PERIO EXAM #2 PERIODONTITIS INCLUDING
STAGING & GRADING
A patient is a periodontal case if there is: - Answer -1. Interdental clinical attachment
loss detectible at 2 or more nonadjacent teeth
OR
2. Facial or lingual clinical attachment loss of 3mm or more with pocketing greater than
3 mm detectible at 2 or more teeth
Attachment loss NOT due to periodontitis can include: - Answer --gingival recession of
traumatic origin
-dental caries extending to or apical to CEJ
-presence of CAL on distal of 2nd molar associated with extraction of 3rd molar
-endodontic lesion draining through marginal gingiva
-vertical root fractures
3 forms of periodontitis - Answer -1. Necrotizing periodontitis
2. Periodontitis as a direct manifestation of systemic diseases
3. Periodontitis
How many stages of periodontitis are there? - Answer -4
Stages of periodontitis are defined by: - Answer --disease severity
-complexity of management
Periodontal stage may shift to a higher level based on ________ - Answer -complexity
factors
I.e. Furcations
Stage 1 periodontitis severity - Answer --interdental CAL of 1-2 mm
-radiographic bone loss extends to coronal 1/3 of root
-no tooth loss due to periodontitis
Stage 1 periodontitis complexity of management - Answer --maximum probing depths
4mm or less
-mostly horizontal bone loss
Stage 1 periodontitis AKA - Answer -initial stage
Stage 2 periodontitis severity - Answer --interdental CAL of 3-4mm
-radiographic bone loss extends to coronal 1/3 of root
-no tooth loss due to periodontitis
, Stage 2 periodontitis complexity of management - Answer --maximum probing depths
of 5mm or less
-mostly horizontal bone loss
Stage 2 periodontitis AKA - Answer -established periodontitis
Stage 3 periodontitis severity - Answer --interdental CAL > 5 mm
-radiographic bone loss extends to middle 1/3 of root
-tooth loss due to periodontitis of 4 teeth or fewer
Stage 3 periodontitis complexity of management - Answer --maximum probing depths
of 6mm or greater
-vertical bone loss of 3mm or greater
-class II or III furcation involvement
-moderate alveolar ridge defect complicating implant placement
Stage 3 periodontitis AKA - Answer -severe periodontitis
Stage 4 periodontitis severity - Answer --interdental CAL > 5 mm
-radiographic bone loss extends to middle 1/3 of root
-tooth loss due to periodontitis of 5 teeth or more
Stage 4 periodontitis complexity of management - Answer --maximum probing depths
of >6mm
-masticatory dysfunction, occlusal trauma
-tooth mobility > class II
-less than 20 teeth remaining
Stage 4 periodontitis AKA - Answer -advanced periodontitis
Grading of periodontitis - Answer --A, B, C
-indicates rate of progression**
-determines likelihood of CAL progressing quicker than normal
-based on direct evidence using longitudinal studies
-based on indirect evidence on assessment of bone loss
Grade A: slow rate of progression - Answer --no evidence of CAL or radiographic bone
loss over a 5-year period
-heavy biofilm deposits with low level of tissue destruction
-modified by nonsmokers and normoglycemic patient
Grade B: moderate rate of progression - Answer --less than 2mm CAL or radiographic
bone loss over a 5-year period
-tissue destruction in line with expectations
-modified by smoking <10 cigarettes a day
STAGING & GRADING
A patient is a periodontal case if there is: - Answer -1. Interdental clinical attachment
loss detectible at 2 or more nonadjacent teeth
OR
2. Facial or lingual clinical attachment loss of 3mm or more with pocketing greater than
3 mm detectible at 2 or more teeth
Attachment loss NOT due to periodontitis can include: - Answer --gingival recession of
traumatic origin
-dental caries extending to or apical to CEJ
-presence of CAL on distal of 2nd molar associated with extraction of 3rd molar
-endodontic lesion draining through marginal gingiva
-vertical root fractures
3 forms of periodontitis - Answer -1. Necrotizing periodontitis
2. Periodontitis as a direct manifestation of systemic diseases
3. Periodontitis
How many stages of periodontitis are there? - Answer -4
Stages of periodontitis are defined by: - Answer --disease severity
-complexity of management
Periodontal stage may shift to a higher level based on ________ - Answer -complexity
factors
I.e. Furcations
Stage 1 periodontitis severity - Answer --interdental CAL of 1-2 mm
-radiographic bone loss extends to coronal 1/3 of root
-no tooth loss due to periodontitis
Stage 1 periodontitis complexity of management - Answer --maximum probing depths
4mm or less
-mostly horizontal bone loss
Stage 1 periodontitis AKA - Answer -initial stage
Stage 2 periodontitis severity - Answer --interdental CAL of 3-4mm
-radiographic bone loss extends to coronal 1/3 of root
-no tooth loss due to periodontitis
, Stage 2 periodontitis complexity of management - Answer --maximum probing depths
of 5mm or less
-mostly horizontal bone loss
Stage 2 periodontitis AKA - Answer -established periodontitis
Stage 3 periodontitis severity - Answer --interdental CAL > 5 mm
-radiographic bone loss extends to middle 1/3 of root
-tooth loss due to periodontitis of 4 teeth or fewer
Stage 3 periodontitis complexity of management - Answer --maximum probing depths
of 6mm or greater
-vertical bone loss of 3mm or greater
-class II or III furcation involvement
-moderate alveolar ridge defect complicating implant placement
Stage 3 periodontitis AKA - Answer -severe periodontitis
Stage 4 periodontitis severity - Answer --interdental CAL > 5 mm
-radiographic bone loss extends to middle 1/3 of root
-tooth loss due to periodontitis of 5 teeth or more
Stage 4 periodontitis complexity of management - Answer --maximum probing depths
of >6mm
-masticatory dysfunction, occlusal trauma
-tooth mobility > class II
-less than 20 teeth remaining
Stage 4 periodontitis AKA - Answer -advanced periodontitis
Grading of periodontitis - Answer --A, B, C
-indicates rate of progression**
-determines likelihood of CAL progressing quicker than normal
-based on direct evidence using longitudinal studies
-based on indirect evidence on assessment of bone loss
Grade A: slow rate of progression - Answer --no evidence of CAL or radiographic bone
loss over a 5-year period
-heavy biofilm deposits with low level of tissue destruction
-modified by nonsmokers and normoglycemic patient
Grade B: moderate rate of progression - Answer --less than 2mm CAL or radiographic
bone loss over a 5-year period
-tissue destruction in line with expectations
-modified by smoking <10 cigarettes a day
