Changes In Alveolar Bone Height Research Articles

Detection of active alveolar bone destruction in human periodontal disease by analysis of radiopharmaceutical uptake after a single injection of 99m-Tc-methylene diphosphonate.

Previous studies have shown that, following a single injection of 99m‐Tc‐MDP, measurement of bone‐seeking radiopharmaceutical uptake can detect “active” alveolar bone loss due to periodontal disease in beagle dogs, as determined by radiographs taken at the time of, and several months after, the nuclear medicine procedure. The efficacy of this diagnostic test. however, had not been assessed in human periodontal disease. The ability of a single bone‐seeking radiopharmaceutical uptake examination to detect “active” alveolar bone loss due to periodontal disease in human patients was assessed by comparing a single uptake measurement to the rate of bone loss determined from serial radiographs taken over a 6‐month period. Uptake was expressed as a ratio of the cpm from the alveolar bone divided by the cpm from the non‐tooth supporting bone of the nuchal crest. High uptake ratios were associated with “active” loss and low uptake ratios were associated with little if any change in alveolar bone height (p < 0.001). The nuclear medicine examination was an accurate detector of periodontal disease activity in nearly 80% of the individual teeth studied. These data indicate that high bone‐seeking radiopharmaceutical uptake ratios may be pathognomonic of active bone loss in human periodontal disease.

A radiographic method for assessing changes in alveolar bone height following periodontal therapy.

A method is described for obtaining reproducible radiographs of several groups of teeth in the same jaw. The method was applied to assess changes in the alveolar bone height following periodontal treatment. An oral device was designed to permit direction of the central rays of the beam perpendicularly to the alveolar process in different parts of the jaws. The exposures were made at 60 kVp and 10mA, and standardized procedures were used for developing, fixing and rinsing the films. Alterations in the marginal alveolar bone level were determined in a stereocomparator system. The reproducibility of the method was determined. A pilot experiment was performed on 5 patients with periodontal disease. Following conservative treatment, including scaling and root planning, all patients were subjected to periodontal surgery, including alveolar bone denudation. Radiographs of the alveolar bone were obtained before and 2 months after the operation. By measuring in the stereocomparator parallaxes of both control points and points of the alveolar bone crest on paired radiographs, a mean decrease in interproximal alveolar bone height of 0.69 mm was found. Taking into account the small errors which are inherent in the method, this change in bone height could be regarded as a reliable measure of actual loss of bone.