Periodontal Diesase Classification

7/17/2019 Periodontal Diesase Classification

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Classifcation o

Periodontal Diseases



Helps in the development of frameworks to study theI. aetiology,II. Pathogenesis &III. treatment of diseases;

. Provides the international healthcare community with a wayof communicating in a common language.

Why Classifcation ?



Where were we?

juvenile periodontitis (prepuertal, locali!ed andgenerali!ed"; early#onset periodontitis (formally prepuertal, juvenile andrapidly progressive";adult periodontitis;( $his classi%cation system is heavily agedependent a cut#o' point of ) *ears"acute necroti!ing ulcerative periodontitis; refractory periodontitis.



Periapical radiographs of a +#year#old patient, showing severegenerali!ed one loss.iagnosis -chronic adult periodontitis or -early#onsetperiodontitis/



The ollowing changes were implemented:

0ingival disease category introduced. -1dult periodontitis replaced y -chronic periodontitis. -2efractory disease category removed.

-3arly#onset periodontitis replaced y -aggressiveperiodontitis. $he implications of systemic diseases on periodontal statuswere e4panded and more comprehensively de%ned. -5ecroti!ing periodontal diseases were introduced to cover

oth -necroti!ing periodontitis and -necroti!ing gingivitis. -Periodontal ascess and -periodontal#endodontic lesionswere added. 1 category for developmental or ac6uired lesions wasintroduced.

Where are we now?



The 1999 International Workshop for the Classication ofGingival Diseases

A. Dental pla!e"ind!ced gingival diseases#. $on"pla!e"ind!ced gingival lesions

The 1999 International Workshop for the Classication of

Periodontal Diseases.

A. Chronic periodontitis#. Aggressive periodontitisC. Periodontitis as a maniestation o systemic diseasesD. $ecroti%ing periodontal diseases

&. A'scesses o the periodonti!m(. Periodontitis associated with endodontic lesionsG. Developmental or ac!ired deormities and conditions



Gingival diseases: A simplifed version o the 1999 International



Classication of GingivalDiseases

Dental pla!e"ind!ced gingival diseases

7. 0ingivitis associated with dental pla6ue onlya. 8ithout other local contriuting factors. 8ith local contriuting factors





9. 0ingival diseases modi%ed y systemic factors

a. associated with the endocrine system7" puerty#associated gingivitis9" menstrual cycle#associated gingivitis

" pregnancy#associated a" gingivitis " pyogenic granuloma:" diaetes mellitus#associated gingivitis

. associated with lood dyscrasias7" leukaemia#associated gingivitis9" other




). Gingival diseases modifed 'y medications

7" drug#inuenced gingival enlargements9" drug#inuenced gingivitis a" oral contraceptive#associated gingivitis

" other


*. Gingival diseases modifed 'y maln!tritiona. ascoric acid#de%ciency gingivitis

. other




$on"pla!e"ind!ced gingivallesions

+. Gingival diseases o specifc 'acterial origin

a. Neisseria gonorrhoea-associated lesions. reponema pallid!m-associated lesionsc. streptococcal species#associated lesions

d. other

,. Gingival diseases o viral origin

a. herpesvir!s inections

7" primary herpetic gingivostomatitis 9" recurrent oral herpes " varicella-"oster inections. other





). Gingival diseases o !ngal origina. candidal infections 7" generali!ed gingival candidosis

. linear gingival erythemac. histoplasmosisd. other

*. Gingival lesions o genetic origin

a. hereditary gingival %romatosis. other



Classication of GingivalDiseases$on"pla!e"ind!ced gingival

lesions). 0ingival manifestations of systemic conditions

a. mucocutaneous disorders7" lichen plan!s9" pemphigoid" pemphig!s v!lgaris:" er#thema m!ltiorme

)" l!p!s er#thematos!s+" drug#induced<" other

. allergic reactions7" dental restorative materials

a" mercury " nickel c" acrylic d" other

9" reactions attriutale to

a" toothpastes=dentifrices "mouthrinses=mouthwashes c" chewing gum additives d" foods and additives

" other





+. $raumatic lesions (factitious, iatrogenic, accidental" a. chemical injury . physical injury c. thermal injury

<. >oreign ody reactions

?. 5ot otherwise speci%ed (5@A"



Gingival diseases: A simplifed version o the 1999 International



The 1999 International Workshop for theClassication of Gingival Diseases

A. Dental pla!e"ind!ced gingival diseases#. $on"pla!e"ind!ced gingival lesions

The 1999 International Workshop for the Classication of

Periodontal Diseases.

A. Chronic periodontitis#. Aggressive periodontitisC. Periodontitis as a maniestation o systemic diseasesD. $ecroti%ing periodontal diseases

&. A'scesses o the periodonti!m(. Periodontitis associated with endodontic lesionsG. Developmental or ac!ired deormities and conditions



$eriodontal diseases: A simplifed version o the 1999 InternationalWorkshop.5



A. Chronic periodontitis

a. -ocali%ed

'. Generali%ed

up to BC of sites

more than BC of sites

I. Alight D1E 7F9 mm.II. Goderate D1E F: mm.III. Aevere D1E ) mm or more.

clinical attachment loss (D1E"

everity o the disease

Classication of Periodontal Diseases.



Clinical eat!res and characteristics oChronic Periodontitis:

Gost prevalent in adults (ut can occur in children andadolescents". 1mount of destruction of the periodontium is consistent with thepresence of local risk factors. Augingival calculus is a fre6uent %nding. Alow to moderate rate of progression (ut can have periods ofrapid attachment loss". Gay e modi%ed y systemic disease. Dan e modi%ed y factors such as smoking and stress.



J. Aggressive periodontitis

a.-ocali%ed.

'. Generali%ed :

Classication of Periodontal Diseases.

@nset around puerty. >irst molar and incisor involvement. 2aised serum antiody response topathogens.

Ksually under B years, ut does occur in olderpatients. Poor antiody response to pathogens. Pronounced episodic nature of loss ofattachment and alveolar one. 0enerali!ed interpro4imal attachment lossa'ecting at least three permanent teeth (other

than%rst molars and incisors".



C. Periodontitis as a maniestation o systemicdiseases

a. Associated with haematological disorders7. 1c6uired neutropenia9. Eeukaemias. @ther'. Associated with genetic disorders

7. >amilial and cyclic neutropenia9. owns syndrome. Eeukocyte adhesion de%ciency syndromes:. PapillonFEefLvre syndrome). DhediakFHigashi syndrome+. Histiocytosis syndromes<. 0lycogen storage disease?. Infantile genetic agranulocytosisM. Dohen syndrome7B. 3hlersFanlos syndrome ($ypes IN and NIII"77. Hypophosphatasia

79. @ther

Classication of PeriodontalDiseases.



D. $ecroti%ing periodontal diseases

a. 5ecroti!ing ulcerative gingivitis (5K0". 5ecroti!ing ulcerative periodontitis (5KP"

&. A'scesses o the periodonti!m

a. 0ingival ascess. Periodontal ascessc. Pericoronal ascess

(. Periodontitis associated with endodonticlesions

Domined periodontic#endodontic lesions




G. Developmental or ac!ired deormities andconditions

a. -ocali%ed tooth"related actors that modiy orpredispose to pla!e"ind!ced gingival

diseases2periodontitis

7. $ooth anatomic factors9. ental restorations=appliances. 2oot fractures:. Dervical root resorption and cemental tears




G. Developmental or ac!ired deormities and

conditions

'. 3!cogingival deormities and conditions aro!nd teeth

7. 0ingival=soft tissue recession

a" facial or lingual surfaces" interpro4imal (papillary"9. Eack of keratini!ed gingiva. ecreased vestiular depth:. 1errant fraenum=muscle position

). 0ingival e4cessc" pseudopocketd" inconsistent gingival margine" e4cessive gingival displayf" gingival enlargement+. 1normal colour





c. 3!cogingival deormities and conditions on edent!lo!sridges

7. Nertical and=or hori!ontal ridge de%ciency9. Eack of gingiva=keratini!ed tissue. 0ingival=soft tissue enlargement:. 1errant fraenum=muscle position). ecreased vestiular depth+. 1normal colour





d. 0ccl!sal tra!ma

7. Primary occlusal trauma9. Aecondary occlusal trauma




$eriodontal diseases: A simplifed version o the 1999 InternationalWorkshop.5



T4A$5 607

Periodontal Diesase Classification

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