Clinical attachment loss/ Classification of periodontal disease Flashcards
Describe the distinguishing characteristics of periodontal health
Periodontal and Gingival health
• Assess the gingival health on intact periodontium i.e, no clinical attachment loss or bone loss
• Assess the gingival health on a reduced periodontium in either a non-periodontitis patient (e.g. in patients with some form of gingival recession or following crown lengthening surgery) or in a patient with a history of periodontitis who is currently periodontally stable
• Clinical gingival health can be restored following treatment of gingivitis and periodontitis
Describe gingival diseases in periodontal health
Biofilm induced gingivitis
• Associated with dental biofilm alone
• Mediated by local or systemic risk factors
• Drug influenced gingival enlargement
Non- biofilm induced gingival disease • Genetic/ developmental; disorders • Specific infections • Immune and inflammatory conditions • Endocrine, nutritional and metabolic diseases • Traumatic lesions
Describe the characteristics of the stages of periodontics
Stages
• Stage I: Initial Periodontitis
• Stage II: Moderate Periodontitis
• Stage III: Severe Periodontitis with potential for additional tooth loss
• Stage IV: Severe Periodontitis with potential for loss of the dentition
Describe stage 1 of periodontitis
Characteristics
• Gingival inflammation
• Microbial dysbiosis
• Early LOA
Management
In addition to probing, salivary biomarkers and imaging technology is used to direct treatment
Describe stage 2 of periodontitis
Characteristics
• Damage to tooth supporting structures
• Established periodontitis
Management
Simple; professional bacterial removal and monitoring to arrest disease progression
Treatment
Patient’s response to treatment must be monitored to determine if more intensive management is required
Describe stage 3 of periodontitis
Characteristics
• Significant LOA
• Deep PD Lesions extending to middle portion of root
Management
• Complicated by intraboney defects, and furcation involvement
Treatment
• No need for rehabilitation of masticatory functions
Describe stage 4 of periodontitis
Characteristics
• Significant LOA
• Deep PD Lesions extending to middle portion of root
Management
• Complicated by tooth hypermobility
Treatment
• Requires stabilisation or restoration of masticatory functions
Describe the stages in severity of periodontics
Stage 1:
CAL/ LOA: 1-2 mm
RBL: coronal third of root (<15%)
Tooth loss: 0
Stage 2:
CAL/ LOA: 3-4 mm
RBL: coronal third of root (15% - 33%)
Tooth loss: 0
Stage 3:
CAL/ LOA: 5 mm
RBL: extending to middle third of root and beyond
Tooth loss: 4
Stage 4:
CAL/ LOA: 5 mm
RBL: extending to middle third of root and beyond
Tooth loss: 5+
Describe the stages in the complexity of periodontics
Stage 1:
PD: 4 mm
Type of bone loss: Horizontal
Furcation: no
Stage 2:
PD: 5 mm
Type of bone loss: Horizontal
Furcation: no
Stage 3:
PD: 6 mm
Type of bone loss: Vertical
Furcation: II or III
Stage 4:
PD: 6 mm
Type of bone loss: Vertical
Furcation: Class II or III WITH tooth mobility and less than 20 remaining teeth
Describe grading of periodontitis
Grade A: CAL in 5 years: No loss % bone loss/ age: < 0.25 Characteristics: • Heavy biofilm deposits • Low levels of destruction
Grade B: CAL in 5 years: < 2 mm over 5 years % bone loss/ age: 0.25 - 1.0 Characteristics: • Level of destruction is directly proportional to the amount of biofilm deposits
Grade C: CAL in 5 years: > 2 mm over 5 years % bone loss/ age: > 1.0 Characteristics: • Level of destruction is greater and unrelated to amount of biofilm
Define and describe ‘Loss of Attachment’ (LOA)
- If recession exists, add probing depth of 3mm to recession measurement for each site of tooth, so LOA = 3 + recession
- If recession does not exist . .
- If probing depth is less than or equal to 3mm, there is considered no LOA, so LOA = 0
- However, if probing depth is greater than or equal to 4 mm, subtract 3mm from the probing depth, then LOA = probing depth – 3mm
