Correlative Assessment of Interdental and Interradicular Bone Loss in Horizontal and Vertical Bone Defects In Chronic Periodontitis: A Clinical and Radiographic Study

Abstract

It is important  to treat periodontitis  before involvement  of furcation areas because of their complex anatomy and difficulty of access. Literature confirms  that it is difficult  to accurately  determine  the relationship  of the amount  of bone loss in the interdental  areas associated  with the interradicular areas and correlate  them with the clinical periodontal  status. The aim of this study was therefore  to assess the existence  of such an association,  if any, in subjects  with  chronic  periodontitis.  The  threshold  of  alveolar  bone  loss  associated  with  progression  of  periodontal  destruction  and  involvement  of interradicular   areas  of  the  furcations  is  not  clearly  defined  in  the  literature.  The  aim  of  this  study  was  to  investigate  a  correlation,  if  any  between interdental  and interradicular  bone loss and clinical parameters  in patients  with chronic periodontitis.  Periapical  (IOPA) radiographs  of mandibular  molars were obtained from 193 sites in 33 males and 21 females between the age group of 25 and 55 years having chronic periodontitis.  These were then scanned and digital measurement  of linear distances  was performed  using dicom software  of height and width of defect (horizontal  and vertical),  bone defect angle and interradicular  bone  loss.  These  measurements  were  correlated  to pocket  depth  (PD)  and  clinical  attachment  loss  (CAL)  using  One-way  ANOVA followed  by Tukeys  HSD post hoc tests. Bone height significantly  correlated  with probing  depth and CAL in horizontal  defects  (p<0.005)  with hardly any furcation  involvement  (1.55%)whereas both bone height and width showed significant  correlation  with probing depth and CAL in vertical defects(P<0.001) with nearly 77% of sites showing  furcation  defects.  A strong correlation  of clinical  parameters  with bone defect  dimensions  suggests  that early diagnosis and management  of interdental  bone loss may be critical to prevent furcation involvement.