Factors Determining Bone Morphology In Periodontal Disease

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Normal Variation in Alveolar Bone

Considerable normal variation in the morphologic features of alveolar bone exists (see Chapter 2), which affects the osseous contours produced by periodontal dis ease. The anatomic features that substantially affect the bone destructive pattern in periodontal disease include the following:

• The thickness, width, and crestal angulation ot the interdental septa

• The thickness ol the facial and lingual alveolar plates

• The presence of fenestrations, dehiscences) or both

• I he alignment of the teeth

• Root and root trunk anatomy

• Root position within the alveolar process

• Proximity with another tooth surface

For example, angular osseous defects cannot form in thin facial or lingual alveolar plates, which have little or no cancellous bone between the outer and inner cortical layers. In such instances the entire crest ol the plate is destroyed, and the height of the bone is reduced d ig. 23-10).

Exostoses

Exostoses are outgrowths of bone ol varied size and shape. Palatal exostoses have been found in 40% of human skulls."' They can occur as small nodules, large nodules, sharp ridges, spike-like projections, or any combination of these (see I ig. 23-20). I xostoses have been described in rare cases «is developing after the placement of free gingival grafts.™

Labial View Lower Incisor
Fig. 23-10 A, A lower incisor with thin labial bone, thicker bone in apical areas. B, Upper molars with Ihn cor. C, Upper molar with a thick facial bone, allowing I
Vertical Bone Loss Periodontal
Bone loss can become vertical only when it reaches facial bone, where only horizontal bone loss can oc )r vertical bone loss.
Buttressing Bone Formation

Fig. 23 11 Lipping «>! lacial bone A, Peripheral buttressing bone formation along the external surface ol the facial bony plate and al the crest. Note the deformity in the bone produced by the buttressing bone formation and the bulging of the mucosa B, Detailed view showing lipping and deformity produced by but tressing bone lormation.

Fig. 23 11 Lipping «>! lacial bone A, Peripheral buttressing bone formation along the external surface ol the facial bony plate and al the crest. Note the deformity in the bone produced by the buttressing bone formation and the bulging of the mucosa B, Detailed view showing lipping and deformity produced by but tressing bone lormation.

Trauma from Occlusion

Trauma from occlusion may be a factor in determining the dimension and shape of bone deformities. It may cause a thickening ol the cervical margin of alveolar bone or a change in the morphology of the bone (e.g., angular defects and buttressing bone |sce following dis-cussionl) on which inflammatory changes will later be superimposed.

Buttressing Bone Formation (Lipping)

Hone formation sometimes occurs in an attempt to buttress bony trabeculac weakened by resorption. When it occurs within the jaw, it is termed central buttressing bone formation. When it occurs on the external surface, it is referred to «is peripheral buttressing bone formation.11 The latter may cause bulging of the bone contour, termed lipping, which sometimes accompanies the production of osseous craters and angular detects (Pig. 23-1 I).

Food Impaction

Interdental bone defects often occur where proximal contact is abnormal or absent. Pressure and irritation from food impaction contribute to the inverted hone architecture. In some instances the poor proximal relationship may be the result of a shift in tooth position because of extensive bone destruction preceding food

Hone Loss and PutUrm of Horn Diminu tion ■ (II \TI I K 2.\

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Responses

  • Kiros
    What causes buttressing bone?
    8 years ago
  • jessica
    How is bony buttress formed?
    8 years ago
  • honey
    What factors determine the shape of a bone?
    6 years ago
  • orlando
    What determine morphlogy of gingival graft?
    6 years ago
  • Maura
    What are the causes of bone lipping in periodontics?
    3 years ago

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