007.classification of periodontal disease and condition

Dr. Jaffar Raza Syed Page 1



Classification of Periodontal Disease and Condition

By AAP 1999 (International Workshop for Classification

of Periodontal Disease)

Gingival Disease

A. Dental plaque-induced gingival diseases:

These diseases may occur on a periodontium with no attachment

loss or on one with attachment loss that is stable and not

progressing.


1. Gingivitis associated with dental plaque only:

a. Without local contributing factors.

b. With local contributing factors

2. Gingival diseases modified by systemic factors:

a. Associated with endocrine system:

i. Puberty-associated gingivitis

ii. Menstrual cycle-associated gingivitis

iii. Pregnancy-associated

– Gingivitis

– Pyogenic granuloma

iv. Diabetes mellitus-associated gingivitis


b. Associated with blood dyscrasias:

i. Leukemia-associated gingivitis

ii. Others

3. Gingival diseases modified by medications:

a. Drug-influenced gingival diseases

i. Drug-influenced gingival enlargements.

ii. Drug-influenced gingivitis

– Oral contraceptive-associated gingivitis

– Others


4. Gingival diseases modified by malnutrition:

a. Ascorbic acid deficiency gingivitis

b. Others

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B. Nonplaque-induced gingival lesions:

1. Gingival diseases of specific bacterial origin.

a. Neisseria gonorrhoeae

b. Treponema pallidum

c. Streptococcal species

d. Others

2. Gingival diseases of viral origin

a. Herpes virus infections

• Primary herpetic gingivostomatitis

• Recurrent oral herpes

• Varicella zoster


3. Gingival diseases of fungal origin

a. Candida species infections; generalized gingival candidiasis

b. Linear gingival erythema

c. Histoplasmosis

d. Others.

4. Gingival lesions of genetic origin

a. Hereditary gingival fibromatosis

b. Others


5. Gingival manifestations of systemic conditions

a. Mucocutaneous lesions:

i. Lichen planus

ii. Pemphigoid

iii. Pemphigus vulgaris

iv. Erythema multiforme

v. Lupus erythematosus

vi. Drug induced

vii. Others


b. Allergic reactions:

i. Dental restorative materials

– Mercury

– Nickel

– Acrylic

– Others

ii. Reactions attributable to:

– Toothpaste’s or dentifrices

– Mouthrinses or mouthwashes

– Chewing gum additives

– Foods and additives


6. Traumatic lesions (factitious, iatrogenic, or accidental)

a. Chemical injury

b. Physical injury

c. Thermal injury

7. Foreign body reactions

8. Not otherwise specified (NOS).


Chronic Periodontitis

a. Localized — Less than 30 percent of sites involved or,

b. Generalized — More than 30 percent of sites involved.

c. Slight — 1 to 2 mm clinical attachment loss.

d. Moderate — 3 to 4 mm clinical attachment loss

e. Severe — More than 5 mm clinical attachment loss.


Aggressive Periodontitis

a. Localized–slight, moderate or severe

b. Generalized

Periodontitis as a Manifestation of Systemic Diseases

a. Associated with hematological disorders:

i. Acquired neutropenia

ii. Leukemias

iii. Others


b. Associated with genetic disorders:

i. Familial and cyclic neutropenia

ii. Down’s syndrome

iii. Leukocyte adhesion deficiency syndrome

iv. Papillon-Lefévre syndrome

v. Chediak-Higashi syndrome

vi. Histiocytosis syndrome

vii. Glycogen storage disease

viii. Infantile genetic agranulocytosis

ix. Cohen syndrome

x. Ehlers-Danlos syndrome (Types IV and VIII)

xi. Hypophosphatasia

xii. Others


Necrotizing Periodontal Diseases

a. Necrotizing ulcerative gingivitis

b. Necrotizing ulcerative periodontitis.

Abscesses of the Periodontium

a. Gingival abscess

b. Periodontal abscess

c. Pericoronal abscess


Periodontitis Associated with Endodontic Lesions

Combined periodontic—endodontic lesions.

Developmental or Acquired Deformities and Conditions

a. Localized tooth-related factors that modify or predispose

to plaque-induced gingival diseases/periodontitis.

i. Tooth anatomic factors

ii. Dental restorations/appliances

iii. Root fractures

iv. Cervical root resorption and cemental tear


b. Mucogingival deformities and conditions around teeth:

i. Gingival/soft tissue recession, facial or lingual surfaces, interproximal

ii. Lack of keratinized gingiva

iii. Decreased vestibular depth

iv. Aberrant frenum/muscle position

v. Gingival excess:

– Pseudopocket

– Inconsistent gingival margin

– Excessive gingival display

– Gingival enlargement

vi. Abnormal color


c. Mucogingival deformities and conditions on edentulous ridges:

i. Vertical and/or horizontal ridge deficiency.

ii. Lack of gingival/keratinized tissue

iii. Gingival/soft tissue enlargement

iv. Aberrant frenum/muscle position

v. Decreased vestibular depth

vi. Abnormal color

d. Occlusal trauma:

i. Primary occlusal trauma

ii. Secondary occlusal trauma.

Health & Medicine

007.classification of periodontal disease and condition