The angular bony defect in the maintenance of the periodontal patient

The present retrospective study was performed to evaluate some long-term alterations of the alveolar bone level at periodontal sites with angular and even ("horizontal") patterns of bone loss. The investigation included 48 patients who, following treatment for advanced periodontal disease, were placed in a maintenance care program which included recall appointments every 3-6 months for a period of 5 to 16 years. The material of the study comprised all teeth at which angular osseous defects (test sites) could be detected in a full-mouth series of radiographs obtained at the end of the active treatment phase. Alterations in the position of the marginal alveolar bone crest and the base of the osseous defect which took place during the maintenance period were assessed by comparing the post-treatment radiographs with a 2nd set of radiographs obtained at the final examination. In the same patients, an equal number of contralateral or neighboring teeth at which bone loss in the radiographs had an even or "horizontal" character were included as controls. The results from the assessments demonstrated that periodontal sites which, following active therapy displayed either angular or "horizontal" patterns of alveolar bone loss underwent, during a 5-16 year period of maintenance, only minor bone level alterations. Additional loss of supporting bone occurred equally frequently at sites with "horizontal" and angular patterns of bone loss. Thus, the findings reported failed to show up sites with angular bony defects as being particularly susceptible to recurrent destructive periodontitis.