1. Introduction. Periodontitis is a prevalent dental health problem and can be classified as a major global challenge that affects developed and developing countries [1,2,3].Triggered by bacterial colonization of the root surface, the host's immune system reacts with inflammatory processes to the microbial transition from a symbiotic bacterial environment to that of dysbiotic pathogens.. Radiographic Changes seen in Periodontal Disease. Periodontal disease causes inflammatory lesions in the marginal bone Both osteoblastic and osteoclastic activity is seen Osteoclastic activity will cause changes in the morphology of the crestal bone Initial response is destruction of bone. Chronic lesions will show some osteosclerosis.

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Periodontitis can often be identified on an OPG. In the early stages, there may be no radiographic signs, as a threshold level of demineralization needs to occur before radiologic signs are evident. The earliest radiographic change is the loss of the crestal bone, the triangle of bone that is normally seen between neighboring teeth.. Causes of Bone Loss. The root cause of bone loss is losing teeth. Typically, the bones are strengthened by the force and consistency of chewing and biting. Once the tooth went missing, the body will find a way to resorb the inactive bone, hence, resulting in bone loss. Research shows that at least 25% of the bone goes missing a year after tooth.