Alveolar bone loss in adults as assessed on panoramic radiographs. (II) Multilevel models

The aim of this study was to delineate factors influencing the severity of bone loss in randomly selected orthopantomograms of adult patients seeking treatment by the dental service of the German Armed Forces. A total of 240 panoramic exposures was available for analysis, 60 in each of the age groups <30, 30–39, 40–49, and ≥50. For each tooth, distances between the coronal landmark (CL) cemento-enamel junction or margin of restoration, and alveolar crest (AC), and bone level (BL) were measured with a calliper to the nearest 0.1 mm. Multilevel models revealed that bone levels decreased by 0.05 mm each year of life, on average. Bone loss was more pronounced in the maxilla, especially at molars. Infrabony lesions were strongly associated with deficient restorations and periapical lesions. Periapical pathology was also associated with radiographic evidence for furcation involvement. In this predominantly male population, periodontal bone loss gradually increased with age, but prevalence of infrabony defects was very low. Multilevel modelling indicated strong associations between infrabony defects and insufficient restorations and periapical pathology.