1. Classification of Periodontal Diseases and Conditions
Dr. Bassam ELGHARABLY

2. Gingivitis: Refers to inflammation of soft tissues surrounding the teeth. Does not include inflammation of alveolar ridges, PDL, cementum or alveolar bone. Periodontitis is a set of inflammatory diseases affecting the periodontium. (PL,Sementum & alveolar bone)

3. Healthy
Gingivitis

4. Gingivitis or periodontitis
Extent of the lesion
% 30 ?
LOCALIZED
GENERALİZED

5. GİNGİVİTİS Distribution of the lesion PAPİLLAR PAPİLLAR and MARGINAL
(diffused)
MARGINAL

6. PAPİLLAR GİNGİVİTİS
PAPİLLAR GİNGİVİTİS
MARGINAlL GİNGİVİTİS
MARGINAlL GİNGİVİTİS

10. GİNGİVİTİS Distribution of the lesion PAPİLLAR PAPİLLAR and MARGINAL
(diffused)
MARGINAL

11. Calssification of periodontitis based on ammont of attachment loss
Slight : 1 to 2 mm clinical attachment loss (CAL)
Moderate : 3 to 4 mm CAL.
Severe : ≥5 mm CAL.

12. American Dental Association Classifications (ADA)
The system developed by the American Dental Association classification
These Case Types are commonly required for insurance billing.
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.

13. American Dental Association Classifications (ADA)
1. Case Type I: Gingivitis 2. Case Type II: Early Periodontitis 3. Case Type III: Moderate Periodontitis 4. Case Type IV: Advanced Periodontitis

14. 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

15. 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)

16. Periodontitis Subdivisions (-)
Adult Periodontitis
Early-Onset Periodontitis
Prepubertal
Juvenile Periodontitis
Rapidly Progressive
Periodontitis Associated with Systemic Diseases
Necrotizing Ulcerative Periodontitis
Refractory Periodontitis

17. Periapical radiographs of a 36-year-old patient, showing severe generalized bone loss.
Diagnosis: ‘chronic adult periodontitis’ or ‘early-onset periodontitis’?

18. AAP Classification (-)
The American Academy of Periodontology has recently published changes in the classification system for periodontal diseases
These changes are from the 1999 International Workshop for a Classification of Periodontal Diseases and Conditions.

19. A AP 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"

20. A. Dental plaque-induced gingival diseases
The 1999 International Workshop for the Classification of Gingival Diseases (+)
A. Dental plaque-induced gingival diseases
B. Non-plaque-induced gingival lesions

21. Dental plaque-induced gingival diseases (+)
1.Gingivitis associated with dental plaque only
2. Gingival diseases modified by systemic factors
3. Gingival diseases modified by medications
4. Gingival diseases modified by malnutrition

22. Classification of Gingival Diseases Non-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

24. Classification of Periodontitis (+)
1.    Chronic Periodontitis
Localized
Generalized
2.    Aggressive Periodontitis
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