Staging and grading of periodontitis: Framework and proposal of a new classification and case definition

Journal of Periodontology, Год журнала: 2018, Номер 89(S1)

Опубликована: Июнь 1, 2018

Authors were assigned the task to develop case definitions for periodontitis in context of 2017 World Workshop on Classification Periodontal and Peri-Implant Diseases Conditions. The aim this manuscript is review evidence rationale a revision current classification, provide framework definition that fully implicates state-of-the-art knowledge can be adapted as new emerges, suggest system implemented clinical practice, research epidemiologic surveillance.Evidence gathered four commissioned reviews was analyzed interpreted with special emphasis changes regards understanding available prior 1999 classification. systems employed variety chronic diseases identified key criteria classification/case periodontitis.The discusses merits based Staging Grading proposes framework. Stage I IV defined severity (primarily periodontal breakdown reference root length periodontitis-associated tooth loss), complexity management (pocket depth, infrabony defects, furcation involvement, hypermobility, masticatory dysfunction) additionally described extent (localized or generalized). Grade estimated direct indirect progression rate three categories: slow, moderate rapid (Grade A-C). Risk factor analysis used grade modifier.The paper describes simple matrix stage appropriately define an individual patient. proposed extends beyond description include characterization biological features disease represents first step towards adoption precision medicine concepts periodontitis. It also provides necessary introduction biomarkers diagnosis prognosis.

Язык: Английский

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

Journal of Periodontology, Год журнала: 2018, Номер 89(S1)

Опубликована: Июнь 1, 2018

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

Язык: Английский

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A new classification scheme for periodontal and peri‐implant diseases and conditions – Introduction and key changes from the 1999 classification

Journal of Periodontology, Год журнала: 2018, Номер 89(S1)

Опубликована: Июнь 1, 2018

Abstract A classification scheme for periodontal and peri‐implant diseases conditions is necessary clinicians to properly diagnose treat patients as well scientists investigate etiology, pathogenesis, natural history, treatment of the conditions. This paper summarizes proceedings World Workshop on Classification Periodontal Peri‐implant Diseases Conditions. The workshop was co‐sponsored by American Academy Periodontology (AAP) European Federation (EFP) included expert participants from all over world. Planning conference, which held in Chicago November 9 11, 2017, began early 2015. An organizing committee AAP EFP commissioned 19 review papers four consensus reports covering relevant areas periodontology implant dentistry. authors were charged with updating 1999 developing a similar Reviewers workgroups also asked establish pertinent case definitions provide diagnostic criteria aid use new classification. All findings recommendations agreed consensus. introductory presents an overview conditions, along condensed each workgroup sections, but readers are directed thorough discussion rationale, criteria, interpretation proposed Changes highlighted discussed. Although intent base strongest available scientific evidence, lower level evidence opinion inevitably used whenever sufficient research data unavailable. scope this align update current understanding schematic tables briefly highlights changes made It cannot present wealth information reviews, definition papers, that has guided development classification, reference its either management or investigation. Therefore, it strongly recommended reader introduction these subjects. Accessing publication online will allow links view source (Table 1).

Язык: Английский

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Periodontal manifestations of systemic diseases and developmental and acquired conditions: Consensus report of workgroup 3 of the 2017 World Workshop on the Classification of Periodontal and Peri‐Implant Diseases and Conditions

Journal of Periodontology, Год журнала: 2018, Номер 89(S1)

Опубликована: Июнь 1, 2018

Abstract Background A variety of systemic diseases and conditions can affect the course periodontitis or have a negative impact on periodontal attachment apparatus. Gingival recessions are highly prevalent often associated with hypersensitivity, development caries non‐carious cervical lesions exposed root surface impaired esthetics. Occlusal forces result in injury teeth Several developmental acquired prostheses may predispose to periodontium. The aim this working group was review update 1999 classification regard these conditions, develop case definitions diagnostic considerations. Methods Discussions were informed by four reviews 1) manifestions conditions; 2) mucogingival around natural teeth; 3) traumatic occlusal trauma; 4) dental tooth related factors. This consensus report is based results expert opinion participants. Results Key findings included following: there mainly rare (such as Papillon‐Lefevre Syndrome, leucocyte adhesion deficiency, others) major effect more common diabetes mellitus) variable effects, well affecting apparatus independently plaque biofilm‐induced inflammation neoplastic diseases); diabetes‐associated should not be regarded distinct diagnosis, but recognized an important modifying factor clinical diagnosis descriptor; likewise, tobacco smoking – now considered dependence nicotine chronic relapsing medical disorder adverse effects supporting tissues modifier importance gingival phenotype, encompassing thickness width context novel for introduced; 5) no evidence that lead loss, lesions, recessions; 6) adaptive mobility normal support, whereas they progressive reduced usually requiring splinting; 7) term biologic replaced supracrestal tissue consisting junctional epithelium connective tissue; 8) infringement restorative margins within and/or loss tissue. However, it evident whether periodontium caused biofilm, trauma, toxicity materials combination factors; 9) anatomical factors tissues. Conclusion An updated manifestations apparatus, introduced. Case considerations also presented.

Язык: Английский

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Osteoporosis and periodontal diseases – An update on their association and mechanistic links

Periodontology 2000, Год журнала: 2022, Номер 89(1), С. 99 - 113

Опубликована: Март 4, 2022

Abstract Periodontitis and osteoporosis are prevalent inflammation‐associated skeletal disorders that pose significant public health challenges to our aging population. Both periodontitis bone closely associated with inflammation aging. There has been consistent intrigue on whether a systemic disease such as will amplify the alveolar loss in periodontitis. A survey of literature published past 25 years indicates low mineral density (BMD) is loss, while recent evidence also suggests correlation between clinical attachment other parameters Inflammation its influence remodeling play critical roles pathogenesis both could serve central mechanistic link these disorders. Enhanced cytokine production elevated inflammatory response exacerbate osteoclastic resorption inhibiting osteoblastic formation, resulting net loss. With aging, accumulation oxidative stress cellular senescence drive progression exacerbation Vitamin D deficiency smoking shared risk factors may mediate connection periodontitis, through increasing impairing host inflammation. localized mind, routine dental exams intraoral radiographs low‐cost screening tool for BMD increased fracture risk. Conversely, patients beyond intervention threshold at greater developing severe undergo tooth Various Food Drug Administration‐approved therapies have shown promising results treating Understanding molecular mechanisms underlying their sheds light potential therapeutic strategies facilitate co‐management

Язык: Английский

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Vitamin D Deficiency and Oral Health: A Comprehensive Review

Nutrients, Год журнала: 2020, Номер 12(5), С. 1471 - 1471

Опубликована: Май 19, 2020

Vitamin D (VD) levels have been gaining growing attention in Oral Health. During growth and adulthood, VD deficiency (VDD) is associated with a wide variety of oral health disorders, impaired synthesis may expedite some these conditions. In children, severe VDD can induce defective tooth mineralization, resulting dentin enamel defects. As consequence, defects increase the risk onset progression dental caries. Further, has higher prevalence periodontitis gingival inflammation, several recent preclinical clinical studies unveiled potential pathways through which interact periodontium. correction supplementation contribute to successful treatment periodontitis; however, alveolar bone regeneration procedures performed baseline patients seem more prone failure. also be linked pathology entities such as certain cancers events osteonecrosis jaw. This review aims provide comprehensive evidence how should considered promote good health, summarize hamper development its role

Язык: Английский

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Green Alternatives as Antimicrobial Agents in Mitigating Periodontal Diseases: A Narrative Review

Microorganisms, Год журнала: 2023, Номер 11(5), С. 1269 - 1269

Опубликована: Май 11, 2023

Periodontal diseases and dental caries are the most common infectious oral impacting health globally. Oral cavity is crucial for enhancing life quality since it serves as entranceway to general health. The microbiome strongly correlated. Gram-negative anaerobic bacteria have been associated with periodontal diseases. Due shortcomings of several antimicrobial medications frequently applied in dentistry, lack resources developing countries, prevalence inflammatory conditions, rise bacterial antibiotic resistance, there a need reliable, efficient, affordable alternative solutions prevention treatment Several accessible chemical agents can alter microbiota, although these substances also unfavorable symptoms such vomiting, diarrhea, tooth discoloration. Natural phytochemicals generated from plants that historically used medicines categorized prospective alternatives due ongoing quest substitute products. This review concentrated on or herbal extracts impact by decreasing formation biofilms plaques, preventing proliferation pathogens, inhibiting adhesion surfaces. Investigations examining effectiveness safety plant-based presented, including those conducted over past decade.

Язык: Английский

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Clinical periodontal diagnosis

Periodontology 2000, Год журнала: 2023, Номер unknown

Опубликована: Июль 14, 2023

Abstract Periodontal diseases include pathological conditions elicited by the presence of bacterial biofilms leading to a host response. In diagnostic process, clinical signs such as bleeding on probing, development periodontal pockets and gingival recessions, furcation involvement radiographic bone loss should be assessed prior therapy, following active during long‐term supportive care. addition, patient‐reported outcomes increased tooth mobility, migration, tilting also considered. More important patient, however, is fact that assessment must followed an appropriate treatment plan. Furthermore, it realized diagnosis based which may not reflect disease but rather represent sequelae previous challenge. Hence, aim present review provide summary criteria required classify patients with health or disease.

Язык: Английский

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Prevalence of Periodontal Disease and Periodontopathic Bacteria in Anti–Cyclic Citrullinated Protein Antibody–Positive At-Risk Adults Without Arthritis

JAMA Network Open, Год журнала: 2019, Номер 2(6), С. e195394 - e195394

Опубликована: Июнь 7, 2019

The prevalence of periodontitis is increased in patients with rheumatoid arthritis (RA) and periodontopathic bacteria can citrullinate proteins. Periodontitis may, therefore, be an initiator RA a target for prevention. Periodontal disease periodontal have not been investigated at-risk individuals autoimmunity but no arthritis.To examine anti-cyclic citrullinated protein (anti-CCP) antibody-positive without arthritis.This cross-sectional study took place at teaching hospital from April 27, 2015, to May 8, 2017. Forty-eight anti-CCP-positive (CCP+ at-risk) were recruited nationally. Twenty-six early (ERA) 32 healthy control locally. Data analyzed between June 1, 2017, December 2017.Periodontal assessment examination joints using ultrasonography.Prevalence diseased sites, clinical periodontitis, inflamed surface area CCP+ compared ERA matched age smoking. Paired-end sequencing DNA subgingival plaque sites was performed profiled analyzed.A total 48 (mean [SD] age, 51.9 [11.4] years; 31 [65%] female), 26 54.4 [16.7] 14 [54%] 49.4 [15.3] 19 [59%] female) recruited. Of individuals, 46 had joint inflammation on ultrasonography. Thirty-five (73%), 12 (38%), (54%) periodontitis. median (interquartile range) percentage greater (3.3% [0%-11.3%] vs 0% [0%-0.7%]) similar (1.1% [0%-13.1%]). Median higher (221 mm2 [81-504 mm2] 40 [12-205 mm2]). Patients relative abundance Porphyromonas gingivalis (but Aggregatibacter actinomycetemcomitans) (effect size, 3.00; 95% CI, 1.71-4.29) 2.14; 0.77-3.52).This found P individuals. This suggests are associated initiation could targets preventive interventions RA.

Язык: Английский

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Clinical application of the new classification of periodontal diseases: Ground rules, clarifications and “gray zones”

Journal of Periodontology, Год журнала: 2019, Номер 91(3), С. 352 - 360

Опубликована: Дек. 31, 2019

Successful dissemination of the new classification periodontitis is facilitated by emphasis on basic ground rules, clarification ambiguities, and identification "gray zones" where thoughtful application guidelines an informed, experienced clinician paramount to arrive at a correct Stage Grade.Highlighted rules are (1) patient-based, not tooth-based concept, therefore, single assigned per patient; (2) can shift upward over time, if periodontal status deteriorates, but initially retained even after improvement post-therapy; (3) complexity factors that determine must be evaluated collectively, in isolation, clinically meaningful assessment; (4) Grade patient based deliberate evaluation "biological fabric" case, terms history of/risk for further progression, interplay risk factors, two-way effects or its treatment general health; (v) time possible towards either direction, thorough, collective, changes above parameters. Exemplified gray zones include radiographically intact with minimal attachment loss older age; presence "frank" affecting tooth; assessment do/do lead increased therapy.Differentiating between I/II versus III/IV relatively uncomplicated; distinction Stages assignment requires nuanced, thorough interpretation broad array findings knowledgeable clinician.

Язык: Английский

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