Periodontics · patient case question
The radiograph of #29 shows caries at and below the cementoenamel junction, with localised bone loss. What is the cause of the bone loss?
Patient case: Post-restorative sensitivity in the mandibular right posterior sextant
Patient: Adult periodontal maintenance patient
Chief complaint: Sensitivity after restorations were placed in teeth #28 and #29.
Background: Controlled periodontal patient. The restorations were well executed.
Current findings: Gingival recession of 3 mm and bone loss. Radiographs of the region are provided.
Show answer and explanation
Correct answer: B. The caries and its associated local inflammation
- A. Occlusal trauma alone widens the periodontal ligament space but does not by itself cause attachment loss without inflammation.
- B. A carious lesion extending to and below the CEJ acts as a persistent plaque-retentive factor and a direct source of local inflammation, driving localised crestal bone loss in that interproximal site.
- C. Endodontic pathology produces a PERIAPICAL radiolucency at the root apex, not crestal bone loss at the CEJ. The described lesion is cervical.
- D. A vertical root fracture classically gives a J-shaped or halo radiolucency tracking along the root, which is not described here.