

    <p>Food impaction</p> Signup and view all the answers

    In relation to periodontal disease, what do local irritating factors commonly include?

    <p>Plaque and calculus</p> Signup and view all the answers

    Which method is not routinely indicated for imaging periodontal bone support?

    <p>Cone beam CT</p> Signup and view all the answers

    What type of periodontal bone loss can be categorized as affecting specific pockets without being generalized?

    <p>Localized bone loss</p> Signup and view all the answers

    How can periodontal disease be tailored based on the classification of bone loss?

    <p>Employing strategies for vertical and localized patterns</p> Signup and view all the answers

    Study Notes

    University of Sydney Acknowledgement

    • Acknowledges the traditional custodianship and laws of the Country on which the University campuses stand
    • Pays respects to those who have cared and continue to care for Country

    2024 BOH1: Radiology and Periodontal Patterns of Bone Loss

    • Presentation by Eduardo Delamare BDS, MSc (DMFR)
    • Email: [email protected]
    • Contributors: Dr Antonia Scott and Dr Malcolm I Coombs

    Adult Patient: History and Examination

    • Complete a thorough history and clinical examination of the tooth-bearing areas before taking any radiographs
    • Seek originals or copies of radiographs taken elsewhere, if relevant
    • Do not perform screening or routine radiographs.
    • Avoid taking new radiographs without examining existing ones.
    • Avoid panoramic radiographs for all patients
    • Do not use a single protocol for all patients

    Reading Radiographic Images

    • Angulation (horizontal, vertical)
    • Orientation
    • Soft tissue shadows
    • Magnification

    Periodontal Conditions

    • Indications for intraoral radiographs:
      • Bone level assessment
      • Alveolar crest condition
      • Furcation area bone loss
      • Periodontal ligament width
      • Local irritating factors increasing periodontal disease risk (e.g., calculus)
      • Poorly contoured or overextended restorations
      • Analysis of root length and morphology/crown-to-root analysis
      • Open interproximal contacts (potential food impaction)
      • Maxillary sinus position relative to periodontal deformity
    • Prescription of radiographs: Bisecting vs Paralleling in Periodontics
    • Periodontal Patterns of Bone Loss

    Periodontal Classification (Table 20.1)

    • Categorizes periodontitis based on several criteria (stage, severity, complexity)
    • Includes I, II, III, and IV stages, considering radiographic bone loss, probing depths and complexities of different types of bone loss (e.g., Maximum probing depth, horizontal bone loss)

    Periodontal Conditions: Recommendations

    • Generalized pocketing (up to 4-5mm or greater than 6mm)
    • Horizontal bitewings
    • Periapicals with paralleling technique (or vertical bitewings)
    • Health vs Affected X-rays (identification of affected vs healthy teeth)
    • Localized vs Generalized Patterns
    • Types of bone loss (horizontal, vertical, furcation involvement)

    Periodontal Patterns of Bone Loss: Horizontal Bone Loss

    • Extension: coronal 1/3, mid 1/3, apical 1/3
    • Health vs. Coronal 1/3 (identification of bone loss in coronal 1/3 of the tooth)

    Periodontal Patterns of Bone Loss: Vertical Bone Defects

    • Types: three-walled, two-walled (craters)*

    Periodontal Patterns of Bone Loss: Vertical Bone Loss

    • One-walled (description)

    Periodontal Patterns of Bone Loss: Furcation Involvement

    • Early vs Moderate/Severe

    Periodontal Patterns of Bone Loss: Local Irritating Factors

    • Calculus
    • Defective restorations

    Prescription of Diagnostic Imaging

    • Bitewings
    • Vertical bitewings
    • Periapical radiographs (paralleling)
    • OPG (overview of teeth)
    • CBCT (Cone Beam CT) scanning

    Periodontal Conditions: Recommendations

    • CBCT not routinely used for periodontal bone support
    • Periapical with Paralleling for indicated lesions
    • Panoramic, supplementary periapicals, or complete series of periapicals for comprehensive assessments

    Periodontal Conditions: Contact Information

    • Eduardo Delamare (email)
    • Shwetha Hegde (email)

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    Description

    This quiz focuses on the principles of radiology in relation to periodontal patterns of bone loss. It emphasizes the importance of history-taking, clinical examination, and proper radiographic interpretation. Ideal for dental professionals engaged in the assessment of adult patients.

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