PDF: Effects of Nonsurgical Periodontal Treatment on the Alveolar Bone Density

The aim of this study was to evaluate the effects of nonsurgical periodontal treatment on alveolar bone density (ABD) and bone height (BH) using direct digital radiography.


Nineteen patients (mean age: 36±7.3 years) with generalized chronic periodontitis were examined at baseline, 90 (90AT) and 180 (180AT) days after nonsurgical periodontal therapy. Radiographs were taken from two sites with specific characteristics: 39 sites with probing pocket depth (PPD)≤3 mm and clinical attachment level (CAL)≤1 mm (shallow sites); and 62 sites with PPD≥5 mm and CAL≥3 mm (deep sites).

The ABD was assessed considering the bone regions of interest at the alveolar bone crest (ROI I) and at the medullar bone (ROI II). The BH was assessed considering the distance from the alveolar bone crest to the cementoenamel junction. Mann-Whitney test was used for the overall demographic data, Wilcoxon test was used to compare the baseline, 90AT and 180AT data as well as to compare the groups and subgroups within the same evaluation period. The significance level was set at 5%.

Periodontitis is characterized by a hyperreactive inflammation against a bacterial load in the gingival sulcus. Such inflammation leads to an irreversible tissue destruction characterized by collagen destruction, alveolar bone loss and consequently an apical migration of the junctional epithelium. Although several studies have analyzed the clinical improvements after periodontal therapy, information about changes in the alveolar bone density (ABD) are very scarce.

Bone is a dynamic tissue undergoing constant remodelling. In healthy adults, maintenance of bone mass is achieved by coupling the bone formation and bone resorption processes, named bone turnover, and indicates the mineralization degree of the alveolar bone tissues. The risk factor for alveolar bone loss and alteration of ABD is based on the deficit in bone turnover.

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