1- Classification

What are the 8 classifications of periodontal diseases by Armitage 1999?

Gingival diseases- plaque induced or not

Chronic periodontitis- localised/generalised

Aggressive periodontitis

Periodontitis as a manifestation of systemic diseases

Necrotising periodontal disease- ulcerative gingivitis or periodontitis

Periodontum abscess- gingival , periodontal, pericoronal

Periodontitis associated with endodontic lesions

Developmental or acquired deformities and conditions

What are the 4 dental plaque induced gingival diseases?

Gingivitis associated with dental plaque only

Gingival disease modified by…

Systemic factors

Medications

Malnutrition

What are the 8 non plaque induced gingival lesions?

Gingival diseases of a…

Specific bacterial origin

Viral

Fungal

Genetic origin

Manifestation of systemic condition

Traumatic lesion

Foreign body reactions

NOS

What are 3 systemic diseases periodontitis is a manifestation of?

Haematological disorders

Genetic disorders

NOS

What are the 4 developmental or acquired deformities causing periodontitis?

Localised tooth related factors that modify/predispose to plaque induced ging disease/perio

Mucogingival deformities and conditions around teeth

Mucogingival deformities and conditions on edentulous ridges

Occlusal trauma

What are the probing characteristics of periodontal stability vs gingivitis?

Under 10% BOP, 3mm or under probing depth

Localised- 10-30%, generalised-over 30%, over 3mm depth

What are the 3 main causes of dental biofilm induced gingivitis?

Plaque

Local/predisposing factors

Systemic/modifying factors - diabetes, drugs, smokers, vit c

Why is the Armitage classification no longer used?

Hard to establish clear diagnosis

Didn’t include many clinical forms- so now use American association 2017

American association of periodontology-

What 5 non dental biofilm related diseases are associated with gingivitis?

Hereditary gingival fibrostomatitis

Contact allergy

Herpetic gingivostomatitis

HPV

Herpetic reaction and pigmentation

What is necrosis, it may favour…?

Series of events that lead to rupture of membrane- Intracellular material flows out- triggers inflammatory reactions in surrounding tissues

Spread of pathogens in a susceptible host

How does necrosis progress in a tooth?(7)

Tip of papilla

Full papilla

Gingival margin

Attached gingiva

Buccal mucosa

Bone exposure

Facial perforation

How is necrotising periodontal disease categorised in chronic/severely effected patient vs temporarily/moderately compromised patients?

Stages, extent and distribution, grades of progression

Periodontal stage severity and complexity

What 4 metabolic syndromes are associated with periodontitis?

Impaired glucose regulation

Central obesity

Hypertension

Dyslipidemia

How can periodontitis have an impact on systemic health? (5)

Bacteraemia

Systemic inflammation

Diabetes- glycemic control, complications

Cardiovascular disease

Pregnancy adverse outcomes

C2- periodontal abscess classification

C2- endodontic periodontal lesion classification

Rates of perio progression + modifying factors