W11 Periodontal disease classification

Question 1

What is 1989 Classification of Inflammatory Periodontal Disease?

Answer 1

5 types of periodontal disease identified:

1. Adult periodontitis
2. Early onset periodontitis
3. Periodontitis Associated with systemic disease
4. Necrotising Ulcerative gingivitis
5. Refractory periodontitis

Question 2

What is the 1999 AAP classification of PD and conditions

Answer 2

Attempted to correct main concerns with 1989. 8 main categories. Focuses on the impact of bacteria on plaque induced periodontal disease and the hosts response.

Question 3

What were the changes that took place from 1989-1999?

Answer 3

Adult perio (89) changed to chronix perio (99).
Early-onset perio (89) changed to aggressive perio (99)
Necrotizing Ulverative gingivitis (89) changed to necrotizing periodisease (99)
Refractory perio )89) removed: can be applied to any type
Added: gingival disorders and perio disease as a result of abscess, systemic diseases in conjunct w lesions, developmental, or genetic

Question 4

What is the 1999 AAP classification Type 1 Plaque induced?

Answer 4

Plaque induced gingival disease. Inflammation without CAL.

Most common, menopause, pregnancy.

Question 5

What is Type I gingival diseases?

Answer 5

Non-plaque induced: inflammation without the presence of plaque. Oral manifestation of a systemic disease

Question 6

Define chronic periodontitis. Type II 1999 AAP classification

Answer 6

Destruction consistent with local factors, CAL is irreversible. 
EXTENT
Localised: <30% of sites CAL
Generalised >30% sites of CAL
SEVERITY:
Mild 1-2mm CAL
Moderate 3-4mm CAL
Severe 5+mm CAL

Question 7

Define 1999 AAP classification type III - aggressive periodontitis

Answer 7

Pt is healthy besides perio disease. Destruction not consistent with local factors. Rapid attachement loss and bone destruction. Family history of disease.
LOCALISED: circumpubertal onset.
- first molar/incisor presentation
GENERALISED:
- <30y of age
- at least 3 permanent teeth affected besides 1st incisor/molar

Question 8

Define 1999 AAP type IV periodontitis as a manifestation of systemic disease

Answer 8

Manifiestation of another idsease process.
3 classifications:
Associated with haematological disorder
Associated with genetic disorder.
Not otherwise specified

Question 9

Define 1999 AAP type V Necrotizing periodontitis

Answer 9

Tissue death, yellowish grayish coating over gingiva.

Necrotizing Ulcerative Gingivitis (NUG)
Necrotising Ulcerative Periodontitis (NUP)

Question 10

Define 1999 AAP type VI Periodontits associated with endodontic lesions.

Answer 10

Periodontitis Associated with endodontic lesions.

Infection or death of the tissue dental pulp. Periodontal disease and pulpal disease can affect a tooth at the same time.

Periodontal infection leading to infection of pulp: perio at apex of teeth through which bacteria can transfer to dental pulp.
Infection of pulp leading to destruction of periodontium: infection from the dental pulp spreading to perio ligament and alveolar bone

Question 11

Define Type VII Developmental or acquired deformities and conditions 1999 AAP

Answer 11

Conditions that exist around the teeth that can predispose the periodontium to disease.
Modifications include root fracture, enamel pearls, mucogingival deformities and conditions, occlusal trauma

Question 12

Define Type VIII Abscesses of the Periodontium 1999 AAP classification

Answer 12

Localised collection of pus in an area of periodontal tissue, exacerbation of an existing periodontal pocket.

Clinically:

• Localised swelling
• drainage from tissue
• TTP
• Mobility