New classification of periodontitis
TLDRThe video script discusses the new classification of periodontitis, presented by the American Academy of Periodontology and the European Federation of Periodontology. The classification is based on five position papers addressing various aspects of periodontitis, including acute periodontitis, aggressive periodontitis, and its progression. The new framework, inspired by oncology staging, aims to individualize diagnosis and align with personalized medicine principles. It considers the multifactorial etiology, management complexity, and disease recurrence risks. A periodontitis case is defined by interdental clinical attachment loss of two millimeters or more in at least two teeth, excluding non-periodontal causes. The classification process involves four steps: initial evaluation, further examination, staging, and grading based on progression or direct assessment.
Takeaways
- 📚 The new classification of periodontitis is based on the work from the World Workshop for the Classification of Periodontal and Peri-implant Diseases, organized by the American Academy of Periodontology and the European Federation of Periodontology.
- 🏆 The presenter chaired a working group with Professor Panagiotis Papapanou from Columbia University, focusing on periodontitis.
- 📝 Five position papers were discussed, covering topics from acute periodontal diseases to the progression and epidemiology of periodontitis.
- 🔍 A systematic review evaluated the relationship between annual attachment and bone level loss and tooth loss, aiming to understand the progression of periodontitis.
- 📉 The concept of aggressive periodontitis was re-evaluated, with 20 years of scientific evidence considered in the classification.
- 🦠 Periodontitis is defined as a chronic, multifactorial inflammatory disease associated with bacterial dysbiosis, characterized by progressive destruction of tooth-supporting structures.
- 📐 The key elements in the new classification include severity, extent, complexity of management, and risk factors such as smoking and diabetes.
- 📈 A new framework for staging and grading of periodontitis was developed, inspired by systems used in oncology, aiming to align with personalized medicine principles.
- 🦷 A case of periodontitis is defined by interdental clinical attachment loss of 2mm or more in at least two teeth, excluding non-periodontal causes.
- 📋 The classification process involves four steps: initial evaluation, further examination of periodontal features, staging, and grading based on existing records or direct evaluation.
- 🌟 The new classification aims to individualize the diagnosis and case definition of periodontitis patients, taking into account the multifactorial etiology, complexity of management, and risk for disease recurrence and progression.
Q & A
What is the main topic of the presentation?
-The main topic of the presentation is the new classification of periodontitis, which is a chronic inflammatory disease associated with bacterial dysbiosis and characterized by progressive destruction of tooth-supporting structures.
Which organizations organized the workshop that led to the new classification?
-The workshop was organized by the American Academy of Periodontology and the European Federation of Periodontology.
What was the role of the speaker in the working group?
-The speaker had the honor to chair the working group that dealt with periodontitis.
How many position papers were discussed in the working group?
-The working group dealt with five position papers.
What was the focus of the first position paper?
-The first position paper focused on acute periodontal diseases, specifically periodontal abscesses, necrotizing periodontal diseases, and endo-periodontal lesions.
What does the new classification aim to incorporate?
-The new classification aims to incorporate severity, extent, complexity of management, and risk factors associated with the progression of periodontitis, such as smoking and diabetes.
What is the significance of the staging and grading framework in the new classification?
-The staging and grading framework is inspired by oncology and aims to individualize the diagnosis and case definition of a periodontitis patient, aligning with the principles of personalized medicine.
How is a periodontitis case defined in the new classification?
-A periodontitis case is defined by interdental clinical attachment loss of equal or more than two millimeters, which must be present in at least two or more teeth and cannot be ascribed to non-periodontal causes.
What are the four steps involved in characterizing a periodontitis case according to the new classification?
-The four steps are: 1) Evaluate a new patient and assess if they are suspected of being a periodontitis case, 2) Further examine the periodontal features of the patient to evaluate the suspicion of periodontitis, 3) Stage the patient in either stage 1, 2, 3, or 4 based on documentation, and 4) Grade the patient based on existing records or evaluate the grade directly if no previous records are available.
What is the importance of defining a periodontitis case in the new classification?
-Defining a periodontitis case is crucial for facilitating optimal care, improving prognosis, and taking into account the multifactorial etiology of the disease, the level of complexity of management, and the risk for disease recurrence and progression.
What is the role of risk factors in the new classification of periodontitis?
-Risk factors play a significant role as they are key elements in the classification, helping to evaluate the rate of progression and the likelihood of disease recurrence. Currently, smoking and diabetes are recognized, but future research may identify additional risk factors.
How does the new classification differentiate between aggressive and chronic periodontitis?
-The new classification evaluates the scientific evidence on aggressive periodontitis, which was defined in the previous classification, and distinguishes it from chronic periodontitis based on the rate of progression, severity, and other clinical features.
Outlines
🌟 Introduction to New Periodontitis Classification
The speaker introduces a new classification system for periodontal diseases, specifically periodontitis, which is derived from a joint workshop by the American Academy of Periodontology and the European Federation of Periodontology. The classification is based on five position papers written by experts in the field, covering topics such as acute periodontitis, aggressive periodontitis, and the relationship between attachment loss and tooth loss. The new classification aims to define periodontitis as a chronic, multifactorial inflammatory disease associated with bacterial dysbiosis, characterized by progressive destruction of tooth-supporting structures, including clinical attachment loss and radiographic bone loss.
📊 Key Elements and Framework of Periodontitis Classification
The classification of periodontitis is discussed in terms of its severity, extent, and complexity of management, which are key elements in the new system. The framework for classifying periodontitis involves staging and grading, inspired by oncology, to individualize diagnosis and align with personalized medicine. The classification considers the multifactorial etiology of the disease, the level of complexity in managing it, and the risk for disease recurrence and progression. A periodontitis case is defined by interdental clinical attachment loss of two millimeters or more, detectable in at least two teeth, and not attributable to non-periodontal causes. The process to characterize a periodontitis case involves four steps: initial evaluation, further examination of periodontal features, staging the patient, and grading the patient based on existing records or direct evaluation.
📝 Staging and Grading of Periodontitis Cases
The final paragraph discusses the two scenarios for grading a patient with periodontitis: when there are existing records to assess the progression of the disease, and when there are no previous records, requiring direct evaluation of the gradient. This step is crucial for determining the stage and grade of periodontitis for each patient, which aids in planning appropriate treatment and management strategies.
Mindmap
Keywords
💡Periodontal Disease
💡Periodontitis
💡Classification
💡Bacterial Dysbiosis
💡Clinical Attachment Loss
💡Staging and Grading
💡Risk Factors
💡Personalized Medicine
💡Acute Periodontitis
💡Aggressive Periodontitis
💡Epidemiological Cohorts
Highlights
New classification of periodontitis presented, derived from the World Workshop for the Classification of Periodontal and Peri-implant Diseases.
Workshop organized by the American Academy of Periodontology and the European Federation of Periodontology.
Five position papers written by world-renowned experts covered various aspects of periodontitis.
First paper focused on acute periodontitis, including periodontal abscesses and necrotizing periodontal diseases.
Second paper revealed the concept of aggressive periodontitis and evaluated scientific evidence on this condition over the past 20 years.
Third paper was a systematic review on the relationship between mean annual attachment loss, bone loss and tooth loss in periodontitis.
Fourth paper evaluated age distribution of periodontitis in large epidemiological cohorts in the US and Germany.
Fifth paper proposed the new classification framework for staging and grading of periodontitis, approved by consensus.
Periodontitis defined as a chronic, multifactorial inflammatory disease associated with bacterial dysbiosis.
Key elements in the new classification include severity, extent, complexity of management, and risk factors like smoking and diabetes.
Classification framework inspired by oncology, aims to individualize diagnosis and case definition.
Classification takes into account disease etiology, management complexity, and risk for recurrence/progression.
A periodontitis case is defined by interdental clinical attachment loss of 2mm or more in at least two teeth.
Four-step process outlined to characterize a periodontitis case: 1) Evaluate suspicion, 2) Examine periodontal features, 3) Stage patient, 4) Grade patient.
Classification aims to align with principles of personalized medicine for optimal care and improved prognosis.
Worldwide panel of 30 experts discussed scientific evidence to make formal proposition of new classification.
Primary features of periodontitis include loss of attachment and tissue support, periodontal pockets, and gingival inflammation.
Classification considers both clinical attachment loss and radiographic bone loss.
New framework will facilitate more accurate diagnosis, prognosis and treatment planning for periodontitis patients.
Transcripts
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