Staging and grading of periodontitis: Framework and proposal of a new classification and case definition.
TLDR
The proposed case definition extends beyond description based on severity to include characterization of biological features of the disease and represents a first step towards adoption of precision medicine concepts to the management of periodontitis.Abstract:
Background Authors were assigned the task to develop case definitions for periodontitis in the context of the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions. The aim of this manuscript is to review evidence and rationale for a revision of the current classification, to provide a framework for case definition that fully implicates state-of-the-art knowledge and can be adapted as new evidence emerges, and to suggest a case definition system that can be implemented in clinical practice, research and epidemiologic surveillance. Methods Evidence gathered in four commissioned reviews was analyzed and interpreted with special emphasis to changes with regards to the understanding available prior to the 1999 classification. Authors analyzed case definition systems employed for a variety of chronic diseases and identified key criteria for a classification/case definition of periodontitis. Results The manuscript discusses the merits of a periodontitis case definition system based on Staging and Grading and proposes a case definition framework. Stage I to IV of periodontitis is defined based on severity (primarily periodontal breakdown with reference to root length and periodontitis-associated tooth loss), complexity of management (pocket depth, infrabony defects, furcation involvement, tooth hypermobility, masticatory dysfunction) and additionally described as extent (localized or generalized). Grade of periodontitis is estimated with direct or indirect evidence of progression rate in three categories: slow, moderate and rapid progression (Grade A-C). Risk factor analysis is used as grade modifier. Conclusions The paper describes a simple matrix based on stage and grade to appropriately define periodontitis in an individual patient. The proposed case definition extends beyond description based on severity to include characterization of biological features of the disease and represents a first step towards adoption of precision medicine concepts to the management of periodontitis. It also provides the necessary framework for introduction of biomarkers in diagnosis and prognosis.read more
Citations
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Journal ArticleDOI
Periodontitis: Consensus report of workgroup 2 of the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions.
Panos N. Papapanou,Mariano Sanz,Nurcan Buduneli,Thomas Dietrich,Magda Feres,Daniel H. Fine,Thomas Frank Flemmig,Raul I. Garcia,William V. Giannobile,Filippo Graziani,Henry Greenwell,David Herrera,Richard T. Kao,Moritz Kebschull,Moritz Kebschull,Denis F. Kinane,Keith L. Kirkwood,Thomas Kocher,Kenneth S. Kornman,Purnima S. Kumar,Bruno G. Loos,Eli E. Machtei,Huanxin Meng,Andrea Mombelli,Ian Needleman,Steven Offenbacher,Gregory J. Seymour,Ricardo Teles,Maurizio S. Tonetti +28 more
TL;DR: 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 as mentioned in this paper.
Journal ArticleDOI
A new classification scheme for periodontal and peri-implant diseases and conditions - Introduction and key changes from the 1999 classification.
Jack G. Caton,Gary C. Armitage,Tord Berglundh,Iain L. C. Chapple,Søren Jepsen,Kenneth S. Kornman,Brian L. Mealey,Panos N. Papapanou,Mariano Sanz,Maurizio S. Tonetti +9 more
TL;DR: An overview for the new classification of periodontal and peri-implant diseases and conditions is presented, along with a condensed scheme for each of four workgroup sections, but readers are directed to the pertinent consensus reports and review papers for a thorough discussion of the rationale, criteria, and interpretation of the proposed classification.
Journal ArticleDOI
Treatment of stage I-III periodontitis-The EFP S3 level clinical practice guideline.
Mariano Sanz,David Herrera,Moritz Kebschull,Moritz Kebschull,Moritz Kebschull,Iain L. C. Chapple,Iain L. C. Chapple,Søren Jepsen,Tord Beglundh,Anton Sculean,Maurizio S. Tonetti,Maurizio S. Tonetti,Methodological Consultants +12 more
TL;DR: This S3 guideline informs clinical practice, health systems, policymakers and, indirectly, the public on the available and most effective modalities to treat periodontitis and to maintain a healthy dentition for a lifetime, according to the available evidence at the time of publication.
Journal ArticleDOI
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: Classification and case definitions for periodontal manifestations of systemic diseases and developmental and acquired conditions
Søren Jepsen,Jack G. Caton,Jasim M. Albandar,Nabil F. Bissada,Philippe Bouchard,Pierpaolo Cortellini,Korkud Demirel,Massimo de Sanctis,Carlo Ercoli,Jingyuan Fan,Nicolaas C. Geurs,Francis J. Hughes,Lijian Jin,Alpdogan Kantarci,Evanthia Lalla,Phoebus N. Madianos,Debora C Matthews,Michael K. McGuire,Michael P. Mills,Philip M. Preshaw,Mark A. Reynolds,Anton Sculean,Cristiano Susin,Nicola X West,Kazuhisa Yamazaki +24 more
TL;DR: An updated classification of theperiodontal manifestations and conditions affecting the course of periodontitis and the periodontal attachment apparatus, as well as of developmental and acquired conditions, is introduced.
Journal ArticleDOI
The role of inflammation and genetics in periodontal disease.
Bruno G. Loos,Thomas E. Van Dyke +1 more
TL;DR: The shared genes suggest that periodontitis is not causally related to atherosclerotic diseases, but rather both conditions are sequelae of similar (the same?) aberrant inflammatory pathways.
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Related Papers (5)
Periodontitis: Consensus report of workgroup 2 of the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions.
Panos N. Papapanou,Mariano Sanz,Nurcan Buduneli,Thomas Dietrich,Magda Feres,Daniel H. Fine,Thomas Frank Flemmig,Raul I. Garcia,William V. Giannobile,Filippo Graziani,Henry Greenwell,David Herrera,Richard T. Kao,Moritz Kebschull,Moritz Kebschull,Denis F. Kinane,Keith L. Kirkwood,Thomas Kocher,Kenneth S. Kornman,Purnima S. Kumar,Bruno G. Loos,Eli E. Machtei,Huanxin Meng,Andrea Mombelli,Ian Needleman,Steven Offenbacher,Gregory J. Seymour,Ricardo Teles,Maurizio S. Tonetti +28 more