Classification of disease Flashcards
What are the indicators of Periodontal Health?
- Minimal to no Bleeding on Probing
- Shallow pockets or deep “healthy” pockets
- Minimal to no radiographic bone loss
- Physiologic tooth mobility <0.2mm
What are gingival disease / conditions classifications?
Gingivitis:
- Gingival Diseases Biofilm Induced
- Gingival Diseases Non Biofilm Induced
Biofilm Induced:
- Mediated by Systemic Local Factors
- Drug Induced Gingival Enlargement
Non Biofilm Induced Categories:
- Inflammatory and Immune Conditions
- Reactive Processes
- Neoplasam
- Endocrine, Nutritional, Metabolic
- Traumatic Lesions
What are the determinants of periodontal health?
- Microbiologic Determinants (Supra/Sub Microorganisms)
- Host Determinants (Local & Systemic Factors)
- Environmental Determinants (Smoking, Medication, Stress, Nutrition)
What is the new classification of periodontal diseases?
- Staging
- Grading
- Extent
What 3 forms of periodontal disease are recognized in the new classification system?
- Periodontitis
- Periodontitis as a Systemic Manifestation
- Necrotizing
What is Stage 1
A. Interdental CAL: 1 - 2 mm
B. Radiographic bone loss: Coronal third is <15%
C. Tooth loss- no tooth loss due to Periodontitis
D. Max probing depth: 4mm or less
What is Stage 2?
A. Interdental CAL 3-4 mm
B. Radiographs Coronal third is 15%-33%
C. Tooth loss- no tooth loss due to Periodontitis
D. Max probing depth = 5mm or less
What is Stage 3
A. Interdental CAL: 5mm or more
B. Radiographic bone loss: Mid third of root or beyond
C. 4 or less teeth lost due to periodontitis
D. PD 6mm or greater
Vertical bone loss >3mm or greater
Furcation involvement Class II or III
Moderate ridge defect
What is Stage 4?
A. Interdental CAL: 5mm or more
B. Radiographic bone loss: Mid third of root or beyond
C. 5+ teeth lost due to periodontitis
D. Stage III complexity plus:
1. Need for complex rehabilitation
2. Masticatory dysfunction
3. Secondary occlusal trauma (> Degree 2 mobility)
4. Severe ridge defect
5. Bite collapse, drifting, flaring
6. Less than 20 remaining teeth (10 opposing pairs)
Think Very severe periodontitis
What is Grading?
Progression of the disease
What is Grade A
A. Progression bone loss/CAL: No evidence of bone loss over 5 years
B. % Bone loss/ Age: < 0.25
C. Phenotype: Heavy biofilm with low level of destruction
D. Risk Factors/ Systemic:
Non-smoker
Non diabetic
<1mg/L high sensitivity CRP
What is Grade B?
A. Progression bone loss/CAL: <2mm over 5 years
B. % Bone loss/ Age: 0.25 – 1.0
C. Phenotype: Destruction commensurates with biofilm deposits
D. Risk Factors/ Systemic:
Smoker <10 cigarettes/day
Diabetic patient with HbA1c <7%
1-3mg/L high sensitivity CRP
What is Grade C?
A. Progression bone loss/CAL: >2mm over 5 years
B. % Bone loss/ Age: > 1.0
C. Phenotype: Destruction exceeds expectation given amount of biofilm
D. Risk Factors/ Systemic:
Smoker >10 cigarettes/day
Diabetic patient with HbA1c >7%
>3mg/L high sensitivity CRP
What is localized
Less than 30% of teeth involved
What is generalized
More than 30% of teeth involved
What stage is tooth loss 4 teeth or less?
Stage III
What stage is tooth loss > 5?
Stage 4
What stages for radiographic bone loss?
Stage 1: <15%
Stage 2: 15 - 33%
Stage 3: mid 1/3 of root or beyond
Stage 4: mid 1/3 of root or beyond
How do you calculate grade?
% bone loss / age
What grade is someone who Smokes less than 10 cigarettes/day?
Grade B
What grade is someone who Smokes more than 10 cigarettes/day?
Grade C
What grade is someone with HbA1c < 7?
Grade B
What grade is someone with HbA1c > 7?
Grade C
What grade is Radiographic bone loss of more than 2 mm in 5 years?
Grade C
Systemic Disease associated with periodontitis?
TOO MANY LOOK AT POWERPOINT
A few are
1. Dx affecting Immunological
leukocyte adhesion deficiency, down syndrome, Papillon-Lefevre syndrome, neutropenias and other severe immunodeficiency disorders.
2. Dx affecting Oral mucosa and gingival tissue
3. Dx affecting Connective Tissue
4. Metabolic and Endocrine Disorders
Papillon-Lefevre syndrome characteristics?
Palms, feet, knees hyperkeratosis
What are the 3 classifications of Necrotizing diseases?
- Necrotizing Gingivitis
- Necrotizing Periodontitis
- Necrotizing Stomatitis
Classify Abscess
- Periodontal abscesses in periodontitis patients
a. acute exacerbation or after treatment - Periodontal abscesses in non-periodontitis patients
a. Impaction
B. Harmful Habits
C. Ortho Factors
D. Gingival Overgrowth
E. Root alteration
F. Iatrogenic
G. Fracture
Classify perio associated with endo lesions
- with root damage
- without root damage
What is the Cairo Recession classification?
1: No loss of interproximal attachment
2: Recession with loss of interproximal attachment < buccal CAL
3: Recession with loss of interproximal attachment > buccal CAL
What is peri implant health?
- No Erythema
- No BOP
- No inflammation
- No radiographic bone loss changes above 2 mm
- PD less than 5mm
What are the case types for insurance?
Type 1: Gingivitis
Type 2: Early perio
Type 3: Moderate perio
Type 4: Severe perio
