Classification of periodontal disease Flashcards
5 categories in 2017 periodontal disease classification system?
Periodontal health Gingivitis Periodontitis Other conditions affecting periodontium Peri-implant diseases
Criteria for gingiva health?
No clinical attachment loss
No pockets >3mm
BOP <10%
No bone loss
List 3 necrotising periodontal diseases?
Necrotising gingivitis
Necrotising periodontitis
Necrotising stomatitis
What is necrotising gingivitis?
Acute inflammation of gingival tissue categorised by necrosis of interdental papillae, gingival bleeding, pain
What is necrotising periodontitis?
Inflammation of periodontium characterised by necrosis of interdental papillae, gingival bleeding, pain, periodontal attachment/bone destruction
What is necrotising stomatitis?
Severe inflammatory condition of periodontium and oral cavity, involving soft tissue necrosis beyond gingiva, bone loss
How can periodontitis classified?
Extent Stage Grade Stability Risk factors
What does the stage of periodontitis reflect?
The amount of periodontal tissue loss
What does the grade of periodontitis reflect?
Historical rate of periodontal progression
How can extent of periodontitis be established?
How many teeth are effected:
<30% = localised periodontitis
>30% = generalised
Only molar/incisor = periodontitis molar-incisor pattern
How can the stage of periodontitis be established?
Bone levels (radiographic assessment) <15% bone loss (<2mm attachment loss from CEJ)) = Stage I = early/mild Coronal third of root = Stage II = moderate Mid third of tooth = stage III = severe Apical third of tooth (or tooth loss due to perio) = stage IV = very severe
How is grading of periodontal disease established?
% bone loss/patients age
<0.5 = grade A = slow rate of progression
0.5-1.0 = grade B = moderate rate of progression
>1.0 = grade c = rapid rate of progression
List 3 risk factors for periodontitis
General health - medications
Smoking
Diabetes
When is a patient with periodontitis classified as stable?
BOP <10%
PPD < 4mm
No BOP at 4mm sites
When is a patient with periodontitis classified as in remission?
BOP>10%
PPD <4mm
No BOP at 4mm sites
When is a patient with periodontitis classified as unstable?
PPD>5mm or PPD?4mm and BOP
List 5 genetic disorders that can cause periodontitis as a manifestation of systemic disease
Downs syndrome Papillon-Lefevre syndrome Ehlers-Danlos syndrome Hypophosphatasia - imparted calcification of bones and teeth Neutropenia
List 2 acquired immunodeficiency diseases that can cause periodontitis as a manifestation of system disease
Acquired neutropenia
HIV infection
How does Papillon-Lefevre syndrome?
Severe periodontal disease early in life
Hyperkeratosis early in life
Name 3 systemic diseases that effect the periodontal supporting tissues
Neoplasma e.g. odontogenic tumours, squamous cell carcinoma
Other disorders e.g. hyperparathyroidism - abnormal bone metabolism
How are periodontal accesses and Endodontics-periodontal lesions classified?
- In periodontitis patients e.g. after treatment
- In non-periodontitis patients e.g. due to impact/harmful habits
Endodontics-periodontal lesions = affect both the periodontal and Endodontics disease affect the same tooth at the same time
How can peri-implant health be classified?
No visual signs of inflammation
Absence of suppuration or profuse BOP
Probing depths don’t increase over time
No bone loss beyond initial
How can peri-implant mucotitis be classified?
Visual signs of inflammation
Suppuration or BOP
Increase in PPD compared to baseline
No bone loss
How can peri-implanitis be classified?
Visual sings of inflammation
Presence of suppuration or BOP
Increased PPD over time
Bone loss
What can cause peri-implant soft and hard tissue deficiencies?
Tooth loss prior to implant placement, malpositioned implants
List 9 factors that influence probing accuracy
Probing force Probe angulation Thickness of probe Accuracy of probe markings Examiner experience Degree of inflammation of soft tissues Presence of subgingival calculus or anatomical features Location of probing Visibility
Is periodontal disease more severe in older or younger patients, generally?
Older
