The morphological characteristics of periodontal tissue in periodontal disease have been interpreted differently by a number of clinical observers. Many have reported that the malposition and functional malocclusion of teeth is injurious to the periodontium. We reported in Part I that a system for evaluating periodontal status was developed for the diagnosis and management of the interproximal area at the initial stage of bone resorption. The patient group consisted of 36 adults, from 21 to 55 years of age. The severity score represented the calculated loss of periodontal support tissues: loss of alveolar bone, evaluated roentgenologically, bone level and pattern in vertical and horizontal form, periodontal pocket and gingival inflammation. Because poor oral hygiene and other factors caused swelling by gingival inflammation, we obtained study specimens from patients with chronic periodontal disease after a few tooth brushing instructions, and scalings during initial therapy in order to detect initial and established pathological changes in periodontal tissue.
The purpose of this study was to clarify the relationship between periodontal disease status and morphological diagnostic indicators and different degrees of harmony and disharmony in the lower jaw. In all age groups the average percentage of bone loss and intraosseous defects tended to be higher in the groups categorized as Type III and Type F, and in the area that showed a very deep concave Spee curve to the occlusal plane in Pattern D.
We considered that these morphological characteristics might be of secondary importance for diagnosis. Oral local factors were the primary extrinsic factor in the pathogenesis of horizontal and vertical interproximal bone absorption in the area of the premolars and molars.
