Classification of periodontal diseases

Question 1

What is the purpose of classifying diseases

Answer 1

For clinicians to properly diagnose and treat patients as well as for scientists to investigate etiology, pathogenesis, natural history, and treatment of the diseases and condition ​

Question 2

How is gingival health on an intect and a reduced and stable periodontium defined

Answer 2

Less than 10% bleeding sites with probing depth less than or equal to 3mm

Question 3

What action should be taken is a BPE of 3 is recorded

Answer 3

Option 1 (BSP Guidelines) ​

If a sextant scores 3, this sextant should be reviewed AFTER initial treatment and a 6 point pocket completed for that sextant only (and only after treatment)​

Option 2 (SDCEP)​

If a sextant scores 3, a 6 point pocket chart should be completed for that sextant BEFORE treatment and AFTER. ‘full periodontal examination of all teeth and root surface instrumentation where necessary (N.B. Where code 3 is observed in only one sextant, carry out full periodontal examination and root surface instrumentation of affected teeth in that sextant only)

Question 4

What is the staging and grading system

Answer 4

4 stages based on severity (I, II, III or IV) ​

3 grades based on disease susceptibility (A, B or C)

Question 5

What are the stages of periodontitis

Answer 5

1​-Early/Mild​

Bone loss < 15% or 2mm​

2​-Moderate​

Bone loss to coronal third of root​

3​-Severe ​
(potential for additional tooth loss)​

bone loss at mid third of root​

4​-Very severe​
(potential for loss of dentition)​

Bone loss to apical third of root​

Question 6

What are the grades of periodontitis

Answer 6

A - Slow​

% bone loss/age <0.5​

B - Moderate​

% bone loss/age 0.5-1.0​

C - Rapid​

% bone loss/age >1.0​

Question 7

What does a percentage bone loss/age of <0.5 indicate

Answer 7

Maximum bone loss is less than half the patients age

Question 8

What is the 2017 disease classification of periodontitis

Answer 8

Capture extent, severity ​
(amount of periodontal tissue loss)​

Patient susceptibility​
(estimated by historical rate of progression)​

Current periodontal state ​
(pocket depths/bleeding on probing)​

A system that can be future proofed for update with new biomarker information

Question 9

What does localised and generalised indicate

Answer 9

Local - <30%

General >30%

Question 10

What factors can modify gingivitis

Answer 10

Sex steroid hormones
-puberty
-menstrual cycle
-pregnancy
-oral contraceptives

Hyperglycemia
Leukemia
Malnutrition
Smoking

Question 11

Why is the threshold for pocket depth 4mm

Answer 11

This is the max deptch most patients can keep clean

Question 12

Why is it essential to be able to identify gingivitits and intervene

Answer 12

Teeth with gingivitis are more liekly to be lost

Question 13

When classifying the stage and grade of periodontitis what teeth do we use as reference

Answer 13

The maximum bone loss at worst site

Question 14

What is the classification of stable periodontitis

Answer 14

Bleeding on probing < 10%
Pocket depth < 4 mm
No Bleeding on probing at 4mm sites

Question 15

How is remission of periodontitis identified

Answer 15

Bleeding on probing > 10%
Probing pocket depth <4mm
No Bleeding on probing at 4mm sites

Question 16

What does unstable periodontitis look like

Answer 16

Probing pocket depths > 5mm
or
Probing pocket depths of 4mm and bleeding on probing