Which radiographic pattern indicates vertical bone loss with infrabony pocket?

• A. Horizontal bone loss
• B. No bone loss
• C. Diffuse sclerosis
• D. Vertical bone loss with infrabony pocket

Answer: (D)

Vertical bone loss with infrabony pockets presents on radiographs as angular, intrabony defects where the base of the defect lies below the alveolar crest, creating an infrabony pocket. This appears as a radiolucent area that slopes apically along the root surface, forming an angle with the crest rather than a uniform, horizontal recession. Horizontal bone loss shows a uniform reduction of the supporting bone with the crest receding in a parallel fashion, not an angular defect. No bone loss would look like normal bone height and intact lamina dura. Diffuse sclerosis would show generalized increased bone density rather than a defect pattern. The key feature here is the angular, apically placed defect within the bone, which corresponds to an infrabony pocket.