Classification of Periodontal Disease
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Questions and Answers

Which factor is considered when staging periodontal disease?

  • Severity based on percentage of bone loss (correct)
  • Current disease status
  • Rate of patient recovery
  • Extent of dental plaque
  • What characteristic distinguishes localized periodontal disease?

  • Bone loss affecting up to 30% of teeth (correct)
  • Presence of dental caries in multiple teeth
  • Persistent inflammation in all quadrants
  • Bone loss affecting more than 30% of teeth
  • What is a limitation of the EFP/BSP classification system?

  • Variations in classification can occur (correct)
  • It is overly complex for clinical practice
  • It requires radiographic evidence for diagnosis
  • It does not include severity assessment
  • What is the primary indicator of periodontitis?

    <p>Bone loss caused by infection</p> Signup and view all the answers

    Which of the following correctly identifies the risk factor associated with periodontal disease?

    <p>Smoking habits</p> Signup and view all the answers

    What type of disease is characterized by host-mediated inflammation leading to the loss of periodontal attachment?

    <p>Periodontitis</p> Signup and view all the answers

    Which of the following best describes plaque-induced gingivitis?

    <p>Exacerbated by systemic conditions</p> Signup and view all the answers

    What is the primary focus of periodontal disease classification from 1970 to the present?

    <p>Complex multifactorial interactions</p> Signup and view all the answers

    Which classification period emphasized the observation of bacterial influences on periodontal disease?

    <p>1920 - 1970</p> Signup and view all the answers

    What distinguishes non biofilm-induced gingival diseases from biofilm-induced diseases?

    <p>Lack of microbial involvement</p> Signup and view all the answers

    Which statement about periodontitis is correct?

    <p>It is a spectrum disorder.</p> Signup and view all the answers

    Which of the following is NOT one of the intended learning outcomes related to periodontal classification?

    <p>Identify surgical techniques for periodontal management</p> Signup and view all the answers

    The rationale for classification systems in periodontal disease is primarily to:

    <p>Understand the interactions between various factors involved in disease</p> Signup and view all the answers

    Which of these conditions is recognized as a necrotising disease?

    <p>Necrotizing ulcerative gingivitis</p> Signup and view all the answers

    What development marked the transition in understanding periodontal disease classification in 2017?

    <p>Acknowledgment of multifactorial aspects of periodontal disease</p> Signup and view all the answers

    What staging classification is assigned to a patient who has lost a tooth due to advanced periodontal bone loss?

    <p>Stage IV</p> Signup and view all the answers

    What does grading primarily assess in periodontal disease?

    <p>Percentage of bone loss relative to age</p> Signup and view all the answers

    According to the guidelines for grading, what is the criterion for Grade A?

    <p>Bone loss is less than half of patient's age</p> Signup and view all the answers

    Why is the current disease status important in periodontal assessment?

    <p>To identify historic disease activity</p> Signup and view all the answers

    What does the statement 'Once a perio patient, always a perio patient' imply?

    <p>Patients must always be monitored for periodontal health.</p> Signup and view all the answers

    What does the process of classification in periodontal diagnosis incorporate?

    <p>Stage, grade, current status, and lifestyle risks</p> Signup and view all the answers

    What is one of the elements factored into grading a periodontal patient?

    <p>The percentage of bone loss</p> Signup and view all the answers

    How does a patient's age impact grading in periodontal evaluation?

    <p>It defines the threshold for acceptable bone loss.</p> Signup and view all the answers

    What classification was established by the American Academy of Periodontology in 1999?

    <p>Chronic Periodontitis</p> Signup and view all the answers

    Which classification system was introduced first according to the chronology?

    <p>Kantorowicz - 1924</p> Signup and view all the answers

    Which of the following is NOT included in the classifications by the American Academy of Periodontology 1999?

    <p>Aggressive periodontitis</p> Signup and view all the answers

    Which term was removed as a separate category in the 1999 classification?

    <p>Refractory Periodontitis</p> Signup and view all the answers

    What was the focus of the World Workshop in Clinical Periodontics held in 1993?

    <p>Adult Periodontitis classification</p> Signup and view all the answers

    How does 'Early-onset Periodontitis' differ from 'Adult Periodontitis' based on previous classifications?

    <p>It begins before the fourth decade of life.</p> Signup and view all the answers

    Who was responsible for a classification system introduced in 1956?

    <p>Goldman</p> Signup and view all the answers

    Which classification system was established last in the chronology provided?

    <p>World Workshop on Classification of Periodontal and Peri-Implant diseases - 2017</p> Signup and view all the answers

    What replaced 'Necrotising Ulcerative Periodontitis' in the 1999 classification?

    <p>Necrotising Periodontal Diseases</p> Signup and view all the answers

    Study Notes

    Periodontal Disease Classification

    • Key GDC learning outcomes include assessing and managing periodontal and soft tissue health, considering risk and lifestyle factors. Monitoring and recording changes in periodontal health using appropriate indices is also crucial.

    History of Periodontal Disease Classification

    • Three paradigms exist in the history of periodontal disease classification:
      • 1870-1920: Lack of information regarding pathogenesis, relying on clinical appearance and patient reports.
      • 1920-1970: Inflammatory/non-inflammatory paradigm, with some acknowledgement of bacterial influence and observation of some cases being degenerative.
      • 1970-present: Recognition of complex multifactorial factors, including subgingival microbiota, host inflammatory response, and environmental influences. No longer simply a bacterial infection.

    Chronology of Classification Systems

    • A timeline of key figures and classification systems, with dates. This section lists various names and dates for these classifications.

    Previous Classifications (World Workshops)

    • 1989 World Workshop: Covered early-onset periodontitis, prepubertal (localized/generalized), juvenile (localized/generalized), adult, necrotizing ulcerative, refractory, and periodontitis associated with systemic diseases.
    • 1993 World Workshop: Emphasized adult periodontitis beginning in the fourth decade, slow progression and early-onset periodontitis starting before the fourth decade, faster progression. Also covered necrotizing periodontitis.

    American Academy of Periodontology - 1999

    • This classification aimed to address issues with the 1989 classification. Included gingival diseases (plaque and non-plaque induced) along with modifications related to systemic factors.
    • Also included periodontitis as a manifestation of systemic diseases, periodontal abscesses, periodontic-endodontic lesions, and developmental/acquired deformities/conditions.

    Why Classify Periodontal Diseases?

    • A classification system is necessary for consistent, accurate diagnosis and treatment. It enables researchers to track disease progression, develop better treatment plans, and compare outcomes across different groups.

    Periodontal Diagnosis in the Context of 2017 Classification

    • The 2017 classification system provides a structured approach to periodontal diagnosis in clinical practice. It includes recommendations, diagnostic pathways, and guidelines for grading and staging of periodontitis.

    Gingivitis Dental Biofilm Induced Disease

    • Plaque-induced gingivitis is exacerbated by systemic conditions. Modifies factors include sex hormones, hormonal cycles (puberty, menstruation, pregnancy, oral contraceptives), hyperglycemia, leukemia, smoking, malnutrition, and others.

    Gingival Diseases - Non Biofilm Induced

    • These involve several potential causes: genetic/developmental disorders (hereditary gingival fibromatosis), specific infections (bacterial, viral, or fungal), inflammatory and immune conditions (contact allergies, plasma cell gingivitis, autoimmune diseases), and reactive processes (epulides).

    Necrotizing Diseases

    • These are characterized by microbially-associated host-mediated inflammation resulting in periodontal attachment loss.

    Extent/Distribution

    • Extent can be localized (up to 30% of teeth) or generalized (more than 30% of teeth) or molar/incisor pattern.

    Staging

    • Staging is based on the severity of bone loss, assessing the degree and location of bone loss in the teeth roots. (i.e., coronal, middle, or apical).

    Current Disease Status

    • A perio patient's status is influenced by stage and grading of disease as well as historic data, and determining if the current disease is active.

    Risk Factor Assessment

    • Risk factors include smoking (cigarettes per day), sub-optimally controlled diabetes, and other potentially modifiable and non-modifiable variables.

    Diagnostic Statement

    • The diagnostic statement for periodontitis is determined from its extent, stage, grade, current status, and relevant risk factors.

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