Classification

Question 1

What are the 10 classifications

Answer 1

1.Health
intact periodontium
reduced periodontium

2.Plaque-induced Gingivitis: (localised/generalised gingivitis)
intact periodontium
reduced periodontium

3.Non Plaque-induced Gingival Diseases and Conditions

4.Periodontitis
Localised(<30% teeth)
Generalised (>30%teeth)
Molar-Incisor pattern

5.Necrotising Periodontal Diseases

6.Periodontitis as a Manifestation of Systemic Disease

7.Systemic Diseases or Conditions Affecting the Periodontal Tissues

8.Periodontal Abscesses

9.Periodontal-endodontic Lesions

10.Mucogingival Deformities and Conditions

Question 2

What is clinical gingival health characterized by

Answer 2

absence of bleeding on probing, erythema and edema, patient symptoms, and attachment and bone loss
Physiological bonelevels range from1.0 to 3.0mm apical to the cemento-enamel junction

For an intact periodontium and a reduced and stable periodontium, gingival health is defined as <10% bleeding sites with probing depths ≤3mm

Question 3

What are the modifying factors of plaque induced gingivitis

Answer 3

A. associated with dental biofilm only

B. Potential modifying factors of plaque induced gingivitis:

1.sysytemic conditions
-sex steroid hormones eg. puberty
-Hyperglycemia
-Leukemia
-Smoking
-Malnutrition

2. Oral factors enhancing plaque accumulation
   -Prominent subG resoration margins
   -Hyposalivation

C. Drug incuded Gingival enlargement

Question 4

What could the causes of non-plaque induced gingival disease be

Answer 4

Genetic/developmental
e.g. hereditary gingival fibromatosis

Specific infections
e.g. herpetic gingival stomatitis, Candida albicans

Inflammatory/immune conditions
e.g. lichen planus, benign mucous membrane pemphigoid

Nutritional deficiency
e.g. vitaminC deficiency

Question 5

What necrotising periodontal disease are there and what do theyinvolve

Answer 5

Necrotising Gingivitis (NG)
– necrosis and ulcer in the interdental papilla (94–100%)
– gingival bleedingn (95–100%)
– pain (86–100%)
– pseudomembrane formation (73–88%)
–halitosis (84–97%).
– extraoral regional lymphadenopathy (44–61%)/fever(20-39%)
– In children, pain and halitosis less frequent, whereas fever, lymphadenopathy, and sialorrhea were more frequent

Necrotising Periodontitis (NP)
– in addition to the signs and symptoms of NG
– periodontal attachment and bone destruction
– frequent extraoral signs
– In severely immune-compromised patients, bone sequestrum may occur

Necrotising Stomatitis (NS)
– bone denudation extended through the alveolar mucosa
– larger areas of osteitis and bone sequestrum

Question 6

What diseases/conditions may show as early presentation of severe perio

Answer 6

Papillon Lefevre Syndrome

leucocyte adhesion deficiency

hypophosphatasia

Down’s syndrome

Ehlers-Danlos

Question 7

What Systemic Diseases or Conditions can Affect the Periodontal Tissues

Answer 7

squamous cell carcinoma

Langerhans cell histiocytosis

uncontrolled diabetes mellitus

Question 8

What types of Gingival recession is there

Answer 8

Recession Type1(RT1):
Gingival recession with no loss of inter-proximal attachment. Interproximal CEJ is clinically not detectable at both mesial and distal aspects of the tooth

Recession Type2 (RT2):
Gingival recession associated with loss of interproximal attachment, The amount of interproximal attachment loss (measured from the interproximal CEJto the depth of the interproximal sulcus/pocket) is less thanor equal to the buccal attachment loss (measured from the buccal CEJ to the apical end-of the buccal sulcus/pocket

Recession Type 3 (RT3):
Gingivalrecession associated with loss of interproximal attachment, The amount of interproximal attachment loss (measured from the interproximal CEJ to the apical end of the sulcus/pocket) is greater than the buccal attachment loss (measured from the buccal CEJ to the apical end of the buccal sulcus/pocket)