Perio Grading and Staging Flashcards
Is probing depth alone considered diagnostic?
No
___% of adults over 30 yrs old have periodontitis
42%
Which stage of periodontitis is the hardest to diagnose?
Stage I
Which stages of periodontitis can be treated by general dentist?
Stage 1 and 2
Which stages of periodontitis need to be routinely referred?
3 and 4
Should you use the best or worst site when staging periodontitis thru CAL?
Worst site
Interdental Clinical Attachment Loss at 2 or more non-adjacent teeth
OR
•Buccal or Oral Clinical Attachment Loss ≥ 3 mm
•with pocketing >3mm
•on 2 or more teeth
Periodontitis
If CAL is 1-2 mm, what stage of periodontitis?
Stage 1
If CAL is 3-4 mm, what stage of periodontitis?
Stage 2
If CAL is greater than or equal to 5 mm, what stage of periodontitis?
Stage 3 or 4
• Max probing depth ≤ 4 mm • Mostly horizontal bone loss
Stage 1
• Max probing depth ≤ 5 mm • Mostly horizontal bone loss
Stage 2
In addition to Stage II complexity • Probing depths ≥ 6mm • Vertical bone loss ≥ 3mm • Class II or III Furcation Involvements • Moderate ridge defects
Stage 3
In addition to Stage III complexity Need for complex rehabilitation due to • Masticatory dysfunction • Secondary Occlusal Trauma (≥ 2 mobility) • Bite collapse, drifting, flaring • <10 opposing pairs remaining teeth (<20 teeth total) • Severe ridge defects
Stage 4
In stage 1 or 2, how many teeth are they at risk of losing due to periodontal disease?
none usually
In stage 3, how many teeth are they at risk of losing due to periodontal disease?
Up to 4
In stage 5, how many teeth are they at risk of losing due to periodontal disease?
5 or more
Stage ____
•1–2 mm clinical attachment loss (CAL), less than 15% bone loss (BL) around
root, no tooth loss due to periodontal disease, probing depth (PD) 4 mm or
less, mostly horizontal BL
•Stage I (initial)
Stage ____
3–4 mm CAL, 15%–33% BL, no tooth loss due to periodontal disease, PD 5 mm
or less, mostly horizontal BL
•Stage II (moderate)
Stage _____
5 mm or more CAL, BL beyond 33%, tooth loss of four teeth or less (due to
periodontal disease), with complex issues such as PD 6 mm or more, vertical
BL 3 mm or more, Class II–III furcations, and/or moderate ridge defects
• Stage III (severe with potential for additional tooth loss)
Stage ______
Encompasses all of Stage III with additional features that will require the need
for complex rehabilitation due to masticatory dysfunction, secondary occlusal
trauma, severe ridge defects, bite collapse, pathologic migration of teeth, less
than 20 remaining teeth (10 opposing pairs)
•Stage IV (severe with potential for loss of dentition)
•if lost ANY teeth due to periodontitis, then automatically Stage ____ or ______
III or IV
•Furcation involvement of Grade 2 or 3 automatically puts patient into
Periodontitis Stage ___ or _____
3 or 4 (Severe or Very Severe)
—Bone Loss involves less than 30% of teeth in mouth
•1. Localized
—Bone Loss involves more than 30% of teeth in mouth
•2. Generalized
What stage and grade is Molar/Incisor pattern generally applies to ‘old’ classifications of
•Localized Aggressive Periodontitis which was known before that as
• Localized Juvenile Periodontitis
Stage 3 Grade C
➢Considers biological features: •RATE of disease progression •Risk for further advancement •Potential threats to general health (including smoking, diabetes) •Response to standard therapy
Grading
*Initially assume Grade _____ then seek specific evidence to shift
to Grade proper grade
Grade B
If there is less than 2 mm of bone loss over 5 yrs, what grade?
Grade B
If there is greater than 2 mm of bone loss over 5 yrs, what grade?
Grade C
Grade ___: Slow rate = Non smoker, non diabetic
Grade A
Grade ___: Moderate rate ≤10 cigarettes/day
Diabetic with HbA1c <7%
Grade B
Grade __: Rapid rate ≥ 10 cigarettes/day
Diabetic with HbA1c ≥ 7%
Grade C
