Casey type 0
Normal healthy - NO bone loss
Case type I
Gingivitis - NO bone loss
Case type II
Early periodontitis - <20% bone loss
Case type III
Moderate periodontitis - 20-50% bone loss
Case type IV
Advanced periodontitis ->50% bone loss
Case type V
Refractory periodontitis
Periodontal maintenance
Bone loss present with no active disease
Which two case types will look the same on x-rays and what must be done
0 and 1 - need to follow up with clinical examination
How do you read bone loss percentage
In a range of 5%
What is the reference point for interproximal bone loss
CEJ
Where does bone loss occur
1-2mm below CEJ
Occurs in a plane parallel to the CEJ of adjacent teeth
Horizontal bone loss
Occurs in an angular plane to the CEJ of adjacent teeth
Vertical bone loss
Vertical bone loss can be ______ or ______
Localized or generalized
In order to be vertical, the bone loss percentage must be at least ______% or case type ___
20%; III or IV
Base of the pocket is below the height of the alveolar crest
Infrabony
Base of the pocket is above the height of the alveolar crest
Suprabony
Infraobony is always ______
Vertical
Suprabony is always _______
Horizontal
How to determine bone loss
Find CEJ
Locate apex
Determine half way point
Determine a range of 5%
Determine case type/horizontal/vertical/etc.
Document the bone levels according to the amount that is _____
Lost
Radiolucent
Low density - shades of dark gray to black
Radiopaque
High density - shades of light gray to white
In health, where is the junctional epithelium
JE is coronal to CEJ
In health, gingival fibers are _____
Intact
In health, PDL fibers are ____
Intact
In health, alveolar bone is _____
Intact
In gingivitis, where is the junctional epithelium
JE is at CEJ
In gingivitis, gingival fibers are ____
Damaged
In gingivitis, PDL fibers are _____
Intact
In gingivitis, alveolar bone is ____
Intact
In periodontitis, where is the junctional epithelium
JE is apical to CEJ
In periodontitis, the gingival fibers are _____
Completely destructed
In periodontitis, the PDL fibers are____
Completely destructed and there is exposure of cementum
In periodontitis, the alveolar bone is _____
Completely destructed, along with interproximal bone and interradicular bone
Acute gingivitis
Lasts for a short period of time
Chronic gingivitis
Lasts for months or years
Periodontitis is characterized by
-Apical migration of the JE
-Loss of CT attachment
-Loss of alveolar bone
Gingivitis is characterized by
Changes in color, contour, consistency of gingival tissues
Gingivitis is ____
Reversible
Periodontitis is ____
Irreversible