9. New Perio Classification Flashcards
What is Stage I Periodontitis?
Initial Periodontitis
*
What is Stage II Periodontitis?
Moderate Periodontitis
What is Stage III Periodontitis?
Severe Periodontitis with potential for additional tooth loss
What is Stage IV Periodontitis?
Severe Periodontitis with potential for loss of the dentition
What is Grade A Periodontitis?
Slow rate of progression
What is Grade B Periodontitis?
Moderate rate of progression
What is Grade C Periodontitis?
Rapid rate of progression
What falls under Other Periodontal Conditions?
- Periodontal Abscesses
- Endodontic - Periodontic Lesions
What term is replacing Aggressive?
Molar/Incisor pattern
What is the most accurate parameter for determining Staging / Severity?
Interproximal CAL
- We will use RBL for staging if we don’t have CAL
What are the 2 “trump cards” that lead to an automatic Stage III diagnosis?
- Vertical Bone Loss > 3mm
- Furcation involvement of Class II or III
What is the “trump card” that leads to an automatic Stage IV diagnosis?
-
< 20 Remaining Teeth (10 opposing pairs)
- Missing due to periodontitis
- Secondary Occlusal Trauma (tooth mobility degree > 2)
What Interdental CAL and RBL coresponds to Stage I?
CAL = 1 - 2mm
RBL = Coronal third (< 15%)
What Interdental CAL and RBL coresponds to Stage II?
CAL = 3 - 4mm
RBL = Coronal third (15% - 33%)
What Interdental CAL and RBL coresponds to Stage III and Stage IV?
CAL = > 5 mm
RBL = extending to middle third of root and beyond
What amount of tooth loss due to periodontitis is classified as Stage III?
< 4 teeth
What amount of tooth loss due to periodontitis is classified as Stage IV?
> 5 teeth
What is added to the Stage as a descriptor?
Extent and Distribution
(based on teeth not sites)
- Localized (< 30% of teeth involved)
- Generalized
- Molar/Incisor pattern
Clinicians should initially assume what Grade of disease?
Grade B
What is the direct evidence of progression used to diagnose Grade B: Moderate Rate?
< 2 mm of RBL or CAL over 5 years
What Risk Factors make someone Grade B?
- < 10 cigarettes/day
- HbA1c < 7.0% in pts with Diabetes
What is the direct evidence of progression used to diagnose Grade C: Rapid Rate?
> 2mm RBL or CAL over 5 years
What Risk Factors make someone Grade C?
- > 10 cigarettes/day
- HbA1c > 7.0% in pts with Diabetes
What is considered Indirect Evidence of Progression when determining Grade?
- % bone loss / age
-
Case Phenotype
- A = heavy biofilm w/ low destruction
- B = destruction commensurate w/ biofilm deposits
- C = destruction exceeds expectations given biofilm deposits (rapid progression / early onset ds)
What is the diagnosis for pts with reduced periodontum for any reason (recession, CL, hx of PD), as long as PDs are < 3mm?
Gingivitis on a reduced periodontium
What is the diagnosis for pts with a history of periodontitis, PDs > 4mm with BOP (at the same sites)?
Indicates a recurrence of disease, so no longer reduced periodontium but Stage I Periodontitis.
What x-rays are needed to diagnosis implant health?
At and 1 year after abutment connection
What is condition is characterized by:
- Absence of: erythema (inflammation), BOP, swelling and suppuration
- NO Bone Loss (< 2 mm)
Peri-implant Health
What is the main characteristic of Peri-implant Mucositis?
BOP on gental probing
erythema, swelling, and/or suppuration may also be present
Increased Probing Depth
What is a plaque-associated pathological condition, characterized by inflammation in ther peri-implant mucosa and subsequent progressive bone loss?
Peri-Implantitis
What are the clinical signs of Peri-Implantitis?
- Inflammation
- Increased probing depths (> 4-8 mm)
- Mucosal recession in addition to loss of supportive bone (> 2-3 mm)
What is used to diagnosis Peri-Implantitis in the absence of previous examination?
- PD > 6mm
- BOP
- Bone Loss > 3mm
What is diagnosed as conditions following the normal healing process of tooth loss that leads to diminished dimensions of the alveolar process/ridge, resulting in both hard- and soft-tissue deficiencies?
Peri-implant Soft- and Hard-Tissue Deficiences
What diagnosis does drug-induced gingival enlargement fall under? What else falls under this diagnosis?
Gingivitis - dental biofilm-induced
- Mediated by systemic or local RFs:
- Pregnancy / puberty induced gingivitis
- Mouth breathing
What are the forms of Periodontitis?
-
Necrotizing Periodontal Disease
- Necrotizing GIngivitis
- Necrotizing Periodontitis
- Necrotizing Stomatitis
- Periodontitis as Manifestations of Systemic Diseases
-
Periodontitis
- Stage
- Extent and Distribution
- Grade
What diagnosis do Periodontal Abscesses and Endodontic-Periodontal Lesions fall under?
Other Periodontal Conditions Affection the Periodontium
- Other Periodontal Conditions
