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Classification of Periodontal Diseases and Conditions

Dr. Bassam ELGHARABLY

Gingivitis:

Refers to inflammation of soft tissues surrounding the teeth. Does not include inflammation of alveolar ridges, PDL, cementum or alveolar bone.

Periodontitis

is a set of inflammatory diseases affecting the periodontium. (PL,Sementum & alveolar bone)

Healthy

Gingivitis





Gingivitis or periodontitis
Extent of the lesion
LOCALIZED
GENERALİZED
% 30 ?

GİNGİVİTİS

Distribution of the lesion

PAPİLLAR

MARGINAL
PAPİLLAR and MARGINAL
(diffused)

PAPİLLAR GİNGİVİTİS

PAPİLLAR GİNGİVİTİS

MARGINAlL GİNGİVİTİS

MARGINAlL GİNGİVİTİS

GİNGİVİTİS

Distribution of the lesion

PAPİLLAR

MARGINAL
PAPİLLAR and MARGINAL
(diffused)

Calssification of periodontitis based on ammont of attachment loss

Slight : 1 to 2 mm clinical attachment loss (CAL)

Moderate : 3 to 4 mm CAL.

Severe : ≥5 mm CAL.

• American Dental Association Classifications (ADA)

The system developed by the American Dental Association classification


These Case Types are commonly required for insurance billing.

system is primarily based on the severity of attachment loss. The clinician uses the clinical and radiographic data gathered and classifies the patient into one of the four Case Types.

• American Dental Association Classifications (ADA)

• 1. Case Type I: Gingivitis
•
• 2. Case Type II: Early Periodontitis
• 3. Case Type III: Moderate Periodontitis
• 4. Case Type IV: Advanced Periodontitis

• American Academy of Periodontology (AAP)

The American Academy of Periodontology classification system was established to identify distinct types of periodontal diseases by taking into consideration factors such as
age of onset, clinical appearance, rate of disease progression, pathogenic microbial flora and systemic influences.
The two major categories are Gingivitis and Periodontitis.
Within each category there are specific types of diseases identified

• Gingivitis Subdivisions (-)

• Chronic Gingivitis
• Acute Necrotizing Ulcerative Gingivitis
• Gingivitis Associated with Systemic Conditions or Medications
• Hormone-Induced Gingival Inflammation
• Drug-Influenced Gingivitis
• Linear Gingival Erythema (LGE)
• Gingival Manifestations of Systemic Diseases and Mucocutaneous Lesions
• Bacterial, Viral or Fungal
• Blood Dyscrasias (for example Acute Monocytic Leukemia)
• Mucocutaneous Diseases (Lichen Planus, Cicatricial Pemphigoid)


• Periodontitis Subdivisions (-)
• Adult Periodontitis
• Early-Onset Periodontitis
• Prepubertal
• Juvenile Periodontitis
• Rapidly Progressive
• Periodontitis Associated with Systemic Diseases
• Necrotizing Ulcerative Periodontitis
• Refractory Periodontitis

Periapical radiographs of a 36-year-old patient, showing severe generalized bone loss.

Diagnosis: ‘chronic adult periodontitis’ or ‘early-onset periodontitis’?

• AAP Classification (-)

The American Academy of Periodontology has recently published changes in the classification system for periodontal diseases

These changes are from the 1999 International Workshop for a Classification of Periodontal Diseases and Conditions.


• A AP Classification (+)
Conditions. Highlights of the changes are as follows:
• Addition of a section on "Gingival Diseases"
• Replacement of "Adult Periodontitis" with "Chronic Periodontitis“
• Replacement of "Early-Onset Periodontitis" with "Aggressive Periodontitis"
• Elimination of a separate disease category for "Refractory Periodontitis"
• Replacement of "Necrotizing Ulcerative Periodontitis" with "Necrotizing Periodontal Diseases"
• Addition of a category on "Periodontal Abscess"
• Addition of a category on "Periodontic-Endodontic Lesions"
• Addition of a category on "Developmental or Acquired Deformities & Conditions"

The 1999 International Workshop for the Classification of Gingival Diseases (+)

A. Dental plaque-induced gingival diseases

B. Non-plaque-induced gingival lesions

Dental plaque-induced gingival diseases (+)
• 1.Gingivitis associated with dental plaque only
• 2. Gingival diseases modified by systemic factors
3. Gingival diseases modified by medications


4. Gingival diseases modified by malnutrition

• Classification of Gingival DiseasesNon-Plaque induced gingival lesions (+)

• 1. Gingival diseases of specific bacterial origin
2. Gingival diseases of viral origin

3. Gingival diseases of fungal origin

4. Gingival diseases of genetic origin

5. Gingival manifestations of systemic conditions

6. Traumatic lesions

7. Foreign body reactions

• Classification of Periodontitis (+)

1. Chronic Periodontitis
Localized
Generalized
2. Aggressive Periodontitis
Localized
Generalized
3. Periodontitis Associated with Systemic Diseases


4. Necrotizing Periodontal Diseases

5. Abscesses of the Periodontium

6. Periodontal Diseases associated with Endodontic Lesions

7. Developmental or Acquired Deformities and Conditions