MCQs 121 Periodontology Dr. Sin Sowatha 2019

Scaling is the process of removing plaque and calculus from both the supra and subgingival tooth surfaces. This procedure is important for maintaining oral health as plaque and calculus can lead to gum disease and tooth decay. By removing these deposits, a clean and healthy tooth surface is achieved, reducing the risk of dental problems.

The correct answer includes all of the risk factors mentioned in the options: smoking, diabetes, poor oral hygiene, osteoporosis, HIV/AIDS, medications, and stress. These factors have been found to be associated with an increased risk of developing periodontal disease. Smoking and poor oral hygiene contribute to the buildup of plaque and tartar, which can lead to gum inflammation and infection. Diabetes weakens the body's immune system, making it harder to fight off infections, including gum disease. Osteoporosis and HIV/AIDS can also weaken the immune system and make individuals more susceptible to periodontal disease. Medications and stress can affect oral health by causing dry mouth and compromising the immune system.

Soft bristles are considered the best toothbrush bristles because they are gentle on the gums and teeth. They effectively remove plaque and debris from the teeth without causing any damage or irritation to the gums. Soft bristles are recommended by dentists for most people, including those with sensitive teeth or gums. They provide a thorough cleaning while minimizing the risk of gum recession or enamel erosion. Medium and hard bristles, on the other hand, can be too abrasive and may cause gum damage or tooth sensitivity over time. Electric toothbrushes, although they may have different bristle types, can also provide a gentle and effective cleaning when used properly.

Gingivitis refers to a condition that is reversible and only affects the gingiva. This means that the inflammation and irritation of the gums can be treated and resolved, and it does not cause any irreversible damage to the underlying bone or affect the alveolar bone. It is important to address gingivitis promptly to prevent it from progressing to a more severe form of periodontal disease.

The signs described in the question, such as loss of interdental and marginal tippling, blue-red tissue color, junction epithelium at the CEJ, and bleeding upon gentle probing, are indicative of chronic gingivitis. Chronic gingivitis is characterized by inflammation of the gums, which can lead to tissue discoloration, bleeding, and recession. This condition is typically caused by poor oral hygiene, allowing plaque and bacteria to accumulate and irritate the gums. It is important to diagnose and treat chronic gingivitis promptly to prevent further progression to periodontitis.

Periodontal disease is a common oral condition that affects the gums and supporting structures of the teeth. It is characterized by inflammation and infection, leading to gum recession, tooth loss, and bone damage. AIDS, or Acquired Immunodeficiency Syndrome, is a medical condition caused by the human immunodeficiency virus (HIV). HIV weakens the immune system, making individuals more susceptible to infections, including periodontal disease. Therefore, AIDS is the correct answer as it is a hematological disorder associated with periodontal disease due to its impact on the immune system.

The dento-gingival unit refers to the connection between the tooth and the surrounding gingival tissues. It consists of two components: the junctional epithelium and the gingival fibers. The junctional epithelium is a specialized epithelial tissue that attaches to the tooth surface, forming a seal between the tooth and the gingiva. The gingival fibers are a network of collagen fibers that provide support and stability to the gingiva. Therefore, the correct answer is "Is junction epithelium and gingival fibers."

Muco-gingival surgery is a procedure that aims to correct or improve the relationship between the gums and the teeth. It is typically performed to address issues such as shallow vestibule, insufficient attached gingiva, and a high frenum attachment. However, an infrabony pocket is not an indication for muco-gingival surgery. Infrabony pockets are deep pockets that form between the tooth root and the surrounding bone, and they usually require a different type of periodontal treatment such as osseous surgery or guided tissue regeneration.

Diabetes mellitus is the most common systemic disease to affect the periodontal tissues. This is because diabetes can impair the body's ability to control blood sugar levels, leading to increased inflammation and a higher risk of infection in the gums. Additionally, diabetes can weaken the immune system, making it harder for the body to fight off gum disease. While aids, hypertension, scurvy, and leukemia can also affect the periodontal tissues, they are not as common as diabetes mellitus in doing so.

Muco-gingival surgery is performed to correct issues related to the gums and the surrounding tissues. Infrabony pocket refers to a deep pocket that forms between the tooth and the bone, indicating bone loss. This condition typically requires periodontal treatment rather than muco-gingival surgery. Therefore, the correct answer is "Infrabony pocket."

Smoking is considered both a risk factor and a prognostic factor for periodontal disease. As a risk factor, smoking increases the likelihood of developing periodontal disease. It has been found that smokers are more susceptible to gum infections and have a higher rate of tooth loss compared to non-smokers. Additionally, smoking also affects the prognosis of periodontal disease. It can worsen the severity and progression of the disease, making it more difficult to treat and manage. Therefore, smoking is both a risk factor and a prognostic factor for periodontal disease.

The correct answer is AIDS. AIDS is a hematological disorder associated with periodontal disease. People with AIDS have weakened immune systems, making them more susceptible to infections, including periodontal disease. In addition, periodontal disease can also worsen the symptoms of AIDS and contribute to the progression of the disease. Therefore, AIDS is a hematological disorder that is commonly associated with periodontal disease.

The correct answer includes a comprehensive list of Phase I therapy procedures that are aimed at controlling plaque biofilm and promoting oral health. These procedures include plaque biofilm control, diet control, scaling and root planning to remove plaque and calculus, correction of contributing and prosthodontic factors, antimicrobial therapy (local or systemic), and occlusal therapy. This combination of interventions addresses various aspects of periodontal health and helps to improve the overall condition of the patient's oral cavity.

The correct answer is "Plaque induced gingival disease modified by systemic factor." This is because the patient exhibits signs of gingival bleeding, edema, redness of the gingival margin, and poor oral hygiene, which are all characteristic of plaque-induced gingival disease. However, the presence of systemic factors, such as pregnancy, can modify the severity of the disease.

The new attachment is possible for both vital teeth and non-vital teeth.

The correct answer includes a comprehensive list of treatments and interventions that are typically included in Phase I therapy for non-surgical periodontal treatment. This includes plaque biofilm control, diet control, scaling and root planning to remove plaque and calculus, correction of contributing and prosthodontic factors, antimicrobial therapy (local or systemic), and occlusal therapy. These interventions aim to control the bacterial infection, remove calculus and plaque, address contributing factors, and improve overall oral health.

Phase II therapy in the surgical phase involves periodontal surgery, including the placement of implants, and endodontic therapy. This phase focuses on addressing specific dental issues such as gum disease, tooth loss, and root canal treatment. It may also involve the use of surgical procedures to correct and restore the oral health of the patient.

When a tooth bristle is forcibly embedded in the gingival tissue, it can cause irritation and inflammation, leading to the formation of a gingival abscess. This abscess is a localized collection of pus within the gingival tissue, often accompanied by pain, swelling, and redness. The bristle acts as a foreign body, triggering an immune response and the formation of an abscess. Gingival recession, periodontal pocket, attachment loss, and bone loss are all associated with advanced stages of periodontal disease and are not directly caused by a forcibly embedded tooth bristle.

False gingival enlargement refers to an increase in the size of the gums that is not caused by inflammation or disease. Instead, it is caused by underlying dental and osseous structures. This means that the enlargement is due to factors such as excessive bone growth or an abnormal positioning of the teeth, rather than inflammation of the gums or drug-induced side effects.

Gingival recession is the process in which the gum tissue pulls away from the teeth, exposing the tooth roots. This can lead to various dental problems. Periodontal abscess is usually not caused by gingival recession. A periodontal abscess is an infection in the gums and surrounding tissues, typically caused by bacteria getting trapped in a periodontal pocket. While gingival recession can contribute to the development of periodontal abscess, it is not the primary cause. Other factors such as poor oral hygiene, gum disease, and trauma to the gums are usually responsible for the formation of a periodontal abscess.

The dentogingival unit refers to the connection between the tooth and the gums. It consists of the junctional epithelium, which is the epithelial attachment between the tooth surface and the gingiva, and the gingival fibers, which are collagen fibers that provide support and stability to the gingiva. Therefore, the correct answer is "Is junction epithelium and gingival fibers."

False gingival enlargement refers to an increase in the size of the gums that is not caused by inflammation or disease. Instead, it is caused by underlying dental and osseous structures. This means that factors such as tooth positioning, dental restorations, or abnormalities in the bone structure can contribute to the appearance of enlarged gums. It is important to differentiate false gingival enlargement from true gingival enlargement, which is caused by inflammation or other pathological conditions.

In Phase III therapy (Restoration phase), the focus is on the final restoration of the teeth and evaluating the restoration periodontal examination. This includes the placement of fixed and removable prosthodontics, which are dental appliances used to replace missing teeth. The evaluation of the restoration periodontal examination involves assessing the periodontal condition, occlusion, and any other pathological changes in the mouth. This phase does not involve periodontal surgery, implant placement, or endodontic therapy, which are mentioned in the other options. Plaque biofilm control, diet control, scaling and root planning, and occlusal therapy are also important components of this phase to ensure the success and longevity of the restorations.

Gingival recession is the process of the gum tissue pulling away from the teeth, exposing the roots. This can lead to various dental problems. Periodontal abscess, which is a localized infection in the gum tissue, is usually not caused by gingival recession. Instead, it is typically caused by deep periodontal pockets and bacterial buildup. Hypersensitivity, root caries (cavities on the root surface), and pulpal hyperemia (increased blood flow to the dental pulp) are all commonly associated with gingival recession.

Active haemorrhage refers to a situation where there is ongoing bleeding. In order to control this bleeding, pressure application and electro-coagulation are effective methods. Pressure application helps to stop bleeding by applying direct pressure on the wound, which helps to compress the blood vessels and reduce blood flow. Electro-coagulation involves using an electrical current to cauterize or seal off blood vessels, stopping the bleeding. By combining these two methods, active haemorrhage can be effectively controlled.

Gingivitis and periodontitis are both dental conditions that affect the gums. Gingivitis is the inflammation of the gums caused by plaque buildup, while periodontitis is the advanced stage of gingivitis where there is damage to the supporting structures of the teeth. The loss of epithelial attachment refers to the separation of the gum tissue from the tooth, which is a characteristic of periodontitis. This condition leads to the formation of periodontal pockets, tooth mobility, and eventually tooth loss if left untreated.

A pseudopocket (or gingival pocket) is formed by the coronal migration of the gingival margin. This means that the gum tissue surrounding the tooth moves upwards towards the crown of the tooth, creating a pocket between the tooth and the gum. This can occur due to factors such as gum disease or inflammation. The other options, including the migration of the epithelial attachment or the apical migration of the gingival margin or epithelial attachment, do not accurately describe the formation of a pseudopocket.

In Stage II gingivitis, bleeding on probing starts to occur. This indicates inflammation and damage to the gums, which is a characteristic of gingivitis. In Stage I gingivitis, there may be some inflammation present, but bleeding on probing is not typically seen yet. Stage III and IV gingivitis are more advanced stages of the disease, where there is further damage to the gums and potential loss of teeth. Therefore, Stage II gingivitis is the correct answer as it is the stage where bleeding on probing first begins.

The most frequently recommended tooth brushing technique for periodontal patients is the sulcular technique. This technique involves placing the bristles of the toothbrush at a 45-degree angle towards the gumline and gently brushing in a circular or vibrating motion. The aim of this technique is to effectively remove plaque and debris from the gumline and the space between the teeth and gums, which is crucial for maintaining oral health and preventing further damage to the gums.

The correct answer is "Overhanging Restoration." Overhanging restorations can cause localized factors in radiographs, which can affect the surrounding structures such as the pulp of the tooth and the gingiva. These localized factors can lead to complications and problems in the oral cavity.

To localize a supernumerary or impacted tooth and determine its exact relationship to the other teeth, the most effective radiographs would be two or more periapical views at different angles and an occlusal view. Periapical views provide detailed images of the tooth and surrounding structures, while the different angles help to visualize the tooth from different perspectives. The occlusal view helps to assess the position of the tooth in relation to the occlusal plane. By combining these radiographs, a comprehensive assessment of the tooth's localization and relationship to other teeth can be achieved.

The correct answer is a combination of three different forms of periodontal disease: Necrotising ulcerative periodontitis, Aggressive periodontitis, and chronic periodontitis. These three forms of periodontal disease are known to cause irreversible damage to the periodontium, which includes the gums, bone, and other supporting structures of the teeth. Plaque-induced inflammation condition gingivitis and drug-induced periodontal disease are not mentioned in the correct answer and are not the most common forms of periodontal disease that cause irreversible damage.

Based on the information provided, the correct diagnosis for this case according to the AAP 1999 periodontal diseases Classification is localized aggressive periodontitis. This is because the patient is a 16-year-old boy and has attachment loss related to the first molars and incisors only. Localized aggressive periodontitis is characterized by rapid attachment loss around first molars and incisors, typically affecting young individuals.

Reattachment refers to the process of reconnecting the periodontal tissues, including the cementum, periodontal ligament, and alveolar bone, to the root surface of the tooth after the treatment of periodontal lesions. This process can occur when the root surface is clean and free of contaminants, allowing for the reestablishment of a functional periodontal attachment. Reattachment is an important goal in periodontal therapy as it helps to restore the integrity and stability of the periodontium.

The correct answer is "Increased by tooth brushing and gingival massage." This is because calculus, which is a hard deposit on the teeth, can form below the gum line. Tooth brushing and gingival massage can cause the calculus to be pushed further towards the alveolar crest, increasing the distance between the two.

A periodontal pocket 8 mm deep, with the junctional epithelium coronal to the cement enamel junction, is classified as a pseudopocket. A pseudopocket is a deepening of the gingival sulcus without any attachment loss or destruction of the periodontal ligament and alveolar bone. In this case, the pocket is not a result of true periodontal disease, but rather a deepening of the gingival sulcus due to inflammation or swelling. It is important to note that pseudopockets can still lead to further periodontal problems if not properly managed.

Oxygen insulflation does not improve healing after periodontal treatment. While pressure, debridement, and immobilization are all known to aid in the healing process, oxygen insulflation does not have the same effect. Oxygen insulflation involves the delivery of oxygen directly to the affected area, but it is not proven to enhance healing in periodontal treatment.

Cavitation is a term used in relation to ultrasonic scaling. This procedure involves the use of high-frequency sound waves to remove plaque and tartar from the teeth. The ultrasonic scaler creates tiny bubbles in the water used during the procedure, and when these bubbles collapse, they produce a powerful cleaning action that helps to remove the buildup on the teeth. This process is known as cavitation.

Microbial analysis of plaque is indicated in all of the mentioned conditions. Aggressive periodontitis refers to a rapidly progressing form of periodontal disease, which may require microbial analysis to identify the specific bacteria causing the infection. Refractory periodontitis is a condition where the periodontal disease does not respond to conventional treatment, and microbial analysis can help determine if there are any resistant bacteria present. Periodontitis associated with systemic conditions, such as diabetes or HIV, may also benefit from microbial analysis to understand the impact of the systemic condition on the oral microbiota.

A chisel is a hand tool that is activated with a push motion. It is used for cutting or shaping wood, metal, or stone by driving the blade into the material with a hammer or mallet. The other options, such as a sickle, curette, or hoe, are not typically activated with a push motion.

Plaque induced gingival disease is the most common disease affecting the periodontium because it is primarily caused by the buildup of plaque on the teeth. Plaque is a sticky film of bacteria that forms on the teeth and gums, and if not properly removed through regular brushing and flossing, it can lead to inflammation of the gums (gingivitis) and eventually progress to more severe periodontal disease. This disease is very common among individuals who do not practice good oral hygiene habits and can be prevented or managed through proper dental care.

The primary predisposing factor in ANUG is plaque. ANUG, or Acute Necrotizing Ulcerative Gingivitis, is a severe form of gum disease that is characterized by painful, ulcerated gums. Plaque, a sticky film of bacteria that forms on the teeth, is the main cause of gum disease. When plaque is not properly removed through regular brushing and flossing, it can irritate and inflame the gums, leading to ANUG. Therefore, plaque buildup is the primary factor that predisposes individuals to develop this condition.

The principle fibers of the periodontal ligament are primarily made up of collagen. Collagen is the main structural protein in the body, providing strength and support to tissues. In the periodontal ligament, collagen fibers help to attach the tooth to the surrounding bone and provide stability during chewing and biting. Elastic fibers, on the other hand, are responsible for the elasticity and flexibility of tissues, but they are not the main component of the periodontal ligament fibers. Reticular fibers are thin and delicate fibers that provide a supporting framework in certain tissues, but they are not the principle fibers of the periodontal ligament.

Based on the information provided, the patient is a 40-year-old diabetic with periodontal attachment loss, which is a characteristic of chronic periodontitis. However, the presence of a systemic condition (diabetes) modifies the presentation of the periodontitis, making it chronic periodontitis modified by a systemic condition. This means that the patient's diabetes has contributed to the development or progression of their periodontal disease.

Two points contact is essential for a hoe because it allows for better leverage and stability when digging or chopping into the soil. The two points on the hoe's blade penetrate the ground simultaneously, providing balance and control while working in the garden or field. This design feature helps to efficiently break up soil, remove weeds, and cultivate the land. The other tools listed (sickle, curette, chisel) do not necessarily require two points of contact for their intended use.

The prognosis for a smoker with severe periodontitis is considered fair when they stop smoking. Quitting smoking can significantly improve the overall health of the gums and reduce the progression of periodontal disease. However, the severity of the existing periodontitis may still have an impact on the long-term prognosis, hence the fair prognosis. It is important for the individual to receive appropriate dental treatment and maintain good oral hygiene practices to further improve their prognosis.

A file is used for crushing of calculus. A file is a tool with a rough surface that is used to remove material by rubbing it against a surface. In the context of crushing calculus, a file can be used to scrape and break down the hard deposits of calculus on teeth or other surfaces. A file's rough surface helps to effectively crush and remove the calculus, making it the correct tool for this purpose.

Applying pressure to the tissues for one minute after a flap procedure helps to adapt the tissue against the bone. This pressure helps to ensure that the tissue is properly positioned and secured in place, allowing for proper healing and integration with the surrounding bone. This helps to prevent any movement or displacement of the tissue, providing stability and support during the healing process.

The prevalence of gingival recession in people who are older than 50 years is 80%. This means that 80% of individuals in this age group are likely to experience gingival recession, which is the process of gum tissue pulling away from the teeth, exposing the roots. This condition is commonly associated with aging and can lead to tooth sensitivity and other oral health issues.

The given question asks for the number of strokes, and the answer is 3. Since the question does not provide any context or additional information, it is unclear what exactly the strokes are referring to. Without more information, it is difficult to provide a specific explanation for why the correct answer is 3.

The correct answer is "Push stroke." When sharpening a chisel, a push stroke is used. This involves pushing the chisel against the sharpening stone or file in a forward motion. This technique helps to remove material from the chisel's edge and create a sharp cutting surface. Pull strokes are not typically used for sharpening chisels as they can be less effective and may even damage the chisel's edge. Therefore, the correct method for sharpening a chisel is to use a push stroke.

The instrument used for supra-gingival scaling is a combination of a sickle, curette, and hoe. These instruments are used by dental professionals to remove plaque and tartar from the surface of the teeth, specifically above the gum line. The sickle, curette, and hoe have different shapes and angles that make them effective in accessing and removing deposits from different areas of the teeth.

Ultrasonic scaling is a dental procedure that involves using high-frequency sound waves to remove plaque and tartar from the teeth. The correct answer, overlapping horizontal strokes, refers to the technique used during the scaling process. This technique involves moving the ultrasonic scaler in a back-and-forth motion along the gum line, overlapping each stroke to ensure thorough cleaning. By using overlapping horizontal strokes, the dental professional can effectively remove plaque and tartar buildup, promoting better oral health.

Juvenile periodontitis is a form of periodontal disease that primarily affects adolescents and young adults. Unlike other forms of periodontal disease, it does not involve the formation of calculus, which is a hardened plaque that forms on the teeth. Instead, juvenile periodontitis is characterized by severe gum inflammation and destruction of the supporting tissues and bone around the teeth. This condition is typically caused by a specific bacteria and is more aggressive than other forms of periodontal disease.

Estrogen deficiency is not one of the action factors that delay wound healing. Estrogen is a hormone that plays a crucial role in the healing process by promoting collagen production, angiogenesis, and immune response. Therefore, a deficiency in estrogen can negatively impact wound healing. However, the question asks for the factor that does not delay wound healing, making estrogen deficiency the correct answer.

The linear action of the tip is a feature of the Piezo scaler.

The correct answer explains that for a treatment plan with code 3 in CPITN, supra and subgingival scaling improvement is required in addition to home care. This suggests that code 3 indicates a pocketing depth of 4-5 mm, which requires more intensive treatment than code 2. The explanation also mentions that the dentition is divided into five segments and that code 4 indicates pocketing of 6 mm or more.

The correct answer is Primordial cyst. The other three types of cysts mentioned in the options (Dentigerous cyst, Calcifying epithelial odontogenic cyst, and Keratocyst) are all associated with impacted teeth. However, a primordial cyst is not specifically associated with an impacted tooth.

The correct answer is Exploratory Stroke. This stroke is used with probes to evaluate the dimensions of a pocket and to explore calculus on the tooth surface. It involves gently inserting the probe into the pocket and moving it along the tooth surface to detect any roughness or deposits. This helps in assessing the severity of periodontal disease and planning the appropriate treatment.

When sharpening strokes are made away from the cutting edge, it creates a wire edge on the instrument. This wire edge is a thin, weak, and flexible metal burr that is formed during the sharpening process. It is important to remove this wire edge after sharpening to ensure the instrument's cutting edge is clean and sharp. Sharpening strokes made towards the cutting edge can actually damage the instrument and dull the cutting edge. Therefore, the correct answer is "Away from cutting edge."

A surgical sickle is a type of surgical instrument that is used for cutting and dissecting tissue during surgical procedures. The options provided include "Ball", "Morse", "Jaquette", and "NEV!-2". Among these options, "Ball" is the most likely choice for a surgical sickle as it is commonly used in surgical procedures for cutting and dissecting tissue. "Morse", "Jaquette", and "NEV!-2" are not typically associated with surgical sickles.

Tooth mobility is caused by various factors, including trauma from occlusion and inflammation in the periodontal ligament. However, loss of alveolar bone is not likely to be corrected and can lead to permanent tooth mobility. Alveolar bone provides support and stability to the teeth, and its loss can result in a lack of anchorage for the teeth, leading to mobility. Therefore, loss of alveolar bone is the correct answer as it is not likely to be corrected and can contribute to tooth mobility.

Periodontal disease is a risk factor for various health conditions, including diabetes, premature delivery, and cardiovascular diseases. However, there is no strong evidence to suggest a direct link between periodontal disease and hypertension. While there may be some association between the two, it is not considered a significant risk factor for developing hypertension.

Color change is a more common expression of gingivae because it refers to a visible alteration in the color of the gums. This can occur due to various factors such as inflammation, infection, or poor oral hygiene. Bleeding, increase in pocket depth, and mobility are also associated with gingivae issues, but color change is a more commonly observed symptom.

Cementoid is a less calcified structure compared to the other options listed. It is an unmineralized matrix that is present during the early stages of cementum formation. As the cementum matures, the cementoid is gradually mineralized and transformed into either cellular or acellular cementum. Dentin, on the other hand, is a hard, calcified tissue that forms the bulk of the tooth structure. Therefore, cementoid is the correct answer as it represents a less calcified form of cementum.

The maintenance phase should start after Phase I. This is because Phase I, also known as the preliminary phase, is the initial stage of a project where the feasibility and basic requirements are assessed. Once this phase is completed, the maintenance phase begins, which involves the ongoing support, updates, and enhancements of the project. Therefore, Phase I serves as the foundation for the maintenance phase to ensure the project is stable and ready for long-term maintenance.

The correct answer is the one that includes all the necessary components for Phase IV therapy (Maintenance phase). This includes plaque biofilm and calculus removal, assessment of the periodontal condition such as pocket depth and inflammation, evaluation of occlusion and tooth mobility, and identification of any other pathologic changes. This answer encompasses all the important aspects that need to be addressed during the maintenance phase of therapy.

The correct answer is Scaling stroke. This is because the scaling stroke is used to remove calculus from both supra gingival (above the gum line) and sub gingival (below the gum line) areas. Exploratory stroke is used to detect calculus and root planning stroke is used to smooth the root surface after calculus removal. However, only the scaling stroke is specifically mentioned to be used for calculus removal in both supra and sub gingival areas.

The main difference between gingivitis and periodontitis is that only gingivitis results in bone loss, while periodontitis is irreversible. Gingivitis is the inflammation of the gums caused by plaque buildup, which can be reversed with proper oral hygiene and professional treatment. On the other hand, periodontitis is a more advanced stage of gum disease where the infection has spread to the supporting structures of the teeth, including the bone. Once bone loss occurs, it cannot be regenerated, making periodontitis irreversible.

Horizontal bone loss is present in Acute necrotizing ulcerative gingivitis. This condition is characterized by severe inflammation and destruction of the gum tissues and underlying bone. The bone loss in this condition occurs in a horizontal pattern, meaning that it affects the entire width of the bone rather than just specific areas. This can result in the loosening and eventual loss of teeth if left untreated.