In periodontitis patients, a periodontal abscess may occur as a result of disease exacerbation that is supported by the existence of deep pockets, the presence of furcation involvement, or a vertical defect. Fine DH, Patil AG, Loos BG. (2018) Periodontal Health. Thin scalloped biotype: slender triangular crown, subtle cervical convexity, interproximal contacts close to the incisal edge and a narrow zone of keratinized tissue, clear thin delicate gingiva, and a relatively thin alveolar bone. If the supracrestal tissue attachment is respected and patients are compliant with home care instructions and undergo regular professional periodontal maintenance, gingival inflammation and its potential for progression to periodontitis can be prevented. By now you would have seen or heard of the new classification of periodontal and peri-implant diseases, which replaced the previous (1999) classification system and addressed most of its limitations. 2. This 3-hour lecture-based course will review the proceedings of the World Workshop on the Classification of Periodontal and Peri-implant Diseases and Conditions from 2017, where the former classification was revised and expanded. They may represent pathologic changes limited to the gingiva and the classification is based on the etiology of the lesions (Table 4). 3. c. Presence of CAL on the distal aspect of a second molar and associated with malposition or extraction of a third molar, 15 Similarly, existence of abfraction and its implication on gingival recession or non-carious cervical lesions as a result of traumatic occlusal forces are not supported in the current literature. J Periodontol. A new global classification system for periodontal health, diseases and conditions, as well as peri-implant diseases and conditions, was revealed at the EuroPerio9 congress, the world’s leading congress in periodontology and implant dentistry in June 2018. 8. Clear and concise oral hygiene instruction and increased patient motivation for adequate home care is imperative in the treatment of gingivitis. Amalgam tattoo. 45(Suppl 20): S78-S94. This applies especially in cases in which additional orthodontics, restorative dentistry, or implant therapy are planned. In defining a state of health, gingivitis, or periodontal disease, it was agreed that bleeding on probing (BOP) should be among the primary parameters to set thresholds for diagnosis and treatment planning. Grade (A-C) encompasses further information about biological features including the rate of progression, assessment of the risk of further progression, an analysis of possible poor outcomes of treatment, and an assessment of the risk of the disease to negatively impact the general health of the patient (Table 6). 8 For a full description of the phenotypes of each stage and grade of periodontitis, please refer to primary research article written by Tonetti and colleagues. (2016) Long-term outcomes of untreated buccal gingival recessions. 17 Other localized anatomical tooth factors such as cervical enamel projections, enamel pearls and developmental grooves can modify or predispose patients to plaque induced gingival diseases and periodontitis. Additional complexity to the diagnosis of gingivitis comes from the large variations in the extent and severity of gingivitis in individuals with these systemic risk factors. The analysis of this evidence has prompted the development of a new classification framework for periodontitis. Periodontitis Cortellini P and Bissada NF. The collaboration required between dental health professionals and physicians has never been more necessary to provide our mutual patients with the most current multi-disciplinary treatment and care. 5 This newly defined term, whereby only a few sites are affected, may even be regarded as within the spectrum of clinical periodontal health. The introduction of the recent 2017 classification of periodontal diseases has been welcomed by the periodontal fraternity. In 1999, the American Academy of Periodontology devised a new classification system for periodontal diseases. Necrotizing periodontitis is an inflammatory process characterized by a prominent bacterial invasion and ulceration of the epithelium. 45(Suppl 20): S68-S77. Development of a classification system for periodontal diseases and conditions. The primary features of the disease include the loss of periodontal tissue support manifested through clinical attachment loss (CAL) and radiographic bone loss, presence of periodontal pocketing and gingival bleeding. The webinar will address the following aims: Providing a simple guide to implementing the new periodontal classification in real world practice Explaining the stepwise approach to periodontal therapy under the new S3-level international…

Within this research program, a number of novel foods and food components are studied: vitamin D, soy and its isoflavones, omega-3 fatty acids in flaxseed and fish oil, and tea and its flavonoids. The complete review of primary information and consensus reports for the innovative model for understanding and diagnosing periodontal diseases was simultaneously published in 17 articles including four review papers in the Journal of Clinical Periodontology and the Journal of Periodontology in June 2018. 45(Suppl 20): S171-S189. Ercoli C and Caton JG. This introductory overview presents the schematic tables for the new classification of periodontal and peri‐implant diseases and conditions and briefly highlights changes made to the 1999 classification. J Clin Periodontol. J Periodontol. Chapple ILC, Mealey BL, Van Dyke TE, Bartold PM, Dommisch H, Eickholz P, Geisinger ML, Genco RJ, Glogauer M, Goldstein M, et al. The 2018 classification system for periodontal and peri-implant diseases and conditions developed by the American Academy of Periodontology and European Federation of Periodontology represents an important collaborative effort that extensively surveyed the existing evidence, evaluated reviews, and reached consensus regarding the updated classifications. 4. The New Periodontal and Peri-implant Disease Classification System was published in June 2018. J Am Dent Assoc. Xerostomia, a symptom caused by perceived lack of salivation (not a diagnosis) may make plaque control difficult and gingival inflammation may be worsened. To enable proper diagnosis and prognostication for patient communication and education. The Workshop involved more than 170 leading clinicians and researchers creating an unique effort to unite the periodontal community worldwide. This is evidenced as CAL by circumferential assessment of the erupted dentition with a standardized periodontal probe with reference to the cemento-enamel junction (CEJ). Degree of periodontal breakdown, Generalized gingivitis involves BOP scores of greater than 30%. Periodontal abscesses represent approximately 8-14% of all dental emergencies. 5. It is important to note that any amount of gingiva is sufficient to maintain periodontal health when optimal oral hygiene is obtained. Updates include staging and grading system for periodontitis; classification of peri-implant diseas e. CHICAGO (June 21, 2018) — The American Academy of Periodontology (AAP) has published the official proceedings from the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions. The new peri-implant and periodontal disease classification addresses most of the limitations identified in the 1999 classification system. AMSTERDAM, Netherlands: A new global classification system for periodontal health, diseases and conditions, as well as peri-implant diseases and conditions, was announced today at EuroPerio9. Secondly, a new identification and classification system of periodontitis has been defined. The comprehensive classification is based upon the most contemporary evidence and includes a staging and grading system for periodontitis, indicating severity and extent of disease, accounting for lifetime disease experience and considering the patient’s overall health status. J Clin Periodontol. Her research program investigates how early diet sets a trajectory for a stronger, healthier skeleton at adulthood, and also how diet can support bone health at older life stages. Biofilm-induced gingivitis is a site-specific inflammatory condition initiated by dental biofilm accumulation and characterized by gingival redness, edema and the absence of periodontal attachment loss. 1 These diseases and conditions can be classified into eight general categories; genetic/developmental disorders, specific infections, inflammatory or immune conditions and lesions, reactive processes, neoplasms, endocrine/nutritional/metabolic disease, traumatic lesions, or gingival pigmentation. In order to transition to the new AAP periodontal classification, certain indices are required. For the complete suite of reviews, case definition papers, and consensus reports, please visit perio.org/2017wwdc. It is defined by no attachment loss, no bleeding upon probing, and no anatomical loss of periodontal structures. Obviously, the old classification system had problems in limiting the use of certain terms to specific forms of periodontal disease. A systematic review and meta-analysis. by Peter C. Fritz, BSc, DDS, FRCD(C), PhD (Perio), MBA; Wendy E. Ward, BArts&Sci, BSc, MSc, PhD; Amanda B. Longo, BSc, MSc, PhD. Although it has long been known that oral health is inextricably linked to overall health, today more than ever, the linkages between periodontics and medicine are stronger and even more well defined. (2011) The interproximal CAL to classify gingival recessions and predict root coverage outcomes: An explorative and reliability study. J Clin Periodontol. Evidence of healthy eating and The New Canada Food Guide Update ... World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions. In conclusion, this new classification system presents a unique opportunity to escalate our precision care for our patients, spark conversations with our medical colleagues about treating the whole patient and push us towards exploring exciting research questions. J Clin Periodontol. 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. 1. Number and distribution of teeth with detectable breakdown, Abstract Objective: To review the 1979 Canadian Task Force on the Periodic Health Examination recommendations on the diagnosis and prevention of periodontal disease. Anyone else have any input on that statement. The New Periodontal and Peri-implant Disease Classification System was published in June 2018. Regardless of the cause, extent or severity of gingival disease, the treatment of gingivitis remains unchanged. Some pre-disposing conditions include HIV/AIDS, immunosuppressed patients, severe malnourishment, or viral infections. 2. Caton G, Armitage G, Berglundh T, et al. The World Workshop was organised jointly by the American Academy of Periodontology (AAP) and the European Federation of Periodontology (EFP) to create a consensus knowledge base for a new classification to … (2018) Dental plaque-induced gingival conditions. Trombelli L, Farina R, Silva CO, Tatakis DN. A summary of parameters defining a healthy state compared to two diseased states is presented in Table 3. This short video describes the new periodontal classification which was released in 2017 by the EFP. Early this year, a new classification for periodontal and peri-implant diseases and conditions was published in the Journal of Periodontology. This newly developed framework provides the clinician the ability to define each individual case by a simple matrix of Stage (severity and complexity) and Grade (evidence or risk of progression). 45(Suppl 20): S149-S161. AAP Releases Proceedings From The 2017 World Workshop, CDC Estimate: High Periodontal Disease Prevalence Found Among Southern U.S. States, Journal of Periodontology and The American Journal of Cardiology Develop Clinical Recommendations on the Treatment of Periodontitis and Atherosclerotic Cardiovascular Disease, New Reports Confirm Perio-Systemic Connection and Outline Clinical Recommendations, Clinical Brief: Successful Endodontic Treatment, Improved Long-Term Treatment Outcomes of Teeth with Deep Pockets and Reduced Periodontal Support by Periodontal Regenerative Surgery. Gingival recession is frequently associated with dentinal hypersensitivity, impaired esthetics, and carious and non-carious cervical lesions. Towards this, a Malaysian 15 However, a reduction of tooth mobility may improve periodontal treatment outcomes. Workgroup 1 discussed periodontal health and gingival diseases and conditions on an intact and a reduced periodontium.6Chapple ILC, Mealey BL, Van Dyke TE, Bartold PM, Dommisch H, Eickholz P, et al. In addition to reports that were prepared prior to the World Workshop, there were 4 working groups at the meeting and each issued a consensus report at the conclusion of the meeting. 3. In addition, normal gingival pigmentation (let’s say like someone with a darker skin tone might have) is not included here. 2. The fabrication and presence of dental prostheses and tooth-related factors have an impact on periodontal health and disease state. 10 Endo-perio lesions can be associated with either endodontic or periodontal infections or associated with trauma and iatrogenic factors (i.e., root perforation, fracture, or external root resorption) often causing root damage. This introductory overview presents the schematic tables for the new classification of periodontal and peri‐implant diseases and conditions and briefly highlights changes made to the 1999 classification. The most common signs and symptoms of an endo-perio lesion are deep periodontal pockets reaching (or nearing) the apex of the tooth and a negative or altered response to pulp vitality tests. 14 Limited evidence suggests that gingival recession does not impair the long-term survival of teeth, however, it may promote dentin hypersensitivity, and compromise esthetics. This super course was developed to explore the most current research and practice-based evidence of periodontal therapy. Sub-optimal design and manufacture of dental prostheses can be associated with plaque retention and the eventual loss of supporting periodontal tissues. Periodontal Health, Gingival Diseases and Conditions This new classification has numerous subcategories; only the major categories will be discussed here. Restoration margins located within the gingival sulcus are not considered to be a cause of gingivitis and inflammation as long as the patient is compliant with their self-performed plaque control. Tooth anatomical factors such as root abnormalities, fractures and tooth relationships within the dental arch (root proximity) and with opposing dentition can enhance plaque retention. Cortellini P, Tonetti MS, Lang NP, Suvan JE, Zucchelli G, Vangsted T, Silvestri M, Rossi R, McClain P, Fonzar A, et al. Severe gingival enlargement involves the gingival papilla, marginal gingiva, and the attached gingiva. Systemic disorders can impact periodontal inflammation via an immunological response (i.e., leukocyte adhesion deficiency syndromes), by affecting the oral mucosa, gingival tissue (i.e., epidermolysis bullosa), connective tissues (i.e., systemic lupus, Ehlers-Danos syndrome), or through metabolic or endocrine disorders (i.e., obesity, osteoporosis, diabetes mellitus, hypophosphotasia, glycogen storage diseases). The 2018 classification system for periodontal and peri-implant diseases and conditions developed by the American Academy of Periodontology and European Federation of Periodontology represents an important collaborative effort that extensively surveyed the existing evidence, evaluated reviews, and reached consensus regarding the updated classifications. Based on the pathophysiology, three categories of periodontitis have been defined: 1. Caton JG, Armitage G, Berglundh T, Chapple ILC, Jepsen S, Kornman KS, Lealey BL, Papapanou PN, Sanz M, Tonetti MS. (2018) A new classification scheme for periodontal and peri-implant diseases and conditions–Introduction and key changes from the 1999 classification. (2018) Plaque-induced gingivitis: Case definition and diagnostic considerations. Periodontitis Dental caries extending in the cervical area of the tooth, These systemic diseases have a major impact on the loss of periodontal tissue through its influence on periodontal inflammation. It was previously believed that oral contraceptives and hormonal changes associated with the menstrual cycle were associated with gingival inflammation, gingival enlargement, and increases in gingival crevicular fluid production. (2018) Classification and diagnosis of aggressive periodontitis. Given the measurement error when quantifying CAL with a standard periodontal probe, the newly proposed clinical definition does not stipulate a specific threshold of CAL to avoid any misclassification of early periodontitis cases as gingivitis. The inauguration of new classification scheme for periodontal diseases and conditions in 2017 World Workshop has a remarkable impact on the diagnosis of periodontal diseases worldwide. Murakami S, Mealey BL, Mariotti A, Chapple ILC. This distinction was made to highlight the need for continued and comprehensive maintenance of patients after successful treatment of periodontitis. This statement in regards to improved attachment levels seem highly unlikely. This is significant for Intra-Oral Dental Assistants as it is part of… Some of the more major changes in the new classification scheme occur in the classification of periodontitis. 3. Implementation of the novel 2017 American Academy of Periodontology (AAP) World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions (WWDC) diagnostic system for our clients with periodontitis and gingivitis allows us to optimize our diagnosis, care, and the communication of client needs. 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