This document classifies periodontal diseases into two main categories: gingivitis and periodontitis. Gingivitis is further divided into plaque-induced and non-plaque induced gingivitis. Periodontitis includes chronic periodontitis, aggressive periodontitis, periodontitis as a manifestation of systemic diseases, necrotizing periodontal diseases, abscesses of the periodontium, and periodontitis associated with endodontic lesions. The document also discusses developmental deformities and conditions that can modify or predispose individuals to plaque-induced gingival diseases and periodontitis.

1. Classification of
Periodontal Diseases
BY
DR JEEVANAND DESHMUKH
DEPARTMENT OF PERIODONTICS

2. ClassificationOf
PeriodontalDiseases
• GINGIVITIS
➢Plaque induced gingivitis
➢Non plaque induced gingivitis

3. • PERIODONTITIS
➢Chronic periodontitis
➢Aggressive periodontitis
➢Periodontitis as manifestation of systemic disease
➢Necrotizing periodontal diseases.
➢Abscess of the periodontium.
➢Periodontitis associated with endodontic lesions.
➢Developmental or acquired deformities and conditions.

4. I-Gingival Diseases:-
A-Dental plaque-inducedgingival disease
1. Gingivitis associated with dental plaque only with or
without local contributing factors.

5. 2. Gingival diseases modified by systemic factors.
Gingival diseases modified by endocrine system
1) Puberty-associated gingivitis
2) Menstrual cycle-associated gingivitis
3) Pregnancy-associated
a. Gingivitis
b. Phyogenic granuloma
4) Menopausal gingivostomatitis
5) Diabetes mellitus-associated gingivitis.

6. 2. Gingival diseases modified by systemic factors.
Gingival diseases modified by blood disorders.
1) Leukemia-associated gingivitis
2) Neutropenia
a. Agranulocytosis
b. Cyclic neutronpenia
3) Immunodeficiency syndrome (AIDS)

7. 3. Gingival diseases modified by medications.
Drug-influenced gingival enlargement
1) Phenytoin
2) Calcium channel blocker (nephedipine)
3) Cyclosporine
b. Drug-influenced gingivitis:
1) Corticosteroids
2) Oral contraceptive – associated gingivitis

8. 4. Gingival diseases modified by malnutrition.
1) Hypovitaminosis: vit c deficiency
2) Protein deficiency.

9. B- Nonplaque-inducedgingival lesions
1. Gingival diseases of specific bacterial origin.
a. Neisseria gonorrhea-associated lesions
b. Treponema pallidum-associated lesions
c. Streptococcal species-associated lesions

10. B- Nonplaque-inducedgingival lesions
2. Gingival diseases of viral origin.
Herpes virus infections
a. Primary herpetic gingivostomatitis
b. Recurrent oral herpes
c. Varicella-Zoster infections

11. B- Nonplaque-inducedgingival lesions
3. Gingival diseases of fungal origin.
a. Candida-species infections
b. Linear gingival erythema
c. Histoplasmosis

12. 4. Gingival lesions of genetic origin.
Hereditary gingival fibromatosis.

13. 5. Gingival lesions appears as a manifestation of systemic
conditions
a. Mucocutaneous disorders b. Allergic reactions
1) Lichen planus
2) Pemphigoid
3) Pemphigus vulgaris
4) Erythema multiforme
5) Lupus erythematosus
Mucocutaneous disorderDs:ental restorative materials as
1)mercury, nickel, acrylic.
2) Toothpastes
3) Month rinses
4) Food

14. 6. Traumatic lesions (iatrogenic, accidental)
) Chemical injury ( aspirin burn
Physical Injury
Malocclusion,
dentures/retainers,
removable partial
and oral piercings;
improper flossing; toothbrush trauma are
common causes of physical injury to the
oral tissues.
Thermal Injury
The most common cause of thermal injury
to the oral region is hot foods/liquids such
as pizza, coffee or soup.

15. 7- Foreign-Body Reactions
Common examples are the introduction of amalgam into the gingiva
during the placement of a restoration, the extraction of a tooth, or an
endodontic apicoectomy with retrofill leaving an amalgam tattoo.

16. • PERIODONTITIS
➢Chronic periodontitis
➢Aggressive periodontitis
➢Periodontitis as manifestation of systemic disease
➢Necrotizing periodontal diseases.
➢Abscess of the periodontium.
➢Periodontitis associated with endodontic lesions.
➢Developmental or acquired deformities and conditions.

17. Chronic
P
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Lo
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d
fo
o
rm
n
: <3
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%
to
i
f t
s
eeth involved
❑ Generalized form: >30% of teeth involved
❖ Mild: 1 to 2 mm clinical attachment loss (CAL)
❖ Moderate: 3 to 4 mm CAL
❖ Severe: ≥5 mm CAL

18. Aggressive
periodontitis
Generalized Form Localized Form

19. Periodontitis as Manifestation of Systemic
diseases
(Blooddisorders)
1) Acquired neurtopenia
2) Leukemias

20. Periodontitis as Manifestation of Systemic
diseases
(geneticdisorders)
1) Familial and cyclic neutropenia
2) Down syndrome
3) Leukocyte adhesion deficiency syndrome
4) Papillon-lefevre syndrome
5) Chediak. Higashi syndrome
6) Histiocytosis syndromes
7) Ihfantile genetic agranulocytosis
8) Ehlers-danlos syndrome
9) Hypophosphatasia

21. ChediakHigashi Syndrome

22. NUP
Necrotizing periodontal
diseases
NUG

23. Abscesses of
the
periodontium
A) Gingival abscess
B) Periodontal abscess
C) Pericoronal abscess

24. Periodontitis
lesions.
Associated with Endodontic

25. A
c
o
)L
no
dca
il
tiz
ie
od
nto
so
.th-relatedfactors that modify or predispose to
plaque-induced gingival diseases/periodontitis:
1) Tooth anatomic factors
2) Dental restorations/appliances
3) Root fractures
4) Cervical root resorption and cemental tears.
Developmental or acquired deformities and

26. Developmental or acquired deformities and
B
c)
M
ou
nc
do
g
ii
tn
g
ii
ov
a
nldse.formities and conditions around teeth:
1) Gingival/soft tissue recession
2) lack of keratinized gingival
3) Decreased vestibular depth
4) Aberrant frenum/muscle position
5) Gingival excess
6) Abnormal color

27. Developmental or acquired deformities and
conditions.
C) Mucogingival deformities and conditions on edentulous ridges:
1) vertical and/or horizontal ridge deficiency
2) lack of gingival keratinized tissue
3) gingival soft tissue enlargement
4) aberrant frenum/muscle position
5) decreased vestibular depth
6) abnormal color

28. Developmental or acquired
conditions.
deformities and
D) Occlusal trauma:
1) Primary occlusal trauma
2) Secondary occlusal trauma