ERIODONTAL DIAGNOSIS In the light of a recent opinion poll carried out on behalf of the Italian Society of Periodontology and Implantology (SIdP), the need to consolidate the inclusion of periodontal diagnosis, as a routine component, in the dental examination appears essential. The related diagnostic process is based on information obtained from medical and dental history, clinical, radiographic and laboratory tests. The purposes of this procedure are: to evaluate the presence of periodontal diseases, the related risk factors, and to quantify the severity and extent of the induced tissue damage. In periodontology the diagnostic process is indicated by the term “periodontal evaluation” and consists of three parts: clinical examination, radiographic exams and laboratory diagnostic tests; in turn, the clinical examination involves the collection of the anam nesis and the physical examination with the compilation of a special periodontal charting. In particular, during the visit, three types of anamnesis are collected: physiological, medical and dental/periodontal ones; then the execution of the physical examination involves the completion of: intraoral inspection, periodontal probing, registration of periodontal indices, periodontal phenotype evaluation, dental mobility, teeth migrations and occlusal analysis. Specifically, periodontal probing is an essential clinical procedure in the diagnostic path of periodontal diseases allowing evaluation of tissue destruction and the differential diagnosis between gingivitis and periodontitis, by means of periodontal biometric parameters. Periodontal evaluation implies, after the physical examination, the execution of radiographic exams; the rx techniques commonly used are three: intraoral radiographs, orthopantomography and computed tomography. The elective method is intraoral radiography which, in patients with suspected periodontitis with pathological probing depths and loss of clinical attachment in multiple dental sites, results in the execution of a complete systematic intraoral radiographic examination. The laboratory tests complete the periodontal evaluation; they are divided into two broad categories, generic and specific: the former assess the patient’s systemic conditions on the basis of anamnestic histories, the second, optional, is divided into microbiological, genetic, immune and biochemical. CLASSIFICATION OF PERIODONTAL DISEASES In the joint American Academy of Periodontology and European Federation of Periodontology World Workshop in 2017, a new classification was introduced to update the pre-existing one from 1999, adapting it to the evolution of scientific evidence and overcoming some unresolved issues. The main innovations include: the introduction of peri-implant diseases, a clear definition of gingival health at a histological and clinical level, the distinction of gingivitis into only two cat egories based on the presence or absence of bacterial biofilm, the abolition of a distinction between chronic and aggressive periodontitis and the adoption of a multilevel framework of staging and grading of periodontitis, the replacement of the terms occlusal trauma and biological width with those of traumatic occlusal force and supracrestal attached tissue respectively, a new classification of gingival recessions. In this Module we analyze in detail the World Workshop proceedings regarding biofilm-inducted gingivitis and periodontitis, from the definition of health and related clinical cases, to the staging and grading model
Periodontal diagnosis and AAP-EFP 2017 CLASSIFICATION|Diagnosi parodontale e classificazione AAP-EFP 2017
Nastri L.
Writing – Original Draft Preparation
;
2022
Abstract
ERIODONTAL DIAGNOSIS In the light of a recent opinion poll carried out on behalf of the Italian Society of Periodontology and Implantology (SIdP), the need to consolidate the inclusion of periodontal diagnosis, as a routine component, in the dental examination appears essential. The related diagnostic process is based on information obtained from medical and dental history, clinical, radiographic and laboratory tests. The purposes of this procedure are: to evaluate the presence of periodontal diseases, the related risk factors, and to quantify the severity and extent of the induced tissue damage. In periodontology the diagnostic process is indicated by the term “periodontal evaluation” and consists of three parts: clinical examination, radiographic exams and laboratory diagnostic tests; in turn, the clinical examination involves the collection of the anam nesis and the physical examination with the compilation of a special periodontal charting. In particular, during the visit, three types of anamnesis are collected: physiological, medical and dental/periodontal ones; then the execution of the physical examination involves the completion of: intraoral inspection, periodontal probing, registration of periodontal indices, periodontal phenotype evaluation, dental mobility, teeth migrations and occlusal analysis. Specifically, periodontal probing is an essential clinical procedure in the diagnostic path of periodontal diseases allowing evaluation of tissue destruction and the differential diagnosis between gingivitis and periodontitis, by means of periodontal biometric parameters. Periodontal evaluation implies, after the physical examination, the execution of radiographic exams; the rx techniques commonly used are three: intraoral radiographs, orthopantomography and computed tomography. The elective method is intraoral radiography which, in patients with suspected periodontitis with pathological probing depths and loss of clinical attachment in multiple dental sites, results in the execution of a complete systematic intraoral radiographic examination. The laboratory tests complete the periodontal evaluation; they are divided into two broad categories, generic and specific: the former assess the patient’s systemic conditions on the basis of anamnestic histories, the second, optional, is divided into microbiological, genetic, immune and biochemical. CLASSIFICATION OF PERIODONTAL DISEASES In the joint American Academy of Periodontology and European Federation of Periodontology World Workshop in 2017, a new classification was introduced to update the pre-existing one from 1999, adapting it to the evolution of scientific evidence and overcoming some unresolved issues. The main innovations include: the introduction of peri-implant diseases, a clear definition of gingival health at a histological and clinical level, the distinction of gingivitis into only two cat egories based on the presence or absence of bacterial biofilm, the abolition of a distinction between chronic and aggressive periodontitis and the adoption of a multilevel framework of staging and grading of periodontitis, the replacement of the terms occlusal trauma and biological width with those of traumatic occlusal force and supracrestal attached tissue respectively, a new classification of gingival recessions. In this Module we analyze in detail the World Workshop proceedings regarding biofilm-inducted gingivitis and periodontitis, from the definition of health and related clinical cases, to the staging and grading modelI documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
