New Perio Classification

Question 1

Why use the new classification?

Answer 1

Include peri-implant health
Defines clinical health
Difference between intact and reduced periodontium

Question 2

Why was aggressive periodontitis removed?

Answer 2

Little evidence chronic and aggressive are separate entities

Question 3

What is grading/ staging system?

Answer 3

Staging - bone loss - graded I–> IV

Grading - progression (% bone lost/pt age) - stage A,B, C

Question 4

What is periodontal and gingival health?

Answer 4

Absence of clinically detectable disease
Less 10% bleeding (biological level of immune surveillance consistent w/ gingival health)
Physiological bone levels range 1-3mm apical to CEJ

Question 5

What is biofilm induced gingivitis?

Answer 5

Inflammatory lesion - interaction between plaque and host immune inflammation response
Local predisposing factors - retentive factors/ systemic modifying factors
Confined gingiva - doesn’t extend beyond mucogingival junction
Reversible
>10% BOP

Question 6

What is non-biofilm induced gingivitis?

Answer 6

Not caused by plaque - doesn’t resolve on plaque removal
Inflammation extend beyond mucogingival junction
e.g Thermal trauma/ herpes simplex virus

Question 7

How is necrotising conditions defined?

Answer 7

1. Necrotising gingivitis
2. Necrotising periodontitis
3. Necrotising stomatitis

Question 8

What is necrotising gingivitis?

Answer 8

Ulceration, necrosis of gingiva
Pain and halitosis
Only soft tissue damage, no bone loss

Question 9

How can systemic conditions or genetic disorders affect perio?

Answer 9

Systemic conditions can impact loss of periodontal tissues

Genetic disorders - immunodeficiency/ altered inflammatory respond

Question 10

What is Ehlers-Danlos syndrome?

Answer 10

Collagen abnormality: hyper-flexibility of joints, hyper extendable skin, increased bleeding and bruising

Question 11

How can mucogingival deformities affect perio?

Answer 11

Gingival phenotype affect gingival thickness and width, inter-proximal attachment

Question 12

How can traumatic occlusal forces affect perio?

Answer 12

Result in injury to teeth leading to adaptive mobility in teeth w/ normal support and progressive mobility in teeth w/ reduced support

Question 13

What is peri-implant health?

Answer 13

Absence erythema, BOP, swelling and suppuration
No increase PD compared previous examination
Need baseline radiograph following completion of implant prosthesis placement
Absence bone loss beyond crestal bone level changes resulting from initial bone remodelling

Question 14

What is peri-implant mucositis?

Answer 14

BOP, erythema, swelling +/or suppuration
Increased PD due swelling or decrease probing resistance
Caused plaque
Absence of bone loss beyond crestal bone level changes resulting from initial bone remodelling

Question 15

What is peri-implantitis?

Answer 15

Inflammation peri-implant mucosa and subsequent loss of supportive bone
Absence tx = progressive non-linear and accelerating pattern

Question 16

How assess implants in absence previous of data - how diagnose?

Answer 16

presence bleeding, probing depth of 6mm+

Question 17

What are the risk factors associated w/ recession of peri-implant mucosa?

Answer 17

Malpositioned implant
Lack buccal bone 
Thin soft tissue 
Lack keratinised tissue
Surgical trauma