Periodontal Diesase Classification (presentation)
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The document discusses the classification of periodontal diseases. It provides an overview of how periodontal diseases were previously classified, noting that the classification system was heavily based on age. It then summarizes the updated 1999 classification system, which introduced categories for gingival diseases and refined the categories for periodontal diseases. The key changes were introducing gingival disease categories, replacing terms like "adult periodontitis" with "chronic periodontitis", and expanding definitions of systemic diseases and their implications for periodontal health.
![Classification of Periodontal Diseases.A. Chronic periodontitisLocalized b. Generalized: up to 30% of sites : more than 30% of sitesSeverity of the disease Slight: CAL 1–2 mm. Moderate: CAL 3–4 mm. Severe: CAL 5 mm or more. [clinical attachment loss (CAL)]:](https://image.slidesharecdn.com/periodontaldiesaseclassificationpresentation-100602215028-phpapp02/85/Periodontal-Diesase-Classification-presentation-26-320.jpg)
Periodontal Diesase Classification (presentation)
- 1. Classification of Periodontal DiseasesDr PrateekShrestha
- 2. Why Classification ?Helps in the development of frameworks to study theaetiology, Pathogenesis & treatment of diseases; Provides the international healthcare community with a way of communicating in a common language.Where were we?juvenile periodontitis (prepubertal, localized and generalized);
- 3. early-onset periodontitis (formally prepubertal, juvenile and rapidly progressive);
- 4. adult periodontitis;( This classification system is heavily age dependent: a cut-off point of 35 Years)
- 5. acute necrotizing ulcerative periodontitis;
- 6. refractory periodontitis.Periapical radiographs of a 36-year-old patient, showing severe generalized bone loss.Diagnosis: ‘chronic adult periodontitis’ or ‘early-onset periodontitis’?
- 7. Where are we now?The following changes were implemented:Gingival disease category introduced.
- 8. ‘Adult periodontitis’ replaced by ‘chronic periodontitis’.
- 9. ‘Refractory disease’ category removed.
- 10. ‘Early-onset periodontitis’ replaced by ‘aggressive periodontitis’.
- 11. The implications of systemic diseases on periodontal status were expanded and more comprehensively defined.
- 12. ‘Necrotizing periodontal diseases’ were introduced to cover both ‘necrotizing periodontitis’ and ‘necrotizing gingivitis’.
- 13. ‘Periodontal abscess’ and ‘periodontal-endodontic’ lesions were added.
- 14. A category for developmental or acquired lesions was introduced.The 1999 International Workshop for the Classification of Gingival DiseasesA. Dental plaque-induced gingival diseasesB. Non-plaque-induced gingival lesionsThe 1999 International Workshop for the Classification of Periodontal Diseases.A. Chronic periodontitisB. Aggressive periodontitisC. Periodontitis as a manifestation of systemic diseasesD. Necrotizing periodontal diseasesE. Abscesses of the periodontiumF. Periodontitis associated with endodontic lesionsG. Developmental or acquired deformities and conditions
- 15. Gingival diseases: A simplified version of the 1999 International Workshop.5
- 16. Classification of Gingival DiseasesDental plaque-induced gingival diseases1. Gingivitis associated with dental plaque onlya. Without other local contributing factorsb. With local contributing factors
- 17. Classification of Gingival DiseasesDental plaque-induced gingival diseases2. Gingival diseases modified by systemic factorsa. associated with the endocrine system1) puberty-associated gingivitis2) menstrual cycle-associated gingivitis3) pregnancy-associated a) gingivitis b) pyogenicgranuloma4) diabetes mellitus-associated gingivitisb. associated with blood dyscrasias1) leukaemia-associated gingivitis2) other
- 18. Classification of Gingival DiseasesDental plaque-induced gingival diseases3. Gingival diseases modified by medications1) drug-influenced gingival enlargements2) drug-influenced gingivitis a) oral contraceptive-associated gingivitis b) other4. Gingival diseases modified by malnutritiona. ascorbic acid-deficiency gingivitisb. other
- 19. Classification of Gingival DiseasesNon-plaque-induced gingival lesions1. Gingival diseases of specific bacterial origina. Neisseriagonorrhoea-associated lesionsb. Treponemapallidum-associated lesionsc. streptococcal species-associated lesionsd. other2. Gingival diseases of viral origina. herpesvirus infections 1) primary herpetic gingivostomatitis 2) recurrent oral herpes 3) varicella-zoster infectionsb. other
- 20. Classification of Gingival DiseasesNon-plaque-induced gingival lesions3. Gingival diseases of fungal origina. candidal infections 1) generalized gingival candidosisb. linear gingival erythemac. histoplasmosisd. other4. Gingival lesions of genetic origina. hereditary gingival fibromatosisb. other
- 21. Classification of Gingival DiseasesNon-plaque-induced gingival lesions5. Gingival manifestations of systemic conditionsa. mucocutaneous disorders1) lichen planus2) pemphigoid3) pemphigusvulgaris4) erythemamultiforme5) lupus erythematosus6) drug-induced7) otherb. allergic reactions1) dental restorative materials a) mercury b) nickel c) acrylic d) other2) reactions attributable to a) toothpastes/dentifrices b) mouthrinses/mouthwashes c) chewing gum additives d) foods and additives3) other
- 22. Classification of Gingival DiseasesNon-plaque-induced gingival lesions6. Traumatic lesions (factitious, iatrogenic, accidental) a. chemical injury b. physical injury c. thermal injury7. Foreign body reactions8. Not otherwise specified (NOS)
- 23. Gingival diseases: A simplified version of the 1999 International Workshop.5
- 24. The 1999 International Workshop for the Classification of Gingival DiseasesA. Dental plaque-induced gingival diseasesB. Non-plaque-induced gingival lesionsThe 1999 International Workshop for the Classification of Periodontal Diseases.A. Chronic periodontitisB. Aggressive periodontitisC. Periodontitis as a manifestation of systemic diseasesD. Necrotizing periodontal diseasesE. Abscesses of the periodontiumF. Periodontitis associated with endodontic lesionsG. Developmental or acquired deformities and conditions
- 25. Periodontal diseases: A simplified version of the 1999 International Workshop.5
- 26. Classification of Periodontal Diseases.A. Chronic periodontitisLocalized b. Generalized: up to 30% of sites : more than 30% of sitesSeverity of the disease Slight: CAL 1–2 mm. Moderate: CAL 3–4 mm. Severe: CAL 5 mm or more. [clinical attachment loss (CAL)]:
- 27. Clinical features and characteristics of Chronic Periodontitis: Most prevalent in adults (but can occur in children and adolescents).
- 28. Amount of destruction of the periodontium is consistent with the presence of local risk factors.
- 29. Subgingival calculus is a frequent finding.
- 30. Slow to moderate rate of progression (but can have periods of rapid attachment loss).
- 31. May be modified by systemic disease.
- 32. Can be modified by factors such as smoking and stress.Classification of Periodontal Diseases.B. Aggressive periodontitisa.Localized.b. Generalized :: Onset around puberty.
- 33. First molar and incisor involvement.
- 34. Raised serum antibody response to pathogens.
- 35. Usually under 30 years, but does occur in older patients.
- 36. Poor antibody response to pathogens.
- 37. Pronounced episodic nature of loss of attachment and alveolar bone.
- 38. Generalized interproximal attachment loss affecting at least three permanent teeth (other thanfirst molars and incisors).
- 39. Classification of Periodontal Diseases.C. Periodontitis as a manifestation of systemic diseasesa. Associated with haematological disorders1. Acquired neutropenia2. Leukaemias3. Otherb. Associated with genetic disorders1. Familial and cyclic neutropenia2. Down’s syndrome3. Leukocyte adhesion deficiency syndromes4. Papillon–Lefèvre syndrome5. Chediak–Higashi syndrome6. Histiocytosis syndromes7. Glycogen storage disease8. Infantile genetic agranulocytosis9. Cohen syndrome10. Ehlers–Danlos syndrome (Types IV and VIII)11. Hypophosphatasia12. Otherc. Not otherwise specified (NOS)
- 40. Classification of Periodontal Diseases.D. Necrotizing periodontal diseasesa. Necrotizing ulcerative gingivitis (NUG)b. Necrotizing ulcerative periodontitis (NUP)E. Abscesses of the periodontiuma. Gingival abscessb. Periodontal abscessc. Pericoronal abscessF. Periodontitis associated with endodontic lesionsCombined periodontic-endodontic lesions
- 41. Classification of Periodontal Diseases.G. Developmental or acquired deformities and conditionsa. Localized tooth-related factors that modify or predispose to plaque-induced gingival diseases/periodontitis1. Tooth anatomic factors2. Dental restorations/appliances3. Root fractures4. Cervical root resorption and cemental tears
- 42. Classification of Periodontal Diseases.G. Developmental or acquired deformities and conditionsb. Mucogingival deformities and conditions around teeth1. Gingival/soft tissue recessionfacial or lingual surfacesinterproximal (papillary)2. Lack of keratinized gingiva3. Decreased vestibular depth4. Aberrant fraenum/muscle position5. Gingival excesspseudopocket inconsistent gingival marginexcessive gingival display gingival enlargement6. Abnormal colour
- 43. Classification of Periodontal Diseases.G. Developmental or acquired deformities and conditionsc. Mucogingival deformities and conditions on edentulous ridges1. Vertical and/or horizontal ridge deficiency2. Lack of gingiva/keratinized tissue3. Gingival/soft tissue enlargement4. Aberrant fraenum/muscle position5. Decreased vestibular depth6. Abnormal colour
- 44. Classification of Periodontal Diseases.G. Developmental or acquired deformities and conditionsd. Occlusal trauma1. Primary occlusal trauma2. Secondary occlusal trauma
- 45. Periodontal diseases: A simplified version of the 1999 International Workshop.5
- 46. THANK YOU