Classification of Periodontal Diseases and Conditions

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Classification of Periodontal Diseases and
Conditions

• Dr. Sameer A. Mokeem

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American Dental Association Classifications (ADA)

• The system developed by the American Dental
  Association classification
• 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.
• 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.

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American Dental Association Classifications (ADA)

• Case Type I GingivitisCase Type II Early
  PeriodontitisCase Type III Moderate
  PeriodontitisCase Type IV Advanced
  Periodontitis
• ADA Risk Management Series, diagnosis and
  Managing the Periodontal patient, 1986

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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
• AAA 1989

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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)

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Periodontitis Subdivisions

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

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AAP Classification

• The American Academy of Periodontology has
  recently published changes in theclassification
  system for periodontal diseases
• These changes are from the 1999 International
  Workshop for a Classification of Periodontal
  Diseases and Conditions.

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AAP 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" AAP
  1999

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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

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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
• Can be further classified on basis of extent and
  severity