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Year 1 Sem 1 Periodontics > Introduction to classification of periodontal disease > Flashcards

Introduction to classification of periodontal disease Flashcards

1
Q

List the determinants of clinical periodontal health according to the 2017 AAP Periodontal Classification system

A
  • Microbiological determinants
  • Host determinants
  • Environmental determinants
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2
Q

Identify the microbiological components of the 2017 AAP Periodontal Classification system

A

• Supragingival plaque composition

* Subgingival biofilm composition

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3
Q

Identify the host determinants of the 2017 AAP Periodontal Classification system

A 
Local predisposing factors
○ Periodontal pockets
○ Dental restorations
○ Root anatomy
○ Tooth position and crowding

Systemic modifying factors
○ Host immune function
○ Systemic health
○ Genetics

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4
Q

Identify the environmental determinants of the 2017 AAP Periodontal Classification system

A
  • Smoking
  • Medications
  • Stress
  • Nutrition
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5
Q

List the general categories included in AAP “Periodontal and Gingival Diseases and Conditions”

A
  • Periodontal and Gingival health
  • Biofilm induced gingivitis
  • Non- biofilm induced gingival disease
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6
Q

Describe the “Periodontal and Gingival health” component of “Periodontal and Gingival Diseases and Conditions”

A

• Assesses the gingival health on intact periodontium i.e, no clinical attachment loss or bone loss
• Assesses 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

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7
Q

Describe the “biofilm induced gingivitis” component of “Periodontal and Gingival Diseases and Conditions”

A
  • Associated with dental biofilm alone
  • Mediated by local or systemic risk factors
  • Drug influenced gingival enlargement
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8
Q

Describe the “non- biofilm induced gingivitis” component of “Periodontal and Gingival Diseases and Conditions”

A 
• Genetic/ developmental; disorders
• Specific infections
• Immune and inflammatory conditions
• Endocrine, nutritional and metabolic diseases
Traumatic lesions
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9
Q

List the general categories included in AAP

‘Periodontitis’

A
  • Necrotising Periodontal Diseases
  • Periodontitis
  • Periodontitis as a Manifestation of Systemic Disease
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10
Q

What are the types of Necrotising Periodontal Diseases?

A
  • Necrotising stomatitis
  • Necrotising gingivitis
  • Necrotising periodontium
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11
Q

What are the systemic diseases identified in the category of ‘Periodontitis as a Manifestation of Systemic Disease’? (10)

A
  • Genetic diseases
  • Diseases associated with immunological disorders; down syndrome, severe neutropenia
  • Diseases affecting oral mucosa and gingival tissue; epidermolysis bullosa
  • Diseases affecting connective tissues; systemic lupus erythematous
  • Metabolic and endocrine disorders; glycogen storage disorders
  • Acquired immunodeficiency diseases; HIV, acquired neutropenia
  • Inflammatory diseases; inflammatory bowel disease
  • Systemic disorders; diabetes, obesity, osteoporosis, arthritis,
  • Neoplasms (growths); squamous Cell Carcinoma, secondary metastatic neoplasms of perio tissues
  • Other disorders; langerhans cell histiocytosis, hyperparathyroidism
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12
Q

Explain ‘staging’ of periodontitis

A

Staging is known as classifying the severity and extent of a patients disease based on the measurable amount of destroyed/ damaged tissue

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13
Q

What are elements included in the staging of diseases?

A
  • Complexity
  • Severity
  • Extent and distribution
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14
Q

Describe the “extent and distribution” staging component

A
  • Disease is localised when less than 30% of teeth have loss of attachment (LOA)
  • Disease is generalised when greater than or equal to 30% of teeth have LOA
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15
Q

What does the “complexity” staging component include?

A
  • Probing depth

* Type of bone loss

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16
Q

Describe the “complexity” staging component

A

Stage 1:
• 4 mm PD
* Horizontal bone loss

Stage 2:
• 5 mm PD
* Horizontal bone loss

Stage 3:
• 6 mm PD
• Vertical bone loss 3 mm
* Furcation of Class II or III

Stage 4:
• 6 mm PD
• Vertical bone loss
• All of stage 3 plus masticatory dysfunction
• Tooth mobility
* Less than 20 remaining teeth
17
Q

What does the “severity” staging component include?

A
  • Radiographic bone loss (RBL)
  • Tooth loss
  • Interdental Clinical Attachment Loss (CAL) or LOA (loss of attachment)
18
Q

Describe the “CAL or LOA” of the severity staging component

A
  • Measured from CEJ to base of sulcus
  • Not the same as probing depth
  • To measure when recession is present: probing depth + recession
  • No recession but PD of 4mm: probing depth - 3mm (healthy gingiva is 3 mm max)

Stage 1: 1- 2mm
Stage 2: 3- 4 mm
Stage 3: 5mm
Stage 4: 5mm

19
Q

Describe the “RBL” of the severity staging component

A
  • Stage I: coronal third of root (<15%)
  • Stage II: coronal third of root(15 - 33%)
  • Stage III and IV: extending to middle third of root and beyond
20
Q

Describe the “Tooth loss” of the severity staging component

A

Stage 1: 0

Stage 2: 0

Stage 3: 4

Stage 4: 5+

21
Q

Discuss the key characteristics of stage 1 periodontitis

A

• Gingival inflammation
• Microbial dysbiosis
* Early LOA

22
Q

Discuss the key characteristics of stage 2 periodontitis

A

• Damage to tooth supporting structures

  • Established periodontitis
  • Management: simple; professional bacterial removal and monitoring to arrest disease progression
23
Q

Discuss the key characteristics of stage 3

A

• Significant LOA

  • Deep PD Lesions extending to middle portion of root
  • Management: complicated by infraboney defects, and furcation involvement
24
Q

Discuss the key characteristics of stage 4

A

• Significant LOA

  • Deep PD Lesions extending to middle portion of root
  • Management: Complicated by tooth hypermobility
  • Requires stabilisation or restoration of masticatory functions
25
Q

Discuss the ‘primary criteria’ and how it assists in determining the grade of periodontitis

A

The primary criteria uses DIRECT EVIDENCE of progression SUCH AS radiographic bone loss or CAL, or INDIRECT EVIDENCE SUCH AS %bone loss/age and characteristics, in order to assign a grade

26
Q

What does the primary criteria in assigning a grade include?

A

Direct evidence:
* RBL

Indirect evidence:

  • % bone loss/ age
  • characteristics
27
Q

List the primary criteria used in classifying a Grade A: Slow rate of progression

A
  • No CAL loss over 5 years
  • % bone loss/ age:
    < 0.25

CHARACTERISTICS

  • Heavy biofilm deposits
  • Low levels of destruction
28
Q

List the primary criteria used in classifying a Grade B: Moderate rate of progression

A
  • < 2mm CAL loss over 5 years
  • % bone loss/ age:
    0. 25- 1.0

CHARACTERISTICS
* Level of destruction is directly proportional to the amount of biofilm deposits

29
Q

List the primary criteria used in classifying a Grade C: Moderate rate of progression

A
  • > 2mm CAL loss over 5 years
  • % bone loss/ age:
    > 1.0

CHARACTERISTICS
* Level of destruction is greater and unrelated to amount of biofilm

Year 1 Sem 1 Periodontics (9 decks)

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