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Classic Lit Fall 2021 > Periodontal Disease Classification > Flashcards

Periodontal Disease Classification Flashcards

1
Q

What was the first Perio Classification recognized by the AAP

A

Orban 1942

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2
Q

When/where was the first world workshop of periodontitis?

A

1966 in Ann Arbor

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3
Q

What are some updates that are included in the newest classification?

A

Multi-dimensional staging and grading
Re-categorization of various forms of perio
Classification of peri-implant diseases/conditions

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4
Q

What type of perio was discussed in the 1966 classification?

A

Chronic Marginal Periodontitis

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5
Q

What type of perio was discussed in the 1977 classification?

A

Juvenile Periodontitis

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6
Q

What kind of perio was discussed in the 1986 classification?

A

Classified by age/distribution:
Prepubertal periodontitis (children)
Localized juvenile (adolescents)
Generalized Juvenile
Adult Perio
Necrotizing ulcerative perio
Refractory perio

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7
Q

What kind of perio was discussed in the 1989 classification?

A

Condensed PreP/LocJuv/GenJuv and added Perio associated with systemic diseasezzzx

Refractory Perio

Adult Perio

Perio associated with systemic disease

Early onset periodontitis (children, adolescents, young adults)

Necrotizing Ulcerative Perio

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8
Q

What kinds of perio were included in the European Workshop on Periodontics? What year?

A

1993

Early-onset perio

Adult perio

Necrotizing Ulcerative Periodontitis

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9
Q

What kinds of perio were included in the 1999 International Workshop on Periodontal Classification?

A
  1. Gingival diseases
    1. Dental plaque-induced gingival diseases
    2. Non-plaque-induced gingival lesions
  2. Chronic Periodontitis
    1. Localized
    2. Generalized
  3. Aggressive Periodontitis
    1. Localized
    2. Generalized
  4. Periodontitis as a Manifestation of Systemic Diseases
  5. Necrotizing Periodontal Diseases
  6. Abscesses of the Periodontium
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10
Q

What is the Case Definition for Periodontal Health? (citation)

A

Absence of clinically detectable inflammation

Less than 10% BOP with PD < 3mm

Chapple et al. 2018

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11
Q

What are the subgroups of Periodontal Health?

A
  1. Periodontal Health
    1. Intact Periodontium (no CAL/BL)
    2. Reduced Periodontium
      1. Periodontitis Patient (Stable)
        1. Non-Periodontitis Patient (CL or GR)
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12
Q

What is the case definition for Stable Periodontitis? (Citation)

A

Control of local/systemic risk factors with minimal (<10%) BOP, PD _<_4mm, and no progressive periodontal destruction. (Chapple et al. 2018)

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13
Q

What are the main groups of the new classification?

A

Periodontal health, Gingival Diseases and Conditions

Forms of Periodontitis

Periodontal Manifestations of Systemic Diseases and Developmental and Acquired Conditions

Peri-implant Diseases and Conditions

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14
Q

What are the subgroups of the first Main Group?

A

Periodontal and Gingival Health

Dental Biofilm Induced (Gingivitis)

Non-Dental Biofilm Induced (Gingival diseases)

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15
Q

What are the subgroups of the second Main Group?

A

Periodontitis

Necrotizing Periodontal Diseases

Periodontitis as a Manifestation of Systemic Diseases

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16
Q

What are the subgroups of the 3rd Main Group?

A

Systemic Diseases or Conditions Affecting the Periodontal Supporting Tissues

Periodontal abscesses and Endo-Perio lesions

Muco-gingival Deformities and Conditions

Traumatic Occlusal Forces

Tooth and Prostheses Related Factors

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17
Q

What are the subgroups of the 4th Main Group?

A

Peri-implant Health

Peri-implant Mucositis

Peri-implantitis

Peri-implant Soft and Hard Tissue Deficiencies

18
Q

What conditions are included in Non-Dental Biofilm-Induced Gingival Diseases?

A

GREAT BIG F’VN PeN

Genetic/Developmental Disorders

Reactive processes

Endocrine

Autoimmune

Traumatic lesions

Bacterial

Inflammatory/Immune conditions

Granulomatous Inflammatory Lesions

Fungal

Viral

Neoplasms

(gingival) Pigmentation

Nutritional/Metabolic diseases

19
Q

Who published on Non-Plaque-Induced Gingival Diseases?

A

Holmstrup et al. 2018

20
Q

What characterizes non-dental biofilm-induced gingival diseases?

A

Not cause by plaque

Does not resolve after plaque removal

May be a manifestation of systemic condition or localized to the oral cavity

Biofilm frequently increases clinical inflammation

21
Q

What are signs and symptoms of Gingivitis?

A

inflammation

swelling

BOP

redness

discomfort on probing

pain

halitosis

difficulty eating

22
Q

What Case Definitions are under the umbrella of Gingival Disease (biofilm induced)? (Citation)

A

Trombelli et al. 2018

Gingivitis in a patient without a reduced periodontium

Gingivitis in a patient with reduced periodontium (who has not been treated for periodontitis)

Gingivitis in a patient with reduced periodontium (who has been treated for periodontitis)

23
Q

Case Definition for Gingivitis

A

Trombelli et al. 2018

PD _<_3mm, BOP >10%, no RBL/CAL

(Generalized = >30%)

24
Q

Case Definition for Gingivitis in a Reduced Periodontium (no hx of perio)

A

Trombelli et al. 2018

CAL (recession)

>10% BOP

RBL Possible (CL)

25
Q

Case Definition for Gingivitis in a patient who has been successfully treated for perio

A

Trombelli et al. 2018

CAL

RBL

BOP >20%

NO BOP IN SITES WITH PD _>_4mm (unstable)

26
Q

How do you diagnose Necrotising Periodontal Diseases?

A

Hx of Pain

Presence of ulceration on gingival margin

Characteristically decapitated gingival papillae

Possible exposure of the marginal alveolar bone

27
Q

What categories are there for Periodontitis as a Manifestation of Systemic Disease?

A

Systemic disorders that:

  1. Impact periodontal inflammation
  2. Influence the pathogenesis of perio
  3. Cause periodontal-tissue loss independent of perio
28
Q

What is the case definition for periodontitis?

A
  • Interproximal* CAL at 2 or more non-adjacent teeth
  • Buccal/Facial* CAL _>_3mm with PD >3mm at 2 or more teeth

Tonetti et al. 2018

29
Q

What are some examples of CAL that are not used to classify a patient as having Periodontitis?

A

Recession of traumatic origin

Caries extending in the cervical area

CAL from malposition or 3rd molar extraction

Endo-Perio lesion

Vertical Root Fracture

30
Q

What is the definition of Periodontitis?

A

Tonetti et al. 2018

Microbially-associated, Host-mediate inflammation that results in loss of periodontal attachment

31
Q

What Categories of Necrotizing Periodontal Diseases are there?

A

Herrera et al. 2018

NUG and NUP are considered different stages of the same disease

Categories:

  1. Necrotizing periodontal disease in a chronic or severely compromised patient
  2. Necrotizing periodontal diseases in a temporarily or moderately compromised patient
32
Q

What is Staging periodontitis based on?

A

Severity

Complexity

Extent

33
Q

What is Severity based on?

A

Interdental CAL at site of greatest loss

RBL

Tooth loss due to Periodontitis

34
Q

What is Complexity based on?

A

Level of Competence/Experience required for optimal care

PD, BL Pattern (vertical/horizontal), Furcation, Ridge defects

Bite collapse, Complex rehab

35
Q

What is Grading based on?

A

Variability and Rate of Progression

Risk of further progression (RBL)

Analysis of possible poor outcomes of tx (Grade Modifiers)

Assessment of the risk that the disease or its treatment may negatively effect the general health of the patient (Risk of Systemic Impact of Perio | Biomarkers)

36
Q

What is the primary criteria for Grading?

A

Direct Evidence:

  • RBL 0mm/5yrs | <2mm/5yrs | >2mm/5yrs

Indirect Evidence:

  • RBL <0.25 | 0.25-1.0 | >1.0
  • Biofilm: Heavy/low progress | Even | Low/Heavy progress
37
Q

What are Grade Modifiers?

A

Risk factors Smoking or Diabetes

38
Q

Case definition of Peri-Implant Health (citation)

A

Araujo and Lindhe 2018

Absence of mucositis

No bone-loss beyond initial remodeling

39
Q

What is the case definition of Peri-Implantitis (Citation)

A

Schwarz et al. 2018

Peri-implant signs of inflammation

RBL following initial healing (>2mm after 1year of prosthesis delivery)

Increased PD vs. initial delivery of prosthesis

in the absence of pervious radiographs - RBL _>_3mm w/ BOP and PD _>_6mm

40
Q

Can Stage improve after initial assignment?

A

NO - not even after improvement post-therapy!

41
Q

What defines a hopeless tooth?

A

Kornman 2020 - Guest editorial (Clarification article)

Hopeless tooth AKA “Irrational to treat”

Teeth which the attachment loss approximates the root WITH a high degree of hypermobility (Grade III)

42
Q

What is a periodontal abscess?

A

a localized accumulation of pus located within the gingival wall of the periodontal pocket, with an expressed periodontal breakdown occurring during a limited period of time, and with easily detectable clinical symptoms

Classic Lit Fall 2021 (29 decks)

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