Change In Bone Score Research Articles

Longitudinal study on the distribution of proximal sites showing significant bone loss.

In 1973, a random sample of 574 dentate individuals aged 15, 20, 30, 40, 50, and 60 years in the city of Jönköping, Sweden, were examined clinically and radiographically to assess oral health and overall treatment needs. Periodontal examination included registration of plaque, gingivitis, probing depths at four aspects of each tooth, and interproximal bone height measurements on full-mouth intraoral radiographs. In 1990, 17 years later, the same individuals were invited to participate in a new investigation. Of these, 433 (75%) agreed to participate in the investigation and were re-examined (Hugoson & Laurell 2000). The proximal alveolar bone height at all interproximal sites was measured and expressed as per cent of tooth length. Only teeth that were present in both 1973 and 1990 were included in the assessment of changes in bone score. From the age of 30 years, about 80% of the population had one or more sites with a bone loss of 2-3 mm or more. Seventeen per cent of the individuals had more than six such sites, indicating destructive periodontal disease. Bone loss occurred at sites both with and without previous bone loss. The present study was undertaken to test the hypothesis that sites with a bone loss of 10% or more of the tooth length (2-3 mm) during the 17 years were randomly distributed in the dentition. Of the 13,197 sites examined in individuals 20-60 years at baseline, 1201 sites (9.0%) in 998 teeth with a bone loss corresponding to 10% or more of the tooth length were found and included in the analysis. A probability test for binomial distribution was used to test the null hypothesis that all teeth had the same risk of losing bone regardless of its position in the dentition. The valid risk for each tooth was 3.571% and the null hypothesis was rejected at the 95% confidence interval. Although all tooth types were affected by tooth loss, some teeth, namely 17, 16, 42, 41, and 31, showed a higher incidence of sites losing bone, whereas 46, 45, 44, and 36 had a lower incidence. Loser sites in smokers appeared more at random. Sites that will develop periodontal break-down over time may appear at random, although with higher risk at maxillary molars and lower incisors. For the early detection of destructive periodontitis, periodontal examination that includes all teeth should be made routine in every dental check-up.

Glycemic control and alveolar bone loss progression in type 2 diabetes.

This study tested the hypothesis that the risk for alveolar bone loss is greater, and bone loss progression more severe, for subjects with poorly controlled (PC) type 2 diabetes mellitus (type 2 DM) compared to those without type 2 DM or with better controlled (BC) type 2 DM. The PC group had glycosylated hemoglobin (HbA1) > or = 9%; the BC group had HbA1 < 9%. Data from the longitudinal study of the oral health of residents of the Gila River Indian Community were analyzed. Of the 359 subjects, aged 15 to 57 with less than 25% radiographic bone loss at baseline, 338 did not have type 2 DM, 14 were BC, and 7 were PC. Panoramic radiographs were used to assess interproximal bone level. Bone scores (scale 0-4) corresponding to bone loss of 0%, 1% to 24%, 25% to 49%, 50% to 74%, or > or = 75% were used to identify the worst bone score (WBS) in the dentition. Change in worst bone score at follow-up, the outcome, was specified on a 4-category ordinal scale as no change, or a 1-, 2-, 3-, or 4-category increase over baseline WBS (WBS1). Poorly controlled diabetes, age, calculus, time to follow-up examination, and WBS1 were statistically significant explanatory variables in ordinal logistic regression models. Poorly controlled type 2 DM was positively associated with greater risk for a change in bone score (compared to subjects without type 2 DM) when the covariates were included in the model. The cumulative odds ratio (COR) at each threshold of the ordered response was 11.4 (95% CI = 2.5, 53.3). When contrasted with subjects with BC type 2 DM, the COR for those in the PC group was 5.3 (95% CI = 0.8, 53.3). The COR for subjects with BC type 2 DM was 2.2 (95% CI = 0.7, 6.5), when contrasted to those without type 2 DM. These results suggest that poorer glycemic control leads to both an increased risk for alveolar bone loss and more severe progression over those without type 2 DM, and that there may be a gradient, with the risk for bone loss progression for those with better controlled type 2 DM intermediate to the other 2 groups.

Non-insulin dependent diabetes mellitus and alveolar bone loss progression over 2 years.

This study tested the hypothesis that persons with non-insulin dependent diabetes mellitus (NIDDM) have greater risk of more severe alveolar bone loss progression over a 2-year period than those without NIDDM. Data from the longitudinal study of the oral health of residents of the Gila River Indian Community were analyzed for 362 subjects, aged 15 to 57, 338 of whom had less than 25% radiographic bone loss at baseline, and who did not develop NIDDM nor lose any teeth during the 2-year study period. The other 24 subjects had NIDDM at baseline, but met the other selection criteria. Bone scores (scale 0-4) from panoramic radiographs corresponded to bone loss of 0%, 1%-24%, 25%-49%, 50%-74%, or 75% and greater. Change in bone score category was computed as the change in worst bone score (WBS) reading after 2 years. Age, calculus, NIDDM status, time to follow-up examination, and baseline WBS were explanatory variables in regression models for ordinal categorical response variables. NIDDM was positively associated with the probability of a change in bone score when the covariates were controlled. The cumulative odds ratio for NIDDM at each threshold of the ordered response was 4.23 (95% C.I. = 1.80, 9.92). In addition to being associated with the incidence of alveolar bone loss (as demonstrated in previous studies), these results suggest an NIDDM-associated increased rate of alveolar bone loss progression.