9. New Perio Classification

Question 1

What is Stage I Periodontitis?

Answer 1

Initial Periodontitis

*

Question 2

What is Stage II Periodontitis?

Answer 2

Moderate Periodontitis

Question 3

What is Stage III Periodontitis?

Answer 3

Severe Periodontitis with potential for additional tooth loss

Question 4

What is Stage IV Periodontitis?

Answer 4

Severe Periodontitis with potential for loss of the dentition

Question 5

What is Grade A Periodontitis?

Answer 5

Slow rate of progression

Question 6

What is Grade B Periodontitis?

Answer 6

Moderate rate of progression

Question 7

What is Grade C Periodontitis?

Answer 7

Rapid rate of progression

Question 8

What falls under Other Periodontal Conditions?

Answer 8

• Periodontal Abscesses
• Endodontic - Periodontic Lesions

Question 9

What term is replacing Aggressive?

Answer 9

Molar/Incisor pattern

Question 10

What is the most accurate parameter for determining Staging / Severity?

Answer 10

Interproximal CAL

• We will use RBL for staging if we don’t have CAL

Question 11

What are the 2 “trump cards” that lead to an automatic Stage III diagnosis?

Answer 11

• Vertical Bone Loss > 3mm
• Furcation involvement of Class II or III

Question 12

What is the “trump card” that leads to an automatic Stage IV diagnosis?

Answer 12

• < 20 Remaining Teeth (10 opposing pairs)
  
  • Missing due to periodontitis
• Secondary Occlusal Trauma (tooth mobility degree > 2)

Question 13

What Interdental CAL and RBL coresponds to Stage I?

Answer 13

CAL = 1 - 2mm

RBL = Coronal third (< 15%)

Question 14

What Interdental CAL and RBL coresponds to Stage II?

Answer 14

CAL = 3 - 4mm

RBL = Coronal third (15% - 33%)

Question 15

What Interdental CAL and RBL coresponds to Stage III and Stage IV?

Answer 15

CAL = > 5 mm

RBL = extending to middle third of root and beyond

Question 16

What amount of tooth loss due to periodontitis is classified as Stage III?

Answer 16

< 4 teeth

Question 17

What amount of tooth loss due to periodontitis is classified as Stage IV?

Answer 17

> 5 teeth

Question 18

What is added to the Stage as a descriptor?

Answer 18

Extent and Distribution

(based on teeth not sites)

• Localized (< 30% of teeth involved)
• Generalized
• Molar/Incisor pattern

Question 19

Clinicians should initially assume what Grade of disease?

Answer 19

Grade B

Question 20

What is the direct evidence of progression used to diagnose Grade B: Moderate Rate?

Answer 20

< 2 mm of RBL or CAL over 5 years

Question 21

What Risk Factors make someone Grade B?

Answer 21

• < 10 cigarettes/day
• HbA1c < 7.0% in pts with Diabetes

Question 22

What is the direct evidence of progression used to diagnose Grade C: Rapid Rate?

Answer 22

> 2mm RBL or CAL over 5 years

Question 23

What Risk Factors make someone Grade C?

Answer 23

• > 10 cigarettes/day
• HbA1c > 7.0% in pts with Diabetes

Question 24

What is considered Indirect Evidence of Progression when determining Grade?

Answer 24

• % bone loss / age
• Case Phenotype
  
  • A = heavy biofilm w/ low destruction
  • B = destruction commensurate w/ biofilm deposits
  • C = destruction exceeds expectations given biofilm deposits (rapid progression / early onset ds)

Question 25

What is the diagnosis for pts with **reduced periodontum** for any reason (recession, CL, hx of PD), as long as **PDs** are **_\<_ 3mm**?

Answer 25

Gingivitis on a reduced periodontium

Question 26

What is the diagnosis for pts with a **history of periodontitis**, **PDs _\>_ 4mm** with **BOP** (at the same sites)?

Answer 26

Indicates a **recurrence of disease**, so no longer reduced periodontium but Stage I **Periodontitis**.

Question 27

What x-rays are needed to diagnosis implant health?

Answer 27

**At** and **1 year after** abutment connection

Question 28

What is condition is characterized by: * Absence of: erythema (inflammation), BOP, swelling and suppuration * NO Bone Loss (\< 2 mm)

Answer 28

Peri-implant Health

Question 29

What is the main characteristic of **Peri-implant Mucositis**?

Answer 29

**BOP** on gental probing *erythema, swelling, and/or suppuration may also be present* Increased Probing Depth

Question 30

What is a plaque-associated pathological condition, characterized by **inflammation in ther peri-implant mucosa** and subsequent **progressive bone loss**?

Answer 30

Peri-Implantitis

Question 31

What are the clinical signs of Peri-Implantitis?

Answer 31

* Inflammation * Increased probing depths **(_\>_ 4-8 mm)** * Mucosal recession in addition to loss of supportive bone **(_\>_ 2-3 mm)**

Question 32

What is used to diagnosis Peri-Implantitis in the absence of previous examination?

Answer 32

* PD _\>_ 6mm * BOP * Bone Loss _\>_ 3mm

Question 33

What is diagnosed as conditions following the normal healing process of tooth loss that leads to diminished dimensions of the alveolar process/ridge, resulting in both hard- and soft-tissue deficiencies?

Answer 33

Peri-implant Soft- and Hard-Tissue Deficiences

Question 34

What diagnosis does **drug-induced gingival enlargement** fall under? What else falls under this diagnosis?

Answer 34

**Gingivitis - dental biofilm-induced** * Mediated by systemic or local RFs: * Pregnancy / puberty induced gingivitis * Mouth breathing

Question 35

What are the forms of Periodontitis?

Answer 35

* **Necrotizing Periodontal Disease** * Necrotizing GIngivitis * Necrotizing Periodontitis * Necrotizing Stomatitis * **Periodontitis as Manifestations of Systemic Diseases** * **Periodontitis** * **​**Stage * Extent and Distribution * Grade

Question 36

What diagnosis do **Periodontal Abscesses** and **Endodontic-Periodontal Lesions** fall under?

Answer 36

Other Periodontal Conditions Affection the Periodontium * Other Periodontal Conditions