KLASIFIKASI PENYAKIT PERIODONTAL

PERIODONTITIS KRONIS DESTRUKTIF

I.Periodontitis

  A. Periodontitis marginalis

     1. Slowly progressing periodontitis

     2. Rapidly progressing periodontitis

     3. Refractory 

  B. Juvenile periodontitis

     1. General

     2. Local

  C. Necrotizing ulcerative periodontitis

II. Trauma oklusi

III. Atrofi periodontal

  A. atrofi persenil

  B. atrofi disus

KLASIFIKASI BERDASARKAN WORKSHOP AMERICAN ACADEMY OF PERIODONTOLOGY (AAP) 1999

I. GINGIVAL DISEASES

  A.  Dental plaque-induce gingival disease

      I. Gingivitis associated with dental   plaque only

         a. without other local contributing   factors

         b. with local contributing factors

     2. Gingival disease modified by   sistemic factors

         a. associated with the endocrine   system

             1) puberty associated gingivitis

             2) menstrual cycle associated   gingivitis

             3) pregnancy associated

                 a) gingivitis

                 b) pyogenic-granuloma

            4) diabetes melitus associated   gingivitis

        b. associated with blood dyscrasias

           1) leukemia associated gingivitis’

           2) other

    3. Gingival diseases modified by medications

       a. drug-induced gingival disease

           1) drug induced gingival enlargement

           2) drug induced gingivitis

               a) oral contrasepsis associated   gingivitis

               b) other

    4. Gingival diseases modified by malnutrition

        a. ascorbic acid deficiency gingivitis

        b. other

B. Non-plaque induced gingival diseases

  1. Gingival diseases of spesific bacterial     origin

       a. Neisseria gonorrhea associated lesion

       b. Treponema pallidum associated lesion

       c. Streptococcal spesies associated lesion

       d. other

  2. Gingival diseases of viral origin

      a. herpes virus infections

         1) primary herpetic gingivostomatitis

         2) recurrent oral herpes

         3)varicella zoster infections

     b. other

  3. Gingival diseases of fungal origin

      a. candida spesies infection

         1) generalized gingival candidosis

      b. linear gingival erythema

      c. histoplasmosis

      d. other

  4. Gingival lesions of genetic origin

       a. hereditary gingival fibromatosis

       b. other

  5. Gingival manifestation of systemic condition

       a. mucocutaneous disorders

           1) lichen planus

           2) pemphigoid

           3) pemphigus vulgaris

           4) erythema multiforme

           5) lupus erythrmatosus

           6) drug-induced

           7) other

      b. allergic reactions

            1) dental restoratif  materials

                 a) mercury

                 b) nickel

                 c) acrylic

                d) other

           2) reactions attributable to

               a) tooth paste/ dentifrices

               b) mouthrinses/mouth washes

               c) chewing gum additives

               d) foods and additives

           3) other

   6. Traumatic lesions ( factitious, iatrogenic, accidental)

        a. chemical injury

        b. physical injury

        c. thermal injury

  7. Foreign body reactions

   8. Not otherwise specified

II. CHRONIC  PERIODONTITIS

  ** prevalent in adult but can occur in children

  ** amount of destruction consistent with local factor

  ** associated with a variable microbial pattern

  ** subgingival calculus frequently found

 ** slow to moderate rate of progresion with   possible periods of rapid progresion

 ** possibly modified by or associated with the   following systemic diseases : DM, HIV

  local factor predisposing periodontitis

  enviromental factor: smoking, emotional stress

  A. Localized----- < 30% sites involved

  B. Generalized---- > 30% of sites involved

      * Slight : 1 to 2 mm of clinical attachment loss

      *moderate: 3 to 4 mm

      *severe: > 5 mm

III. AGGRESSIVE PERIODONTITIS

     * Otherwise clinically healthy patien

 *Rapid attachment loss and bone destruction

 *Amount of microbial deposits inconsistent with diseases severity

 *Familial aggregation of diseases individuals

 A.Localized

  * circumpubertal onset diseases

  * localized first molar or  incisor diseases with proximal attachment loss on at least 2 permanent teeth, one of which is a first molar

  * robust serum antibody response to infecting agents

 B. Generalized

    * usually affecting person under 30 years of age (however may be older)

    * generalized proximal attachment loss affecting at least 3 teeth other than first molar and incisor

   * pronounced episodic nature of periodontal destruction

   * poor serum antibody response of infecting agents

IV . Periodontitis as Manifestationof Systemic diseases

    A.Associated with hematological disorders

         1. Acquired neutropenia

         2. Leukemias

         3. other

     B. Associated with genetic disorders

         1. familial and cyclic neutripenia

         2. down syndrome

         3. leukocyte adhesion deficiency      syndromes

         4. papilon lefevre syndrom

         5. chediak higashi syndrome

         6. histiocytosis syndrome

         7. glycogene storage diseases

         8. infantile genetic agranulocytosis

         9.cohen syndrom

         10. ehlers danlos syndrom

         11. hypophosphatasia

         12. other

    C. Not otherwise specified (NOS)

V. Necrotizing  Periodontal diseases

   A.Necrotizing Ulcerative Gingivitis

   B.Necrotizing Ulceratif Periodontitis

VI. Abcesses on Periodontium

     A.Gingival abces

     B.Periodontal abces

     C.Pericoronal abces

VII. Periodontitis associated with endodontic lesions

     A. Combined periodontic endodontic lesion

VIII. Developmental or Acquired    deformities and conditions

     A.Localized tooth related factor that modify or predispose to plaque induced gingival diseases/periodontitis

              1. tooth anatomic factor

              2. dental restoration/ appliances

              3. root fractures

              4. cervical root resorption and cemental tears

      B. Mucogingival deformities and condition around teeth

             1. Gingiva/soft tissue resesion

                  a. facial or lingual surface

                  b. interproximal/ pappllary

              2. lack of keratinized gingiva

              3. decreased vestibular depth

              4. Aberrant frenum/ muscle   position

              5. Gingival excess

                   a. pseudo pocket

                  b. inconsistent gingival margin

                  c. excessive gingival display

                 d. gingival enlargement

             6. Abnormal color

     C. Mucogingival deformities and condition on edentulous ridge

           1. vertical/horizontal ridge   deficiency

           2. lack of gingiva/ keratinized tissue

           3. gingival/soft tissue enlargement

           4. Aberrant frenum/muscle position

           5.  Decreased vestibular depth

           6. abnormal color

     D. Occlusal trauma

           1. primay

           2. secondary