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Periodontitis and angular alveolar lesions: a critical distinction
1Department of Dentistry, University of Adelaide, South Australia.
Oral Surgery, Oral Medicine, and Oral Pathology
|May 1, 1990
Summary
Periodontitis incidence is low, and plaque/gingivitis don't strongly correlate with bone loss. The cementoenamel junction to alveolar crest (CEJ-AC) distance is influenced by tooth wear and facial growth, not solely disease.
Area of Science:
- Anthropology
- Epidemiology
- Periodontology
Background:
- Modern studies indicate a low incidence of periodontitis across populations.
- Plaque and gingivitis show minimal correlation with pathological alveolar bone loss or periodontitis.
- The significance of cementoenamel junction to alveolar crest (CEJ-AC) distance is often misinterpreted.
Purpose of the Study:
- To re-evaluate the diagnostic criteria for periodontitis.
- To investigate the relationship between CEJ-AC distance and physiological factors.
- To explore alternative explanations for localized angular bone loss.
Main Methods:
- Review of anthropologic and epidemiologic data.
- Analysis of anatomical, physiological, and pathological factors influencing CEJ-AC distance.
- Comparison of conventional periodontitis hypotheses with pulpal-alveolar explanations.
Main Results:
- The incidence of periodontitis is consistently low.
- CEJ-AC distance is influenced by continuous eruption compensating for tooth wear and facial growth.
- Gingivitis-induced horizontal periodontitis is typically minor and linked to diminished host defenses.
- A pulpal-alveolar etiology is proposed for angular bone lesions.
Conclusions:
- The 2mm threshold for CEJ-AC distance as indicative of disease is questionable.
- Physiological factors significantly impact CEJ-AC measurements, independent of periodontal disease.
- Localized angular bone loss may stem from pulpal-alveolar issues rather than primary periodontal infection.