Classification of Periodontal Diseases

Question 1

What is the staging system in periodontitis?

Answer 1

Staging from 1-4,
1 = Early/mild (Less than 15% bone loss)
2 = Moderate (Coronal third of root)
3 = Severe (mid third root)
4 = Very severe (apical third of root)

Bone loss = At WORST site

Question 2

what is the grading system for periodontitis and how is it calculated?

Answer 2

Grades A-C
A = Slow (Less than 0.5)
B = Moderate (0.5-1.0)
C = Rapid (More than 1.0)

% bone loss / AGE

Question 3

How is the extent of periodontitis shown?

Answer 3

Localised (Less than 30% teeth)

Generalised (More than 30% teeth)

Molar-incisor pattern

Question 4

How is the current periodontitis status measured?

Answer 4

Currently stable = BoP less 10%, PPD less 4mm

Currently in Remission (improving but not resolved) = BoP more 10%, PPD less 4mm

Currently unstable = PPD more 4mm & BoP

Question 5

what is the risk factor assessment when diagnosing a patient with periodontitis?

Answer 5

examples:
- smoking (# cigarettes a day)
- Diabetes (suboptimally controlled)
- Obesity
- Alcohol

etc

Question 6

what action should you take on a BPE 3 score?

Answer 6

BSP Guidelines:
- sextant should be reviewed AFTER initial treatment and 6ppc completed only for that sextant (AFTER treatment)

SDCEP:
- sextant should have 6ppc BEFORE and AFTER treatment. Carry our RSD where necessary

Question 7

What else apart from the BSP flowchart is required for a periodontitis diagnosis?

Answer 7

• Medical history
• Dental history
• Oral examination
• Further investigations (Radiographs for bone levels etc)

Question 8

what is good gingival health?

Answer 8

• no BoP (less 10%), swelling
• Little to no attachment & bone loss

Question 9

what is plaque-induced gingivitis (includes localised/generalised gingivitis)?

Answer 9

• associated with dental biofilm alone
• mediated by systemic or local risk factors
• drug influenced gingival enlargement (falls into this category)

Question 10

what is non plaque-induced gingival diseases & conditions?

Answer 10

gingival diseases/conditions as a result of:

• genetic/developmental disorders
• specific infections
• neoplasms
• endocrine, nutritional diseases
• traumatic lesions
• etc

Question 11

what is necrotising periodontal disease and what are the 3 main types?

Answer 11

NPD is severe form of perio that can lead to death of the periodontium.

• Necrotising ulcerative gingivitis (NUG)
• Necrotising ulcerative periodontitis (NUP)
• Necrotising stomatitis

Question 12

what is necrotising ulcerative gingivitis (NUG)?

Answer 12

• necrosis and ulcer in the interdental papilla
• gingival bleeding
• halitosis
• pain

Question 13

what is necrotising ulcerative periodontitis (NUP)?

Answer 13

same as NUG but additionally, periodontal attachment and bone destruction

Question 14

What is necrotising stomatitis (NS)?

Answer 14

• bone denudation (erosion) extended through the alveolar mucosa
• larger areas of osteitis