Classification and diagnosis of aggressive periodontitis

Fine, Daniel H.; Patil, Amey G.; Loos, Bruno G.

doi:10.1111/jcpe.12942

Cited by 81 publications

(96 citation statements)

References 97 publications

(175 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Furthermore, a thorough evaluation of the scientific evidence conducted as part of the due diligence process in preparation of the classification workshop did not support the existence of different forms of periodontitis based on clear differences in pathobiology (Papapanou et al, ). At present, there is neither adequate knowledge of unique mechanisms nor evidence to support the need for specific treatments to justify the distinction between aggressive and chronic periodontitis (Fine, Patil, & Loos, ; Lang et al, ; Lindhe et al, ; Needleman et al, ; Tonetti et al, ).…”

Section: Introductionmentioning

confidence: 99%

Implementation of the new classification of periodontal diseases: Decision‐making algorithms for clinical practice and education

Tonetti

Sanz

2019

J Clinic Periodontology

174

155

View full text Add to dashboard Cite

Background Implementation of the new classification of periodontal diseases requires careful navigation of the new case definitions and organization of the diagnostic process along rationale and easily applicable algorithms. The aim of this report was to describe the rationale for one such approach designed for clinical practice and education. Methods The authors developed empiric decision‐making algorithms based on the new classification to effectively discriminate between the key periodontal diagnoses of periodontal health, gingivitis and periodontitis. Results A stepwise approach is proposed that includes (a) a sensitive screening step able to discriminate periodontal health, gingivitis and suspect periodontitis; (b) a specific confirmation step to provide differential diagnosis between periodontitis and the other conditions characterized by attachment loss; (c) a step to assess the severity and complexity of management of the periodontitis case (staging); and (d) a step to assess the risk profile of the case (grading). Specific decision‐making algorithms are described for all steps of the diagnostic process. Conclusions The proposed process allows discrimination between the different case definitions of periodontal health and disease. The diagnostic accuracy and cost‐effectiveness of the process need to be validated in prospective trials generalizable to operators with different level of expertise, different populations and clinical settings.

show abstract

Section: Introductionmentioning

confidence: 99%

Implementation of the new classification of periodontal diseases: Decision‐making algorithms for clinical practice and education

Tonetti

Sanz

2019

J Clinic Periodontology

174

155

View full text Add to dashboard Cite

show abstract

“…Essa publicação é um esforço conjunto da Academia Americana de Periodontia e da Federação Europeia de Periodontia e substitui a classificação até então vigente 2 . Nessa edição de 291 páginas, há 18 artigos relacionados [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20] , além do relato de consenso de cada um dos quatro grupos de trabalho [21][22][23][24] e uma introdução 1 . A introdução à nova classificação apresenta-se resumida e faz frequentes menções (inclusive com a disponibilização de link) a artigos originais, tornando uma primeira familiarização com a nova classificação dependente de leituras mais aprofundadas.…”

Section: No Mês De Junho De 2018 Foi Lançado O Proceedings Do Workhunclassified

Classificação das Doenças e Condições Periodontais e Peri-implantares 2018: guia Prático e Pontos-Chave

Steffens

Marcantonio

2018

Rev. odontol. UNESP

View full text Add to dashboard Cite

show abstract

“…Although it is established that all three phenotypes have a microbially-driven etiology, our current understanding of the microbiota associated with these phenotypes is not su cient to explain the clinical differences. For example, the prevailing paradigm that similar bacteria are found in CP and GAP [7] does not explain the rapid disease progression seen in GAP, nor does the presence of speci c bacteria in GAP and LAP [8][9][10] explain the involvement of speci c teeth in LAP.…”

Section: Introductionmentioning

confidence: 99%

Metagenomic Sequencing of Stage 3 Periodontitis Reveals Phenotype-Specific Taxonomic and Functional Features of the Subgingival Microbiome

Altabtbaei

Maney

Ganesan

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: The search for microbial biomarkers of periodontitis has been hampered by our ability to separate disease-specific associations from those that are common to all forms of periodontitis. Here, we present the first functional characterization of the microbiomes of three common clinical phenotypes of this disease: Localized aggressive periodontitis (LAP), generalized aggressive periodontitis (GAP) and chronic periodontitis (CP). Methods: We collected subgingival plaque samples from sites with disease of 59 subjects with Stage 3 periodontitis and 25 periodontally healthy individuals and used shotgun metagenomics to characterize the aggregate of bacterial genes. Results: Beta-dispersion metrics demonstrated that no two individuals with disease, especially those with chronic disease, are alike (the Anna Karenina Principle), indicating that microbial modulation therapies will have to incorporate patient-specific parameters for efficacy. We discovered broad patterns of microbial dysbiosis that spanned the three disease phenotypes, as well as disease-specific indicators unique to each phenotype. Genes common to all forms of periodontitis encoded pathways that facilitate life in an oxygen-poor, protein and heme-rich, pro-oxidant environment, and enhance capacity for attachment and biofilm formation, while genes encoding the acetate switch, c-type cytochrome and molybdenum cofactor biosynthesis, iron-sulfur clusters, and formate dehydrogenase were unique to LAP. These can serve as potential biomarkers for molecular identification of clinical phenotypes and clarify the role of the microbiome in disease pathogenesis. We also discovered that clinical phenotypes of disease resolved variance in the microbiome with greater clarity than the newly established grading system. Importantly, we observed that one-third of the metagenome of LAP is unique to this phenotype while GAP shares significant functional and taxonomic features with both LAP and CP, suggesting either attenuation of an aggressive disease or an early-onset chronic disease. Conclusion: Within the limitations of a small sample size and a cross-sectional study design, the distinctive features of the microbiomes associated with LAP and CP strongly persuade us that these are discrete disease entities, while calling into question whether GAP is a separate disease entity, or an artifact induced by cross-sectional study designs.

show abstract

Classification and diagnosis of aggressive periodontitis

Cited by 81 publications

References 97 publications

Implementation of the new classification of periodontal diseases: Decision‐making algorithms for clinical practice and education

Implementation of the new classification of periodontal diseases: Decision‐making algorithms for clinical practice and education

Classificação das Doenças e Condições Periodontais e Peri-implantares 2018: guia Prático e Pontos-Chave

Metagenomic Sequencing of Stage 3 Periodontitis Reveals Phenotype-Specific Taxonomic and Functional Features of the Subgingival Microbiome

Contact Info

Product

Resources

About