Periodontitis: Consensus report of workgroup 2 of the 2017 World Workshop on the Classification of Periodontal and Peri‐Implant Diseases and Conditions

Abstract

A new periodontitis classification scheme has been adopted, in which forms of the disease previously recognized as "chronic" or "aggressive" are now grouped under a single category ("periodontitis") and are further characterized based on a multi-dimensional staging and grading system. Staging is largely dependent upon the severity of disease at presentation as well as on the complexity of disease management, while grading provides supplemental information about biological features of the disease including a history-based analysis of the rate of periodontitis progression; assessment of the risk for further progression; analysis of possible poor outcomes of treatment; and assessment of the risk that the disease or its treatment may negatively affect the general health of the patient. Necrotizing periodontal diseases, whose characteristic clinical phenotype includes typical features (papilla necrosis, bleeding, and pain) and are associated with host immune response impairments, remain a distinct periodontitis category. Endodontic-periodontal lesions, defined by a pathological communication between the pulpal and periodontal tissues at a given tooth, occur in either an acute or a chronic form, and are classified according to signs and symptoms that have direct impact on their prognosis and treatment. Periodontal abscesses are defined as acute lesions characterized by localized accumulation of pus within the gingival wall of the periodontal pocket/sulcus, rapid tissue destruction and are associated with risk for systemic dissemination.

Biomarkers of oral inflammation in perinatally HIV‐infected and perinatally HIV‐exposed, uninfected youth

“…It involves four stages of disease severity (I-IV) and three grades of rate of progression (A-C). In addition to probing depths and clinical attachment loss, this system uses radiographs and also may include furcation involvement, masticatory factors and past dental records to determine current and predict future rates of progression (Papapanou et al, 2018;Tonetti, Greenwell, & Kornman, 2018). At the time, this cross-sectional multicentre study took place, this classification system had not been published, and this latter clinical information was not available.…”

Characterization of macrophages infiltrating peri‐implantitis lesions

“…showing signs of loss of clinical attachment level (CAL) ≥5mm, probing depths (PD) ≥4mm, bleeding on probing (BOP), and radiographic marginal bone loss of ≥ 33% (Caton et al, 2018;Papapanou et al, 2018).…”

Could drug burden be associated with severe periodontitis in patients receiving haemodialysis?

“…The inclusion criteria of the present study were as follows: treatment by maintenance haemodialysis three times a week for at least six months, age >18 years and having >2 teeth. Patients also required a diagnosis of initial too severe periodontitis, defined as interdental clinical attachment level (CAL) at ≥2 non-adjacent teeth or buccal or oral CAL ≥3 mm with periodontal probing depth (PPD) ≥3 mm (Papapanou et al 2018). Exclusion criteria were the presence of active infection, inflammation or malignancy.…”

“…• initial periodontitis (stage I) was defined as interdental CAL of 1-2 mm and PPD ≤ 4 mm; • moderate periodontitis (stage II) was defined as interdental CAL of 3-4 mm and PPD ≤ 5 mm; • severe periodontitis (stage III) was defined as interdental CAL of ≥5 mm and PPD ≥ 6 mm with tooth loss due to periodontitis of ≤ 4 teeth; • extremely severe periodontitis (stage IV) was defined as interdental CAL of ≥5 mm and PPD ≥ 6 mm with tooth loss due to periodontitis of ≥5 teeth (Papapanou et al 2018).…”