Perio Classification

Question 1

Give examples of non-plaque induced gingival diseases

Answer 1

• herpetic gingival stomatitis
• genetic
• immune conditions e.g. lichen planus
• vitamin c deficiency

Question 2

What are the signs and symptoms of necrotising gingivitis?

Answer 2

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

Question 3

Periodontal health definitions

Answer 3

• patients with an intact peridontium
• patients with a reduced periodontium due to causes other than periodontitis and
• patients with a reduced periodontium due to periodontitis

Question 4

gingival health definition for an intact periodontium

Answer 4

absence of:
- bleeding on probing
- erythema and edema
- patient symptoms
- attachment and bone loss

physiological bone levels range from 1 to 3mm apical to ACJ

Question 5

Gingival health definition for reduced and stable periodontium that’s intact

Answer 5

• <10% bleeding sites
• probing depth less than or equal to 3mm

Question 6

plaque induced gingivitis features

Answer 6

• associated with dental biofilm alone
• mediated by systemic or local risk factors
• drug influenced gingival enlargement
• no radiological bone loss
• no interdental recession

Question 7

Localised vs generalised gingivitis

Answer 7

localised
<30% BOP

generalised
>30% bleeding on probing

Question 8

potential modifying factors of plaque induced gingivitis

Answer 8

systemic conditions
- sex steroid hormones e.g. menstrual cycle, puberty, pregnancy, oral contraceptives
- hyperglycaemia
- leukaemia
- smoking
- malnutrition
oral factors enhancing plaque accumulation
- prominent sub gingival restoration margins
- hyposalivation

Question 9

necrotising gingivitis - features

Answer 9

• necrosis and ulcer in interdental papilla
• gingival bleeding
• pain
• pseudomembrane formation
• halitosis
• regional lymphadenopathy
• fever

Question 10

necrotising periodontitis features

Answer 10

in addition to signs and symptoms of NG:
- periodontal attachment and bone destruction
- frequent extraoral signs
- bone sequestrum possible in severely immune-compromised patient

Question 11

necrotising stomatitis symptoms

Answer 11

• bone destruction extended through alveolar mucosa
• larger areas of osteitis and bone sequestrum

Question 12

Periodontitis as a manifestation of systemic disease

Answer 12

classification based on primary systemic disease
mainly rare diseases affecting course of periodontitis in early presentation of severe periodontitis:
- papillon lefervre syndrome
- leucocyte adhesion deficiency
- Down’s syndrome

Question 13

systemic diseases or conditions affecting periodontal tissues

Answer 13

mainly rare conditions affecting the periodontal sporting tissues independently of dental plaque biofilm induced inflammations:
- squamous cell carcinoma
- langerhans cell histicytosis

Question 14

mucogingival deformities and conditions

Answer 14

gingival recession
- lack of keratinised gingiva/abnormal frenal attachment

Question 15

Recession type 1 characteristics

Answer 15

gingival recession with no loss of inter-proximal attachment

Question 16

Recession type 2 characteristics

Answer 16

gingival recession associated with loss of inter proximal attachment
- interproximal attachment loss less than or equal to buccal attachment loss

Question 17

Recession type 3 characteristics

Answer 17

gingival recession associated with loss of inter-proximal attachment
- interporximal attachment loss greater than buccal attachment loss