periodontology

Dr. Rawand Samy Mohamed Abu Nahla

.Oral Medicine, periodontology&oral Radiology Department
.Dr. Haydar.A.Shafy Faculty Of Dentistry
.El Azhar University

Lecture 5
classification of periodontal diseases

Periodontal Disease Classification System

I. Gingival Diseases

A. Dental plaque-induced gingival diseases

(Can occur on a periodontium with no attachment loss or on a
periodontium with attachment loss that is not progressing)
Gingivitis associated with dental plaque only . 1
a. without other local contributing factors
b. with local contributing factors

Gingival diseases modified by systemic factors. 2

a. associated with the endocrine system

puberty-associated gingivitis( 1
menstrual cycle-associated gingivitis( 2
pregnancy-associated( 3
a( gingivitis
b( pyogenic granuloma

diabetes mellitus-associated gingivitis( 4

b. associated with blood dyscrasias
leukemia-associated gingivitis( 1
other( 2

Gingival diseases modified by medications . 3

a. drug-influenced gingival diseases
drug-influenced gingival enlargements( 1
drug-influenced gingivitis( 2
a( oral contraceptive-associated gingivitis
b( other

Gingival diseases modified by malnutrition . 4

a. ascorbic acid-deficiency gingivitis
b. other
B. Non-plaque-induced gingival lesions
Gingival diseases of specific bacterial origin . 1
a. Neisseria gonorrhea-associated lesions
b. Treponema pallidum-associated lesions
c. streptococcal species-associated lesions
d. other

Gingival diseases of viral origin. 2

a. Herpes virus infections
primary herpetic gingivostomatitis( 1
recurrent oral herpes( 2
varicella-zoster infections( 3
b. other

Gingival diseases of fungal origin. 3

a. Candida-species infections
generalized gingival candidosis( 1
b. linear gingival erythema
c. histoplasmosis
d. other

Gingival lesions of genetic origin. 4

a. hereditary gingival fibromatosis
b. other

Gingival manifestations of systemic conditions. 5

a. mucocutaneous disorders
lichen planus( 1
pemphigoid( 2
pemphigus vulgaris( 3
erythema multiforme( 4
lupus erythematosus( 5
drug-induced( 6
other( 7

dental restorative materials( 1

a( mercury
b( nickel
c( acrylic
d( other
reactions attributable to( 2
a( toothpastes/dentifrices
b( mouthrinses/mouthwashes
c( chewing gum additives
d( foods and additives

Traumatic lesions (factitious, iatrogenic, accidental(. 6

a. chemical injury
b. physical injury
c. thermal injury
Foreign body reactions. 7
Not otherwise specified (NOS(. 8

II. Chronic Periodontitis (slight: 1-2 mm CAL; moderate: 3-4 mm CAL;

severe: > 5 mm CAL)
A. Localized (< 30% of sites are involved)
Chronic localized slight periodontitis
Chronic localized moderate periodontitis
Chronic localized severe periodontitis
B. Generalized (> 30% of sites are involved)
Chronic generalized slight periodontitis
Chronic generalized moderate periodontitis
Chronic generalized severe periodontitis

III. Aggressive Periodontitis (slight: 1-2 mm CAL; moderate: 3-4 mm CAL; severe: >
5 mm CAL)
A. Localized (< 30% of sites are involved)
Aggressive localized slight periodontitis
Aggressive localized moderate periodontitis
Aggressive localized severe periodontitis
B. Generalized (> 30% of sites are involved)
Aggressive generalized slight periodontitis
Aggressive generalized moderate periodontitis
Aggressive generalized severe periodontitis

IV. Periodontitis as a Manifestation of Systemic Diseases

A. Associated with hematological disorders

Acquired neutropenia. 1
Leukemias. 2
Other. 3
B. Associated with genetic disorders
Familial and cyclic neutropenia. 1
Down syndrome 2
Leukocyte adhesion deficiency syndromes . 3
Papillon-Lefvre syndrome. 4
Chediak-Higashi syndrome. 5

Histiocytosis syndromes. 6
Glycogen storage disease. 7
Infantile genetic agranulocytosis. 8
Crohens syndrome. 9
Ehlers-Danlos syndrome (Types IV and VIII(. 10
Hypophosphatasia. 11
Other. 12
C. Not otherwise specified (NOS(

V. Necrotizing Periodontal Diseases

A. Necrotizing ulcerative gingivitis (NUG(
Localized necrotizing ulcerative gingivitis
Generalized necrotizing ulcerative gingivitis
B. Necrotizing ulcerative periodontitis (NUP(
Localized necrotizing ulcerative periodontitis
Generalized necrotizing ulcerative periodontitis

VI. Abscesses of the Periodontium

A. Gingival abscess
B. Periodontal abscess
C. Pericoronal abscess
VII. Periodontitis Associated With Endodontic
Lesions

A. Combined periodontic-endodontic lesions

VIII. Developmental or Acquired Deformities and

Conditions
A. Localized tooth-related factors that modify or predispose
to plaque-induced gingival diseases/periodontitis
Tooth anatomic factors. 1
Dental restorations/appliances. 2
Root fractures. 3
Cervical root resorption and cemental tears . 4

B. Mucogingival deformities and conditions around teeth

Gingival/soft tissue recession. 1

a. facial or lingual surfaces
b. interproximal (papillary(
Lack of keratinized gingiva. 2
Decreased vestibular depth. 3
Aberrant frenum/muscle position. 4
Gingival excess. 5
a. pseudopocket
b. inconsistent gingival margin
c. excessive gingival display
d. gingival enlargement
Abnormal color. 6

Thank you