Classification and Epidemiology of PD's

Question 1

the 1999 Workshop classification of PDs

Answer 1

3 broad categories:

periodontitis - chronic/ aggressive, NUG/ NUP
gingival diseases
additional categories

Question 2

the 2017 classification does not use chronic/ aggressive for periodontitis. rather, the types of periodontitis are …

Answer 2

periodontitis

necrotising peridontitis

periodontitis as a direct manifestation of systemic disease

Question 3

types of necrotising periodontal diseases

Answer 3

necoritising gingivitis
necrotitisng periodontitis
necrotising stomatitis

Question 4

in periodontitis, the classification is given as stage, event/ distribution, and grade in 2017

what are the stages of periodontitis

Answer 4

1- 4
1= initial periodontitis
2= moderate perio
3= severe perio WITH potential for TOOTH loss
4= severe perio WITH potential LOSS OF DENTITION

Question 5

what are the event/ distribution of periodontitis, 2017 classification

Answer 5

localised
generalised
molar-incisor distribution

Question 6

what are the grades of periodontitis, 2017 classification

Answer 6

A-C
A= slow rate of progression
B=moderate rate of progression
C= rapid rate of progression

Question 7

in staging you look for worst tooth and assess…

Answer 7

extent of bone loss

Question 8

in grading you look at % bone loss/ age. what percentage is given for each grade

Answer 8

A = <0.5
B= 0.5-1.0 
C= >1.0

Question 9

the 1999 classification of necrotising periodontal diseases is

Answer 9

NUG
NUP
and that they may be linked with HIV+ ve

Question 10

features of NUG

Answer 10

changes in gingival contour
necrosis causes punched out interdental papillae
ulceration, BOP,
PAIN
possible secondary foetor oris (hallitosis)
possible pseudomembrane

Question 11

features of NUP

Answer 11

necrosis of:

—> gingival tissues, periodontal ligament and alveolar bone

Question 12

1999 classification of CHRONIC periodontitis is equivalent to 2017 classification of stage ___, grade ____

Answer 12

stage 3/4

grade b

Question 13

chronic periodontitis features..

Answer 13

1. prevalent in ADULTS/ can occur in adolescent s
2. slow- moderate progression
3. plaque aetiology but modifying factors can influence (local and systemic)
4. CAL
5. recession

Question 14

what points is recession marked from

Answer 14

from the CEJ –> to gingival margin

Question 15

when chronic periodontitis affects adolescents, it can be described as being

Answer 15

INCIPIENT because in the initial stage

Question 16

in adolescents a high CAL is linked with ..

Answer 16

SUB- gingival calculus AND the sub-gingival microflora is very complex with 27 genera, 60 species

• -> p gingivalis
• -> p intermedia
• -> a. actinomycetemcomitans

Question 17

1999 classification of AGGRESSIVE periodontitis is equivalent to 2017 classification of stage ___, grade ____, extent ____

Answer 17

stage 4, sometimes 3
grade C (rapid)
extent= molar- incisor if localised, OR can be generalised

Question 18

AGGRESSIVE periodontitis features..

Answer 18

RAPID CAL
patient will generally be healthy except for periodontitis
has a FAMILIAL aggregation (linked with family)
can be localised OR generalised

the amount of microbial deposits is NOT consistent with severity of destruction

high a. actinomycetemcomitans and sometimes p. gingivalis

phagocyte abnormalities

HYPER-responsive macrophage phenotype

progression of CAL and bone loss can be self-limiting

Question 19

LOCALISED aggressive periodontitis specific features..

Answer 19

localised has a CIRCUM- PUBERTAL onset (around time of puberty)

ROBUST serum Ig response to A. actinomycetemcomitans

localised to 1st molar- incisor presentation

INTER-proximal CAL on at LEAST 2 PERMANENT TEETH (one has to be the 1st molar and CANNOT involve more than 2 teeth other than 1st molar or incisors.

Question 20

GENERALISED aggressive periodontitis specific features…

Answer 20

generalised affects 30 plus ages

POOR serum IG response to infecting agents such as A. actinomycetemocomitans, p. gingivalis, p. forsythensis

PRONOUNCED EPISODIC nature of destruction

INTER-proximal CAL on at LEAST 3 TEETH WHICH ARE NOT THE 1ST MOLARS/ INCISORS

stage 4, grade c, generalised

Question 21

periodontitis can also occur PRE-puberty in children/ adolescents in which case aetiological factors are..

Answer 21

systemic conditions such as:

neutropenia 
PLS
downs syndrome
hypo-phosphatasia 
chediak higashi syndrome

Question 22

epidemiology definition

Answer 22

study of distribution/ determinants of health related states/ events in a specific population AND the application of this study to control health problems

Question 23

types of epidemiological studies

Answer 23

cross-sectional study= conducted at a specific point in time. often DESCRIPTIVE

longitudinal study= extends over a long period of time. often ANALYTICAL.

Question 24

what is meant by descriptive study

Answer 24

describes an EXISTING DISTRIBUTION OF VARIABLES

Question 25

what is meany by analytical study

Answer 25

examines ASSOCIATIONS - tests hypotheses

Question 26

in periodontitis, there are 3 models to describe the MODES of PROGRESSION of LOA- loss of attachment. these are….

Answer 26

linear/ continous

bursts of activity

• –> random bursts of activity with quiescent (inactive) phases
• –> Asynchronous multiple bursts clustered during a PARTICULAR PERIOD of patients life