Development of a Classification System for Periodontal Diseases and Conditions

Abstract

Classification systems are necessary in order to provide a framework in which to scientifically study the etiology, pathogenesis, and treatment of diseases in an orderly fashion. In addition, such systems give clinicians a way to organize the health care needs of their patients. The last time scientists and clinicians in the field of periodontology and related areas agreed upon a classification system for periodontal diseases was in 1989 at the World Workshop in Clinical Periodontics. Subsequently, a simpler classification was agreed upon at the 1st European Workshop in Periodontology. These classification systems have been widely used by clinicians and research scientists throughout the world. Unfortunately, the 1989 classification had many shortcomings including: 1) considerable overlap in disease categories, 2) absence of a gingival disease component, 3) inappropriate emphasis on age of onset of disease and rates of progression, and 4) inadequate or unclear classification criteria. The 1993 European classification lacked the detail necessary for adequate characterization of the broad spectrum of periodontal diseases encountered in clinical practice. The need for a revised classification system for periodontal diseases was emphasized during the 1996 World Workshop in Periodontics. In 1997 the American Academy of Periodontology responded to this need and formed a committee to plan and organize an international workshop to revise the classification system for periodontal diseases. The proceedings in this volume are the result of this reclassification effort. The process involved development by the Organizing Committee of an outline for a new classification and identification of individuals to write state-of-the-science reviews for each of the items on the outline. The reviewers were encouraged to depart from the preliminary outline if there were data to support any modifications. On October 30-November 2, 1999, the International Workshop for a Classification of Periodontal Diseases and Conditions was held and a new classification was agreed upon (Fig. 1). This paper summarizes how the new classification for periodontal diseases and conditions presented in this volume differs from the classification system developed at the 1989 World Workshop in Clinical Periodontics. In addition, an analysis of the rationale is provided for each of the modifications and changes.

Immunoglobulin G antibodies againstPorphyromonas gingivalisorAggregatibacter actinomycetemcomitansin cardiovascular disease and periodontitis

“…It manifests as breakdown of the tooth-supporting tissues and, if left untreated, periodontitis may cause tooth loss [1]. The disease affects 50% of the adult population [2] and is diagnosed on the basis of clinically evident inflammation, loss of attachment associated with periodontal pocket formation, and alveolar bone loss [3]. In a recent study, the risk of myocardial infarction was significantly increased in patients with periodontitis [4].…”

Site‐specific treatment outcome in smokers following 12 months of supportive periodontal therapy

“…Eighty patients, 40 smokers and 40 non‐smokers, with moderate to severe chronic periodontitis (Armitage 1999) referred for periodontal treatment from general practitioners in a rural district of Norway were consecutively enroled in this single‐arm clinical trial March 2012 through September 2013 (Table 1). Medical, periodontal, and smoking history of the patients was obtained from clinical examinations, health forms, questionnaires, and by consulting their physicians.…”

Increased salivary level of 8-hydroxydeoxyguanosine is a marker of premature oxidative mitochondrial DNA damage in gingival tissue of patients with periodontitis

“…The subjects were selected from among individuals who applied to the Ataturk University Faculty of Dentistry, Department of Periodontology, due to periodontal problems or for routine check-ups. The criteria for CP were judged from standard measurements of clinical probing depths (PDs) and radiographic bone loss according to currently accepted criteria (Armitage 1999). Subjects with CP had at least two sides showing a PD of >4 mm, gingival inflammation, and 30% bone loss.…”