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PERIODONTAL ATTACHMENT LOSS
Basic Periodontal Pathology
Schematic illustration of the anatomy of periodontal destruction on a single rooted tooth. The extent of destroyed periodontal attachment varies from surface to surface and the borderline between the normal and diseased parts is very irregular with destructions extending in all directions on the root.
Bucco-lingual section of the periodontium in a molar tooth of a dog with naturally occurring periodontal disease. The junctional epithelium is located onto the root cementum. Apically to the termination of the junctional epithelium the connective tissue attach and further apically the pocket epithelium and attachment loss reappear. The reason for this varying pattern of periodontal destruction is the occurrence of lateral spread of the lesion from neighboring areas of subgingival infection.
Schematic illustration of the spreading mechanisms of periodontal destruction. Subgingival bacteria spread in all directions by their proliferation which is determined by the efficacy of the defence mechanisms. The radial spread of the periodontal lesions result in various small micro destructions which do not become clinically notable until a greater area has been involved and can be diagnosed by the clinical probing or by the analysis of radiographic images.
Macroscopic anatomy of periodontal destruction on the mesio-buccal surface of an upper right central tooth. The flap has been raised to the mucogingival line and a large defect is disclosed. On the mesial surface the defect include an intraosseous destruction with one remaining bony wall. On the buccal surface of the tooth the intraosseous defect is rather shallow and around 1 mm deep. The root surface on the buccal and mesial sites is uneven with numerous pits and furrows. These anatomical defects have probably contributed to the colonization pattern of the subgingival bacteria.
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