Alveolar bone levels in adults as assessed on panoramic radiographs. (I) Prevalence, extent, and severity of even and angular bone loss

There is limited information regarding the prevalence and intraoral distribution of infrabony lesions potentially suitable for regenerative procedures in common patients seeking regular dental care in a dental practice. The aim of the present study was to investigate the prevalence and extent of alveolar bone loss and infrabony defects in randomly selected orthopantomograms of adult patients in different age groups seeking treatment at the dental service of the German Armed Forces. A total of 240 panoramic exposures were available for analysis, 60 in each of the age groups <30, 30–39, 40–49, and ≥50 years of age. At each tooth, distances between the cementoenamel junction or margin of restoration and the alveolar crest as well as the bone level were measured with a calliper to the next 0.1 mm. Whereas virtually no bone loss was present in the youngest age group, a major change in bone level frequency distributions occurred after age 30 years. At age 50 years, about 50% of subjects had considerable bone loss of more than 4 mm at 10% or more sites, and 6 mm or more at about 5% sites. Deep infrabony defects were infrequently found before age 40 years. About 20% of patients at least 50 years of age had radiographic evidence of infrabony pockets of 4 mm or more at not more than 5% of sites. Bone loss was more pronounced in the maxilla, especially at molars. In this predominantly male population, periodontal bone loss gradually increased with age. However, prevalence of infrabony defects was very low.