Classification of Periodontal Diseases and Conditions

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Classification of Periodontal Diseases and Conditions

  1. 1. Classification of Periodontal Diseases and Conditions Dr. Sameer A. Mokeem
  2. 2. American Dental Association Classifications (ADA) <ul><li>The system developed by the American Dental Association classification </li></ul><ul><li>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. </li></ul><ul><li>These Case Types are commonly required for insurance billing. In addition, the ADA provides treatment recommendations for each Case Type which is not part of this presentation. </li></ul>
  3. 3. American Dental Association Classifications (ADA) <ul><li>Case Type I: Gingivitis Case Type II: Early Periodontitis Case Type III: Moderate Periodontitis Case Type IV: Advanced Periodontitis </li></ul><ul><li>ADA: Risk Management Series, diagnosis and Managing the Periodontal patient, 1986 </li></ul>
  4. 4. American Academy of Periodontology (AAP) <ul><li>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 . </li></ul><ul><li>The two major categories are Gingivitis and Periodontitis . </li></ul><ul><li>Within each category there are specific types of diseases identified </li></ul><ul><li>AAA 1989 </li></ul>
  5. 5. Gingivitis Subdivisions <ul><li>Chronic Gingivitis </li></ul><ul><li>Acute Necrotizing Ulcerative Gingivitis </li></ul><ul><li>Gingivitis Associated with Systemic Conditions or Medications </li></ul><ul><li>Hormone-Induced Gingival Inflammation </li></ul><ul><li>Drug-Influenced Gingivitis </li></ul><ul><li>Linear Gingival Erythema (LGE) </li></ul><ul><li>Gingival Manifestations of Systemic Diseases and Mucocutaneous Lesions </li></ul><ul><li>Bacterial, Viral or Fungal </li></ul><ul><li>Blood Dyscrasias (for example Acute Monocytic Leukemia) </li></ul><ul><li>Mucocutaneous Diseases (Lichen Planus, Cicatricial Pemphigoid) </li></ul>
  6. 6. Periodontitis Subdivisions <ul><li>Adult Periodontitis </li></ul><ul><li>Early-Onset Periodontitis </li></ul><ul><ul><li>Prepubertal </li></ul></ul><ul><ul><li>Juvenile Periodontitis </li></ul></ul><ul><li>Rapidly Progressive </li></ul><ul><li>Periodontitis Associated with Systemic Diseases </li></ul><ul><li>Necrotizing Ulcerative Periodontitis </li></ul><ul><li>Refractory </li></ul>
  7. 7. AAP Classification <ul><li>The American Academy of Periodontology has recently published changes in the classification system for periodontal diseases </li></ul><ul><li>These changes are from the 1999 International Workshop for a Classification of Periodontal Diseases and Conditions. </li></ul>
  8. 8. AAP Classification <ul><li>Conditions. Highlights of the changes are as follows: </li></ul><ul><ul><li>Addition of a section on &quot;Gingival Diseases&quot; </li></ul></ul><ul><ul><li>Replacement of &quot;Adult Periodontitis&quot; with &quot;Chronic Periodontitis“ </li></ul></ul><ul><ul><li>Replacement of &quot;Early-Onset Periodontitis&quot; with &quot;Aggressive Periodontitis&quot; </li></ul></ul><ul><ul><li>Elimination of a separate disease category for &quot;Refractory Periodontitis&quot; </li></ul></ul><ul><ul><li>Replacement of &quot;Necrotizing Ulcerative Periodontitis&quot; with &quot;Necrotizing Periodontal Diseases&quot; </li></ul></ul><ul><ul><li>Addition of a category on &quot;Periodontal Abscess&quot; </li></ul></ul><ul><ul><li>Addition of a category on &quot;Periodontic-Endodontic Lesions&quot; </li></ul></ul><ul><ul><li>Addition of a category on &quot;Developmental or Acquired Deformities & Conditions&quot; AAP 1999 </li></ul></ul>
  9. 9. Classification of Gingival Diseases Non-Plaque induced gingival lesions <ul><li>1. Gingival diseases of specific bacterial origin </li></ul><ul><li>2. Gingival diseases of viral origin </li></ul><ul><li>3. Gingival diseases of fungal origin </li></ul><ul><li>4. Gingival diseases of genetic origin </li></ul><ul><li>5. Gingival manifestations of systemic conditions </li></ul><ul><li>6. Traumatic lesions </li></ul><ul><li>7. Foreign body reactions </li></ul>
  10. 10. Classification of Periodontitis <ul><li>1.    Chronic Periodontitis* </li></ul><ul><ul><li>Localized </li></ul></ul><ul><ul><li>Generalized </li></ul></ul><ul><li>2.    Aggressive Periodontitis </li></ul><ul><ul><li>Localized </li></ul></ul><ul><ul><li>Generalized </li></ul></ul><ul><li>3.    Periodontitis Associated with Systemic Diseases </li></ul><ul><li>4.    Necrotizing Periodontal Diseases </li></ul><ul><li>5.    Abscesses of the Periodontium </li></ul><ul><li>6.    Periodontal Diseases associated with Endodontic Lesions </li></ul><ul><li>7.    Developmental or Acquired Deformities and Conditions </li></ul><ul><li>*Can be further classified on basis of extent and severity </li></ul>

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