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 (B)</p> Signup and view all the answers

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

<p>Smoking habits (A)</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 (C)</p> Signup and view all the answers

Which of the following best describes plaque-induced gingivitis?

<p>Exacerbated by systemic conditions (D)</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 (C)</p> Signup and view all the answers

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

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

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

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

Which statement about periodontitis is correct?

<p>It is a spectrum disorder. (C)</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 (B)</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 (A)</p> Signup and view all the answers

Which of these conditions is recognized as a necrotising disease?

<p>Necrotizing ulcerative gingivitis (C)</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 (D)</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 (D)</p> Signup and view all the answers

What does grading primarily assess in periodontal disease?

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

Why is the current disease status important in periodontal assessment?

<p>To identify historic disease activity (B)</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. (C)</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 (A)</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 (D)</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. (B)</p> Signup and view all the answers

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

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

Which classification system was introduced first according to the chronology?

<p>Kantorowicz - 1924 (D)</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 (A)</p> Signup and view all the answers

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

<p>Refractory Periodontitis (B)</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 (A)</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. (A)</p> Signup and view all the answers

Who was responsible for a classification system introduced in 1956?

<p>Goldman (B)</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 (D)</p> Signup and view all the answers

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

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

Flashcards

Clinical Characteristics Paradigm

Classifying periodontal diseases based on clinical appearance, patient reports, and no scientific understanding of the disease process.

Classical Pathology Paradigm

Classifying periodontal diseases based on whether they are inflammatory or non-inflammatory, focusing on the involvement of bacteria.

Infection/Host Response Paradigm

Classifying periodontal diseases based on the complex interplay of bacteria, host response, and environmental factors.

Classical Pathology Paradigm Era

The period between 1920 and 1970, when periodontal diseases were classified based on whether they were inflammatory or non-inflammatory, with a focus on bacterial involvement.

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Infection/Host Response Paradigm Era

The present approach to classifying periodontal diseases, acknowledging the complex interplay of bacteria, host response and environmental factors.

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Periodontitis

A microbial-associated, host-mediated inflammatory process that leads to the loss of periodontal attachment.

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Gingivitis

Inflammation of the gums caused by dental biofilm (plaque)

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Non-Biofilm Induced Gingival Diseases

Gingival diseases that are not caused by bacterial biofilms.

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Necrotising Diseases

A group of periodontal diseases characterized by necrosis and destruction of soft tissues.

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Exacerbated Gingivitis

Dental biofilm-induced gingivitis that is worsened by systemic conditions.

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Simplified EFP

A classification system for periodontal diseases developed in the UK, offering a simplified approach for clinical practice.

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Extent/Distribution

The extent of periodontal disease, indicating how many teeth are affected.

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Periodontal disease classification system

A system used to organize and categorize different types of periodontal diseases.

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Staging

The severity of periodontal disease, determined by the percentage of bone loss relative to the root length.

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Rate of Progression

The rate at which periodontal disease progresses, indicating how quickly the condition worsens.

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Bone Loss

A characteristic feature of periodontitis, indicating that the underlying cause is bacterial infection.

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Early-onset Periodontitis

A type of periodontitis that starts early in life (before the 4th decade) and progresses rapidly.

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Adult Periodontitis

A type of periodontitis that typically starts in adulthood and advances slowly.

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World Workshop in Clinical Periodontics (1989)

A classification system that arose in 1989, separating periodontitis into various subtypes based on age and progression rate.

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World Workshop in Clinical Periodontics (1993)

A classification system that updated the 1989 system, incorporating new knowledge and addressing shortcomings.

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Worst case scenario bone loss

The worst possible bone loss observed in a patient's mouth, regardless of other teeth.

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Divide the root

The process of dividing the root of a tooth into sections, usually for treatment purposes.

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Healthy Periodontium

A healthy periodontium, the tissues surrounding a tooth, including gums, bone, and ligaments.

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Tooth loss

The loss of a tooth or teeth due to severe periodontal bone loss, needing to be categorized in Stage IV.

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What is the purpose of grading?

The classification system focuses on the worst bone loss in the mouth and how susceptible the patient is to further bone loss, considering their age.

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Current disease status

A classification system that takes into account the patient's history of periodontal disease and current disease activity, not just the amount of bone loss.

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Lifestyle factors in periodontal disease

Lifestyle factors, like smoking or poor oral hygiene, contribute to the risk of developing or worsening periodontal disease.

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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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