1. Copyright © 2014 Wolters Kluwer All Rights Reserved Section 1Major Diagnostic Categories of Periodontal Disease Chapter 4—Classification of Periodontal Diseases and Conditions Section 1—Major Diagnostic Categories of Periodontal Disease

2. Copyright © 2016 Wolters Kluwer All Rights Reserved Topic Overview—Disease Classification What are the major diagnostic categories of periodontal disease? What is the purpose of a classification system? What is the current disease classification system? 2

3. Copyright © 2016 Wolters Kluwer All Rights Reserved Periodontal Disease Periodontal disease is a broad term used to refer to a bacterial infection of the periodontium. There are many specific periodontal diseases that affect the periodontium. 3

4. Copyright © 2016 Wolters Kluwer All Rights Reserved Major Diagnostic Categories of Periodontal Diseases 4

5. Copyright © 2016 Wolters Kluwer All Rights Reserved 5

6. Gingivitis Bacterial infection confined to the gingiva Damage to gingival tissues is reversible with good self-care and professional care. 6

7. Copyright © 2016 Wolters Kluwer All Rights Reserved Periodontitis Bacterial infection of – Gingiva – PDL – Bone – Cementum Destruction is irreversible. 7

8. Copyright © 2016 Wolters Kluwer All Rights Reserved Is it Health, Gingivitis, or Periodontitis? 8

9. Copyright © 2016 Wolters Kluwer All Rights Reserved Periodontal Disease Versus Periodontitis Periodontal disease: Bacterial infection of periodontium – If the infection is limited to gingival tissues, it is called gingivitis. – If the infection involves all structures of the periodontium, it is called periodontitis. 9

10. Copyright © 2016 Wolters Kluwer All Rights Reserved Purpose of Classifying Periodontal Diseases 10

11. Copyright © 2016 Wolters Kluwer All Rights Reserved Classification provides Information needed to Communicate clinical findings accurately and universally to other dental healthcare providers Present information to patients about their disease status Formulate individualized treatment plans Predict treatment outcomes 11

12. Copyright © 2016 Wolters Kluwer All Rights Reserved Current Disease Classification 12

13. Copyright © 2016 Wolters Kluwer All Rights Reserved AAP Classification (1999) In 1999, an international workshop adopted a new classification system for periodontal diseases and conditions. This classification was developed by the American Academy of Periodontology (AAP). 13

14. Copyright © 2016 Wolters Kluwer All Rights Reserved Prior Disease Classifications When reading the dental literature, you may come across unfamiliar names for periodontal diseases. These most likely are from the 1989 classification of periodontal diseases. You may need to refer to this older classification in order to determine the current terminology for the disease. 14

15. Copyright © 2016 Wolters Kluwer All Rights Reserved Terminology Example Early onset periodontitis (1989) is now called aggressive periodontitis (1999). Journal articles written prior to the publication of 1999 classification will use the term early onset periodontitis. There are classic studies in the dental literature that are still important today (e.g., Listgarten and Schroeder studies on the microscopic anatomy of the periodontium). Readers should be aware that older terminology will be used in classic literature. 15

16. Copyright © 2016 Wolters Kluwer All Rights Reserved Disease Subdivisions 16

17. Copyright © 2016 Wolters Kluwer All Rights Reserved Gingival Diseases—Two Categories 17

18. Copyright © 2016 Wolters Kluwer All Rights Reserved Periodontitis—Three Major Categories 18

19. Periodontitis—Main Categories Chronic periodontitis Aggressive periodontitis Manifestation of systemic disease Necrotizing periodontal diseases Abscesses of the periodontium Deformities and conditions 19 Copyright © 2016 Wolters Kluwer All Rights Reserved

20. Recap—Disease Classification Periodontal disease is a general term for the bacterial infection of the periodontium. The two major diagnostic categories of periodontal disease are – Gingivitis – Periodontitis 20

21. Copyright © 2016 Wolters Kluwer All Rights Reserved Recap—Disease Classification (cont.) Gingivitis — no attachment loss and reversible tissue damage Periodontitis — attachment loss and permanent tissue damage 21

22. Copyright © 2016 Wolters Kluwer All Rights Reserved Recap—Disease Classification (cont.) Disease classification systems improve communication, treatment, and documentation of periodontal diseases. The 1999 AAP Classification of Periodontal Diseases and Conditions is the current disease classification system. 22