User:Toothscraper/periodontalAAP


Periodontal Health, Gingival Diseases, and Conditions
Periodontal Health and Gingival Health Gingivitis; Dental Biofilm-Induced Gingival Diseases: Nondental Biofilm-Induced

Forms of Periodontitis:


Periodontitis
1. Necrotizing Periodontal Diseases
2. Periodontitis
3. Periodontitis as a Manifestation of Systemic Disease


Other Conditions Affecting the Periodontium
1.Systemic Diseases or Conditions Affecting the Periodontal Supporting Tissues
2. Periodontal Abscesses and Endodontic-Periodontal Lesions
3. Mucogingival Deformities and Conditions
4. Traumatic Occlusal Forces
5. Tooth and Protheses Related Factors


Peri-Implant Disease and Contitions
1. Peri-Implant Health
2. Peri-Implant Mucositis
3. Peri-Implantitis
4. Peri-Implant Soft and Hard Tissue Deficiencies

2018 AAP/EFP Classification of Periodontal and Peri-Implant Diseases and Conditions

In 2017 the American Academy of Periodontology (AAP) and the European Federation of Periodontology (EFP) together collaborated to revise and adopt a new classification system for periodontal conditions to aid in a more personalized approach to patient care. In 2018 they released an updated classification system which includes a multi-dimensional staging and grading system for periodontitis classification, a recategorization of various forms of periodontitis, and the inaugural classification for peri-implant diseases and conditions.^[1]

Periodontal Health, Gingivitis, and Gingival Diseases/Conditions

The 2018 Disease Classification for periodontal health, gingivitis, and gingival diseases and conditions are outlined in detail below:^[2]

Periodontal health and gingival health
1. Clinical gingival health on an intact periodontium
2. Clinical gingival health on a reduced periodontium
  - Stable periodontitis patient
  - Non-periodontitis patient
Gingivitis--dental biofilm-induced
1. Associated with dental biofilm alone
2. Medicated by systemic or local risk factors
3. Drug-influenced gingival enlargement
Gingival diseases--nondental biofilm-induced
1. Gingivitis after treatment
  Genetic/developmental disorders
2. Specific infections
3. Inflammatory and immune conditions
4. Reactive processes
5. Neoplasms
6. Endocrine, nutritional, and metabolic diseases
7. Traumatic lesions
8. Gingival pigmentation

Disease Classification for the Three Major Forms of Periodontitis

2018 Disease Classification of Periodontal Diseases and Conditions breaks down the category of periodontitis into three forms and each of these forms are further broken down into two or more subcategories.^[2]

Necrotizing Periodontal Diseases
1. Necrotizing gingivitis
2. Necrotizing periodontitis
3. Necrotizing stomatitis
Periodontitis as Manifestation of Systemic Diseases -- Classification of these conditions should be based on the primary systemic disease according to the International Statistical Classification of Diseases and Related Health Problems (ICD) codes
Recession parodontale
Bone loss in periapical xray
Periodontitis
1. Stages: Based on severity^[3] and complexity of management^[4]
  - Stage I: Initial periodontitis
  - Stage II: Moderate periodontitis
  - Stage III: Severe periodontitis with potential for additional tooth loss
  - Stage IV: Severe periodontitis with potential for loss of the dentition
2. Extent and distribution^[5]: Localized, generalized; molar-incisor distribution
3. Grades: Evidence or risk of rapid progression^[6], anticipated treatment response^[7]
  - Grade A: Slow rate of disease progression
  - Grade B: Moderate rate of disease progression
  - Grade C: Rapid rate of disease progression


3.1 Stages Based on	Periodontitis
Severity^[3]	Interdental clinical attachment level at site with the GREATEST loss; Radiographic bone loss and tooth loss
Complexity of management^[4]	Probing depth, pattern of bone loss, furcation depth, pattern of bone loss, furcation lesions, number of remaining teeth, tooth mobility ridge defects, masticatory dysfunction


3.2 Extent and Distribution^[5]	Periodontitis
Add to Stage as descriptor:	Localized <30% of teeth, generalized > or equal to 30% of teeth


3.3 Grades	Periodontitis
Evidence of risk of rapid progression^[6]	Direct evidence by periapical radiographs of CAL loss, or indirect (% bone loss/age ratio)
Anticipated treatment response^[7]	Case phenotype, smoking, hyperglycemia

Other Conditions Affecting the Periodontium

The 2018 Disease Classification of Periodontal Disease and Conditions contains a category for other conditions that may have an effect upon the health of the periodontium.^[2]

Systemic diseases or conditions affecting the periodontal supporting tissues
Abscessed tooth periapical radiograph
Other periodontal conditions
1. Periodontal abscesses
2. Endodontic periodontal lesions
Mucogingival deformities and conditions around teeth
1. Gingival phenotype
2. Gingival/soft tissue recession
3. Lack of gingiva
4. Decreased vestibular depth
5. Aberrant frenum/muscle position
6. Gingival excess
7. Abnormal color
8. Condition of exposed root surface
Traumatic occlusal forces
1. Primary occlusal trauma
2. Secondary occlusal trauma
3. Orthodontic forces
Prostheses and tooth-related factors that modify or predispose to plaque-induced gingival diseases/periodontitis
1. Localized tooth-related factors
2. Localized dental prostheses-related factors

Peri-Implant Diseases and Conditions

The 2018 Disease Classification of Periodontal Disease and Conditions divides this category into four subcategories.^[2]

Peri-implant health
Peri-implant mucositis
Peri-implantitis
Peri-implant soft and hard tissue deficiencies

^ "2017 Classification of Periodontal and Peri-implant Diseases and Conditions". American Academy of Periodontology. Retrieved 2023-02-21.
^ ^a ^b ^c ^d Gehrig, Jill S. (2019). Foundations of periodontics for the dental hygienist. Daniel E. Shin, Donald E. Willmann (5th ed.). Philadelphia. ISBN 978-1-4963-8402-7. OCLC 1054269026.{{cite book}}: CS1 maint: location missing publisher (link)
^ ^a ^b Severity: Interdental clinical attachment level at site with greatest loss; Radiographic bone loss and tooth loss.
^ ^a ^b Complexity of management; Probing depth, pattern of bone loss, furcation lesions, number of remaining teeth, tooth mobility, ridge defects, masticatory dysfunction.
^ ^a ^b Add to Stage as descriptor: Localized < 30% teeth, generalized > or equal to 30%.
^ ^a ^b Anticipated treatment response: case phenotype, smoking, hyperglycemia.
^ ^a ^b Risk of progression; direct evidence by periapical radiographs of CAL loss, or indirect (bone/age ratio).

[1] "2017 Classification of Periodontal and Peri-implant Diseases and Conditions". American Academy of Periodontology. Retrieved 2023-02-21.

[:0-2] Gehrig, Jill S. (2019). Foundations of periodontics for the dental hygienist. Daniel E. Shin, Donald E. Willmann (5th ed.). Philadelphia. ISBN 978-1-4963-8402-7. OCLC 1054269026.{{cite book}}: CS1 maint: location missing publisher (link)

[:2-3] Severity: Interdental clinical attachment level at site with greatest loss; Radiographic bone loss and tooth loss.

[:3-4] Complexity of management; Probing depth, pattern of bone loss, furcation lesions, number of remaining teeth, tooth mobility, ridge defects, masticatory dysfunction.

[:4-5] Add to Stage as descriptor: Localized < 30% teeth, generalized > or equal to 30%.

[:5-6] Anticipated treatment response: case phenotype, smoking, hyperglycemia.

[:6-7] Risk of progression; direct evidence by periapical radiographs of CAL loss, or indirect (bone/age ratio).

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