Perio Grading and Staging

Question 1

Is probing depth alone considered diagnostic?

Answer 1

No

Question 2

___% of adults over 30 yrs old have periodontitis

Answer 2

42%

Question 3

Which stage of periodontitis is the hardest to diagnose?

Answer 3

Stage I

Question 4

Which stages of periodontitis can be treated by general dentist?

Answer 4

Stage 1 and 2

Question 5

Which stages of periodontitis need to be routinely referred?

Answer 5

3 and 4

Question 6

Should you use the best or worst site when staging periodontitis thru CAL?

Answer 6

Worst site

Question 7

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

Answer 7

Periodontitis

Question 8

If CAL is 1-2 mm, what stage of periodontitis?

Answer 8

Stage 1

Question 9

If CAL is 3-4 mm, what stage of periodontitis?

Answer 9

Stage 2

Question 10

If CAL is greater than or equal to 5 mm, what stage of periodontitis?

Answer 10

Stage 3 or 4

Question 11

• Max probing 
depth ≤ 4 mm
• Mostly 
horizontal bone 
loss

Answer 11

Stage 1

Question 12

• Max probing 
depth ≤ 5 mm
• Mostly 
horizontal 
bone loss

Answer 12

Stage 2

Question 13

In addition to 
Stage II
complexity
• Probing 
depths ≥ 6mm
• Vertical bone 
loss ≥ 3mm 
• Class II or III 
Furcation 
Involvements
• Moderate 
ridge defects

Answer 13

Stage 3

Question 14

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

Answer 14

Stage 4

Question 15

In stage 1 or 2, how many teeth are they at risk of losing due to periodontal disease?

Answer 15

none usually

Question 16

In stage 3, how many teeth are they at risk of losing due to periodontal disease?

Answer 16

Up to 4

Question 17

In stage 5, how many teeth are they at risk of losing due to periodontal disease?

Answer 17

5 or more

Question 18

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

Answer 18

•Stage I (initial)

Question 19

Stage ____
3–4 mm CAL, 15%–33% BL, no tooth loss due to periodontal disease, PD 5 mm
or less, mostly horizontal BL

Answer 19

•Stage II (moderate)

Question 20

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

Answer 20

• Stage III (severe with potential for additional tooth loss)

Question 21

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)

Answer 21

•Stage IV (severe with potential for loss of dentition)

Question 22

•if lost ANY teeth due to periodontitis, then automatically Stage ____ or ______

Answer 22

III or IV

Question 23

•Furcation involvement of Grade 2 or 3 automatically puts patient into
Periodontitis Stage ___ or _____

Answer 23

3 or 4 (Severe or Very Severe)

Question 24

—Bone Loss involves less than 30% of teeth in mouth

Answer 24

•1. Localized

Question 25

—Bone Loss involves more than 30% of teeth in mouth

Answer 25

•2. Generalized

Question 26

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

Answer 26

Stage 3 Grade C

Question 27

➢Considers biological features:
•RATE of disease progression
•Risk for further advancement
•Potential threats to general health (including smoking, diabetes)
•Response to standard therapy

Answer 27

Grading

Question 28

*Initially assume Grade _____ then seek specific evidence to shift
to Grade proper grade

Answer 28

Grade B

Question 29

If there is less than 2 mm of bone loss over 5 yrs, what grade?

Answer 29

Grade B

Question 30

If there is greater than 2 mm of bone loss over 5 yrs, what grade?

Answer 30

Grade C

Question 31

Grade ___: Slow rate = Non smoker, non diabetic

Answer 31

Grade A

Question 32

Grade ___: Moderate rate ≤10 cigarettes/day

Diabetic with HbA1c <7%

Answer 32

Grade B

Question 33

Grade __: Rapid rate ≥ 10 cigarettes/day

Diabetic with HbA1c ≥ 7%

Answer 33

Grade C