Periodontal radiographic assessment: Horizontal bone loss and Vertical bone defects 4


This week is all about the basics of horizontal bone loss and vertical bone defects on radiographs.

Horizontal Bone Loss

When identifying horizontal bone loss you must first go through the same steps of evaluating normal bone appearances (last weeks post).  The two lines (adjacent cemento-enamel junctions and crest of the alveolar ridge) will still be parallel.

periodontal assessment horizontal bone level bitewing with animationsThe only difference for horizontal bone loss is that the crest of the alveolar ridge is more than 2 mm apical from the cemento-enamel junction.

periodontal assessment horizontal bone level bitewingVertical Bone Defects

Vertical bone defects present when the line from the adjacent cemento-enamel junctions and the line of the crest of the alveolar ridge are NOT PARALLEL.  The vertical bone defect is typically described by the tooth and surface where more bone loss is evident.

periodontal assessment vertical bone defect with animation

periodontal assessment vertical bone defectIf you note the bone between the mandibular second and third molar appears to have two different crests seen.  This is an example of cortical plate loss which will be covered next week. 😀

Next week: Cortical plate loss and furcation involvement

If you have any questions or comments, please leave them below. Thanks and enjoy!



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