Classification of alveolar bone destruction patterns on maxillary molars by using cone-beam computed tomography

Area of Science:

• Periodontology and Dental Imaging

Background:

• Accurate diagnosis of alveolar bone defects is critical for selecting appropriate periodontal treatments and preventing tooth loss.
• The maxillary molar region presents unique challenges for dental implant applications due to complex anatomical structures.

Purpose of the Study:

• To classify alveolar bone defects in the maxillary molar region.
• To determine the prevalence of different types of periodontal bone defects using cone-beam computed tomography (CBCT).

Main Methods:

• Investigated alveolar bone patterns and furcation areas of 669 maxillary molars from 243 patients with periodontal bone loss.
• Classified bone defects into six main groups, also reporting combined periodontal-endodontic lesions (CPELs).
• Utilized cone-beam computed tomography (CBCT) for detailed imaging and analysis.

Main Results:

• After excluding CPELs, horizontal bone defects were most prevalent (71.4%).
• Three-walled vertical bone defects were least common (1.9%).
• Osseous craters, dehiscence, and fenestration were observed at 6.7%, 2.7%, and 3.3% respectively. Furcation involvement was absent in 61.4% of teeth, with Grade-II involvement at 26.2%.

Conclusions:

• Accurate imaging of periodontal defect morphology, particularly with CBCT, aids in selecting optimal treatment strategies.
• CBCT provides comprehensive data on alveolar bone structures in the maxillary molar region.
• This detailed understanding may help avoid dental implants in favor of more conservative treatments.