INDEX ASSESSMENT OF DENTAL STATUS AND ALVEOLAR BONE DESTRUCTION BEFORE DENTAL IMPLANTATION IN PATIENTS WITH SECONDARY EDENTULISM ASSOCIATED WITH PERIODONTITIS

Abstract

Aim of the study. To conduct a comprehensive index assessment of the dental status and the degree of alveolar bone destruction before dental implantation in patients with secondary partial edentulism associated with periodontitis, in order to optimize the surgical stage and improve the prognosis of osseointegration. Materials and methods. A comprehensive clinical and radiographic examination of 119 patients (aged 18 to 60 years) with secondary partial edentulism burdened by generalized periodontitis (stages I–IV) was conducted. For detailed analysis, the sample was stratified into four age groups. The condition of dental hard tissues was assessed according to ICDAS-II criteria. The severity of gingival inflammation and bleeding were determined by PMA and PBI indices. Clinical attachment loss (CAL) and the screening need for specialized treatment were evaluated using periodontal probing (PSR index). Oral hygiene status was recorded using the OHI-S index. Radiomorphometric analysis based on cone-beam computed tomography (CBCT) and digital orthopantomography included the determination of absolute radiographic bone loss (RBL) and the destruction progression rate index (Ratio), according to the AAP/EFP criteria. Results of the study. The results of the clinical and radiographic analysis revealed a progressive age- dependent deterioration of the periodontal status and the condition of the alveolar bone. The mean absolute radiographic bone loss (RBL) was 4.13±0.87 mm, while in patients of the older age group (48–60 years) it reached a critical 6.5±1.30 mm (p < 0.05). The destruction progression rate index (Ratio) averaged 0.75±0.06, significantly increasing from 0.55±0.04 in young individuals (18–25 years) to 0.95±0.07 in the older age group (p < 0.01). Reduced caries resistance (according to the ICDAS-II index – 2.97±0.98 points) was noted against the background of unsatisfactory oral hygiene (OHI-S –2.35±0.10 points). The clinical attachment loss (CAL) averaged 3.19±0.10 mm, and the intensity of gingival inflammation (PMA) significantly increased from 16.29±2.42% in the youngest group to 54.82±3.86% in the oldest (p < 0.01), accompanied by pronounced bleeding (PBI –1.94±0.09 points). Conclusions. Secondary edentulism associated with periodontitis is characterized by severe age-dependent alveolar bone destruction and clinical attachment loss, leading to a critical deficit of functional bone support. Under such conditions, achieving stable osseointegration of implants using standard surgical protocols is accompanied by a high risk of disintegration. Consequently, the pre-implant stage fundamentally requires preliminary periodontal sanitation and the involvement of guided bone regeneration methods.