Dentaltown January 2020 - 63

Table 1

Periodontitis Stage
Severity

Complexity

Extent and
distribution

Stage I

Stage II

Stage III

Stage IV

Interdental CAL
at site of
greatest loss

1-2 mm

3-4 mm

≥ 5 mm

≥ 5 mm

Radiographic
bone loss

Coronal third
(< 15%)

Coronal third
(15-33%)

Extending to
mid-third of root
and beyond

Extending to
mid-third of root
and beyond

Tooth loss

No tooth loss due to periodontitis

Loss of four or
fewer teeth due
to periodontitis

Loss of five or
more teeth due
to periodontitis

Local

Maximum probing
depth ≥ 4 mm

Maximum probing
depth ≥ 5 mm

Mostly horizontal
bone loss

Mostly horizontal
bone loss

In addition to
Stage II complexity:
* Probing depth
≥ 6mm
* Vertical bone loss
≥ 3mm
* Furcation
involvement
Class II or III
* Moderate ridge
defect

In addition to Stage III
complexity, need for
complex rehabilitation
due to:
* Masticatory dysfunction
* Secondary occlusal
trauma (tooth mobility
degree ≥ 2)
* Severe ridge defect
* Bite collapse, drifting,
flaring
* Less than 20 remaining
teeth (10 opposing pairs)

Add to stage
as descriptor

Key definitions
According to the updated classifications,
a patient has periodontitis if:
* Interdental clinical attachment
loss (CAL) is detectable in two
or more nonadjacent teeth.
* Buccal or lingual CAL ≥ 3 mm with
pocketing > 3 mm is detectable
in two or more teeth.
* The observed CAL cannot be
ascribed to trauma-induced gingival
recession, dental caries extending
to the cervical area, endodontic
lesions draining through the
periodontium, or tooth fractures.

For each stage, describe extent as localized (less than 30% of teeth involved),
generalized, or molar/incisor pattern.

The new classification of periodontitis
is based on a two-vector system defined by
stage and grade, inspired by a scheme used
in oncology.
Stage classifies the severity and extent of
current tissue loss, including tooth loss due
to periodontitis. As seen in Table 1, this
classification incorporates an assessment of
the level of complexity of management of
the patient's condition.
According to the revised ground rules
for assessing the stage of periodontal disease:
* The stage is defi ned on the basis
of the most severe fi nding and on
the patient level, not the individual
tooth level.

*

*

*

The stage is assigned before treatment
and cannot revert after therapy, but
may advance over time if the
periodontal conditions deteriorate
significantly.
Disease severity, case complexity and
periodontitis-associated tooth loss
are "alternative paths" that guide the
selection of the appropriate stage.
Selection of the appropriate stage
requires more than "checking off"
individual boxes; it is a deliberate
process that necessitates a holistic
evaluation of multiple findings.

dentaltown.com \\ JANUARY 2020

63



http://www.dentaltown.com

Dentaltown January 2020

Table of Contents for the Digital Edition of Dentaltown January 2020

Dentaltown January 2020 - Intro
Dentaltown January 2020 - Cover1
Dentaltown January 2020 - Cover2
Dentaltown January 2020 - 1
Dentaltown January 2020 - 2
Dentaltown January 2020 - 3
Dentaltown January 2020 - 4
Dentaltown January 2020 - 5
Dentaltown January 2020 - 6
Dentaltown January 2020 - 7
Dentaltown January 2020 - 8
Dentaltown January 2020 - 9
Dentaltown January 2020 - 10
Dentaltown January 2020 - 11
Dentaltown January 2020 - 12
Dentaltown January 2020 - 13
Dentaltown January 2020 - 14
Dentaltown January 2020 - 15
Dentaltown January 2020 - 16
Dentaltown January 2020 - 17
Dentaltown January 2020 - 18
Dentaltown January 2020 - 19
Dentaltown January 2020 - 20
Dentaltown January 2020 - 21
Dentaltown January 2020 - 22
Dentaltown January 2020 - 23
Dentaltown January 2020 - 24
Dentaltown January 2020 - 25
Dentaltown January 2020 - 26
Dentaltown January 2020 - 27
Dentaltown January 2020 - 28
Dentaltown January 2020 - 29
Dentaltown January 2020 - 30
Dentaltown January 2020 - 31
Dentaltown January 2020 - 32
Dentaltown January 2020 - 33
Dentaltown January 2020 - 34
Dentaltown January 2020 - 35
Dentaltown January 2020 - 36
Dentaltown January 2020 - 37
Dentaltown January 2020 - 38
Dentaltown January 2020 - 39
Dentaltown January 2020 - 40
Dentaltown January 2020 - 41
Dentaltown January 2020 - 42
Dentaltown January 2020 - 43
Dentaltown January 2020 - 44
Dentaltown January 2020 - 45
Dentaltown January 2020 - 46
Dentaltown January 2020 - 47
Dentaltown January 2020 - 48
Dentaltown January 2020 - 49
Dentaltown January 2020 - 50
Dentaltown January 2020 - 51
Dentaltown January 2020 - 52
Dentaltown January 2020 - 53
Dentaltown January 2020 - 54
Dentaltown January 2020 - 55
Dentaltown January 2020 - 56
Dentaltown January 2020 - 57
Dentaltown January 2020 - 58
Dentaltown January 2020 - 59
Dentaltown January 2020 - 60
Dentaltown January 2020 - 61
Dentaltown January 2020 - 62
Dentaltown January 2020 - 63
Dentaltown January 2020 - 64
Dentaltown January 2020 - 65
Dentaltown January 2020 - 66
Dentaltown January 2020 - 67
Dentaltown January 2020 - 68
Dentaltown January 2020 - 69
Dentaltown January 2020 - 70
Dentaltown January 2020 - 71
Dentaltown January 2020 - 72
Dentaltown January 2020 - 73
Dentaltown January 2020 - 74
Dentaltown January 2020 - 75
Dentaltown January 2020 - 76
Dentaltown January 2020 - 77
Dentaltown January 2020 - 78
Dentaltown January 2020 - 79
Dentaltown January 2020 - 80
Dentaltown January 2020 - 81
Dentaltown January 2020 - 82
Dentaltown January 2020 - 83
Dentaltown January 2020 - 84
Dentaltown January 2020 - 85
Dentaltown January 2020 - 86
Dentaltown January 2020 - 87
Dentaltown January 2020 - 88
Dentaltown January 2020 - Cover3
Dentaltown January 2020 - Cover4
https://www.nxtbook.com/farran/dentaltown/dentaltown-november-2024
https://www.nxtbook.com/farran/dentaltown/dentaltown-october-2024
https://www.nxtbook.com/farran/dentaltown/dentaltown-september-2024
https://www.nxtbook.com/farran/dentaltown/dentaltown-august-2024
https://www.nxtbook.com/farran/dentaltown/dentaltown-july-2024
https://www.nxtbook.com/farran/dentaltown/dentaltown-june-2024
https://www.nxtbook.com/farran/dentaltown/dentaltown-may-2024
https://www.nxtbook.com/farran/dentaltown/dentaltown-april-2024
https://www.nxtbook.com/farran/dentaltown/dentaltown-march-2024
https://www.nxtbook.com/farran/dentaltown/dentaltown-february-2024
https://www.nxtbook.com/farran/dentaltown/dentaltown-january-2024
https://www.nxtbook.com/farran/dentaltown/dentaltown-december-2023
https://www.nxtbook.com/farran/dentaltown/dentaltown-november-2023
https://www.nxtbook.com/farran/dentaltown/dentaltown-new-grad-2023
https://www.nxtbook.com/farran/dentaltown/dentaltown-october-2023
https://www.nxtbook.com/farran/dentaltown/dentaltown-september-2023
https://www.nxtbook.com/farran/dentaltown/dentaltown-august-2023
https://www.nxtbook.com/farran/dentaltown/dentaltown-july-2023
https://www.nxtbook.com/farran/dentaltown/dentaltown-june-2023
https://www.nxtbook.com/farran/dentaltown/dentaltown-may-2023
https://www.nxtbook.com/farran/dentaltown/dentaltown-april-2023
https://www.nxtbook.com/farran/dentaltown/dentaltown-march-2023
https://www.nxtbook.com/farran/dentaltown/dentaltown-february-2023
https://www.nxtbook.com/farran/dentaltown/dentaltown-january-2023
https://www.nxtbook.com/farran/dentaltown/dentaltown-december-2022
https://www.nxtbook.com/farran/dentaltown/dentaltown-november-2022
https://www.nxtbook.com/farran/dentaltown/dentaltown-october-2022
https://www.nxtbook.com/farran/dentaltown/dentaltown-new-grad-2022
https://www.nxtbook.com/farran/dentaltown/dentaltown-september-2022
https://www.nxtbook.com/farran/dentaltown/dentaltown-august-2022
https://www.nxtbook.com/farran/dentaltown/dentaltown-july-2022
https://www.nxtbook.com/farran/dentaltown/dentaltown-june-2022
https://www.nxtbook.com/farran/dentaltown/dentaltown-may-2022
https://www.nxtbook.com/farran/dentaltown/dentaltown-april-2022
https://www.nxtbook.com/farran/dentaltown/dentaltown-march-2022
https://www.nxtbook.com/farran/dentaltown/dentaltown-february-2022
https://www.nxtbook.com/farran/dentaltown/dentaltown-january-2022
https://www.nxtbook.com/farran/dentaltown/dentaltown-december-2021
https://www.nxtbook.com/farran/dentaltown/dentaltown-november-2021
https://www.nxtbook.com/farran/dentaltown/dentaltown-new-grad-2021
https://www.nxtbook.com/farran/dentaltown/dentaltown-october-2021
https://www.nxtbook.com/farran/dentaltown/dentaltown-september-2021
https://www.nxtbook.com/farran/dentaltown/dentaltown-august-2021
https://www.nxtbook.com/farran/dentaltown/dentaltown-july-2021
https://www.nxtbook.com/farran/dentaltown/dentaltown-june-2021
https://www.nxtbook.com/farran/dentaltown/dentaltown-may-2021
https://www.nxtbook.com/farran/dentaltown/dentaltown-april-2021
https://www.nxtbook.com/farran/dentaltown/dentaltown-march-2021
https://www.nxtbook.com/farran/dentaltown/dentaltown-february-2021
https://www.nxtbook.com/farran/dentaltown/2021January
https://www.nxtbook.com/farran/dentaltown/2020December
https://www.nxtbook.com/farran/dentaltown/2020November
https://www.nxtbook.com/farran/dentaltown/2020NewGrad
https://www.nxtbook.com/farran/dentaltown/2020October
https://www.nxtbook.com/farran/dentaltown/2020September
https://www.nxtbook.com/farran/dentaltown/2020August
https://www.nxtbook.com/farran/dentaltown/2020July
https://www.nxtbook.com/farran/dentaltown/2020June
https://www.nxtbook.com/farran/dentaltown/2020May
https://www.nxtbook.com/farran/dentaltown/2020April
https://www.nxtbook.com/farran/dentaltown/2020March
https://www.nxtbook.com/farran/dentaltown/2020February
https://www.nxtbook.com/farran/dentaltown/2020January
https://www.nxtbook.com/farran/dentaltown/2019December
https://www.nxtbook.com/farran/dentaltown/2019November
https://www.nxtbook.com/farran/dentaltownuk/2019OctoberNovember
https://www.nxtbook.com/farran/dentaltown/2019October
https://www.nxtbook.com/farran/dentaltown/2019NewGrad
https://www.nxtbook.com/farran/dentaltown/2019September
https://www.nxtbook.com/farran/dentaltown/2019August
https://www.nxtbook.com/farran/dentaltown/2019July
https://www.nxtbook.com/farran/dentaltownuk/2019JuneJuly
https://www.nxtbook.com/farran/dentaltown/2019June
https://www.nxtbook.com/farran/dentaltown/2019May
https://www.nxtbook.com/farran/dentaltownuk/2019AprilMay
https://www.nxtbook.com/farran/dentaltown/2019April
https://www.nxtbook.com/farran/dentaltown/2019March
https://www.nxtbook.com/farran/dentaltown/2019February
https://www.nxtbook.com/farran/dentaltownuk/2019FebruaryMarch
https://www.nxtbook.com/farran/dentaltown/2019January
https://www.nxtbook.com/farran/dentaltownuk/2018Winter
https://www.nxtbook.com/farran/dentaltown/2018December
https://www.nxtbook.com/farran/dentaltown/2018November
https://www.nxtbook.com/farran/dentaltownuk/2018November
https://www.nxtbook.com/farran/dentaltown/2018October
https://www.nxtbook.com/farran/dentaltownuk/2018October
https://www.nxtbook.com/farran/dentaltown/2018NewGrad
https://www.nxtbook.com/farran/dentaltown/2018September
https://www.nxtbook.com/farran/dentaltownuk/2018September
https://www.nxtbook.com/farran/dentaltown/2018August
https://www.nxtbook.com/farran/dentaltownuk/2018July
https://www.nxtbook.com/farran/dentaltown/2018July
https://www.nxtbook.com/farran/dentaltownuk/2018June
https://www.nxtbook.com/farran/dentaltown/2018June
https://www.nxtbook.com/farran/dentaltownuk/2018May
https://www.nxtbook.com/farran/dentaltown/2018May
https://www.nxtbook.com/farran/dentaltownuk/2018April
https://www.nxtbook.com/farran/dentaltown/2018April
https://www.nxtbook.com/farran/dentaltown/2018March
https://www.nxtbook.com/farran/dentaltownuk/2018March
https://www.nxtbook.com/farran/dentaltown/2018February
https://www.nxtbook.com/farran/dentaltownuk/2018February
https://www.nxtbook.com/farran/dentaltown/2018January
https://www.nxtbook.com/farran/dentaltown/2017December
https://www.nxtbook.com/farran/dentaltownuk/2017Winter
https://www.nxtbook.com/farran/dentaltown/2017November
https://www.nxtbook.com/farran/dentaltown/2017October
https://www.nxtbook.com/farran/dentaltownuk/2017october
https://www.nxtbook.com/farran/dentaltown/NewGrad2017
https://www.nxtbook.com/farran/dentaltown/2017September
https://www.nxtbook.com/farran/dentaltownuk/2017September
https://www.nxtbook.com/farran/dentaltownuk/2017August
https://www.nxtbook.com/farran/dentaltown/2017August
https://www.nxtbook.com/farran/dentaltown/2017July
https://www.nxtbook.com/farran/dentaltownuk/2017July
https://www.nxtbook.com/farran/dentaltown/2017June
https://www.nxtbook.com/farran/dentaltownuk/2017may
https://www.nxtbook.com/farran/dentaltown/2017May
https://www.nxtbook.com/farran/dentaltownuk/2017April
https://www.nxtbook.com/farran/dentaltown/2017April
https://www.nxtbook.com/farran/dentaltown/2017March
https://www.nxtbook.com/farran/dentaltownuk/dentaltownuk/2017march
https://www.nxtbook.com/farran/dentaltown/February2017
https://www.nxtbook.com/farran/dentaltown/2017January
https://www.nxtbook.com/farran/dentaltown/2016December
https://www.nxtbook.com/farran/dentaltown/2016November
https://www.nxtbook.com/farran/dentaltown/2016October
https://www.nxtbook.com/farran/dentaltown/2016nge
https://www.nxtbook.com/farran/dentaltown/2016september
https://www.nxtbook.com/farran/dentaltown/2016august
https://www.nxtbook.com/farran/dentaltown/2016july
https://www.nxtbook.com/farran/dentaltown/2016june
https://www.nxtbook.com/farran/dentaltown/2016may
https://www.nxtbook.com/farran/dentaltown/2016april
https://www.nxtbook.com/farran/dentaltown/2016march
https://www.nxtbook.com/farran/dentaltown/2016february
https://www.nxtbook.com/farran/dentaltown/2016january
https://www.nxtbook.com/farran/dentaltown/2015december
https://www.nxtbook.com/farran/dentaltown/2015november
https://www.nxtbook.com/farran/dentaltown/2015october
https://www.nxtbook.com/farran/dentaltown/2015nge
https://www.nxtbook.com/farran/dentaltown/2015september
https://www.nxtbook.com/farran/dentaltown/2015august
https://www.nxtbook.com/farran/dentaltown/2015july
https://www.nxtbook.com/farran/dentaltown/2015june
https://www.nxtbook.com/farran/dentaltown/2015may
https://www.nxtbook.com/farran/dentaltown/2015april
https://www.nxtbook.com/farran/dentaltown/2015march
https://www.nxtbook.com/farran/dentaltown/2015february
https://www.nxtbook.com/farran/dentaltown/2015january
https://www.nxtbook.com/farran/dentaltown/2014december
https://www.nxtbook.com/farran/dentaltown/2014decemberb
https://www.nxtbook.com/farran/dentaltown/2014november
https://www.nxtbook.com/farran/dentaltown/2014october
https://www.nxtbook.com/farran/dentaltown/2014newgrad
https://www.nxtbook.com/farran/dentaltown/2014september
https://www.nxtbook.com/farran/dentaltown/2014august
https://www.nxtbook.com/farran/dentaltown/2014july
https://www.nxtbook.com/farran/dentaltown/2014june
https://www.nxtbook.com/farran/dentaltown/2014may
https://www.nxtbook.com/farran/dentaltown/2014april
https://www.nxtbook.com/farran/dentaltown/2014march
https://www.nxtbook.com/farran/dentaltown/2014february
https://www.nxtbook.com/farran/dentaltown/2014january
https://www.nxtbook.com/farran/dentaltown/2013december
https://www.nxtbook.com/farran/dentaltown/2013november
https://www.nxtbook.com/farran/dentaltown/2013october
https://www.nxtbook.com/farran/dentaltown/2013newgrad
https://www.nxtbook.com/farran/dentaltown/2013september
https://www.nxtbook.com/farran/dentaltown/2013august
https://www.nxtbook.com/farran/dentaltown/2013july
https://www.nxtbook.com/farran/dentaltown/2013june
https://www.nxtbook.com/farran/dentaltown/2013may
https://www.nxtbook.com/farran/dentaltown/2013april
https://www.nxtbook.com/farran/dentaltown/2013march
https://www.nxtbook.com/farran/dentaltown/2013february
https://www.nxtbook.com/farran/dentaltown/2013january
https://www.nxtbook.com/farran/dentaltown/2012december
https://www.nxtbook.com/farran/dentaltown/2012November
https://www.nxtbookmedia.com