New

classification
Staging is identified mainly by determining the
enter dental Cal add the site of greatest loss in the
case of cal is not available staging can be
determined by assessing the amount of radio
graphic bone loss
Stage 4 Stage 3 Stage 2

regarded as an advanced Periodontitis at this represents perio

stage of periodontitis stage has produced established the b
wher significant damage to .periodontitis
the gin
considerable damage to
the periodontal support attachment .pe
.has occurred apparatus

This usually causes In the absence of More than stage 1 It

significant tooth loss ,advanced treatment the e
of a
.tooth loss may occur

loss of The stage is At this stage of

characterized by the the disease
masticatory function. In
presence of deep process,
the absence of proper perio
periodontal management
control of the r
remains
periodontitis lesions that extend to per
the middle portion of relatively simple
and adequate
the root and whose infl
rehabilitation, the
dentition is at risk of being management is
 .lost complicated by the
:presence of

a. Deep intrabony
defects

b. Furcation
involvement

c. History of •
periodontal tooth loss

d. Presence of
localized ridge
defects

This stage is characterized possibility of tooth Pa

:by loss, masticatory
function is perio
a. Presence of deep
ear
periodontal lesions that preserved
extend to the apical
h
portion of the
susce
.root
dise
b. History of multiple ther
.tooth loss d

c. tooth hypermobility due

to secondary occlusal pati
.trauma opp

d. Posterior bite collapse in

and drifting, as a result of and m
the sequelae of tooth loss
that

effec

CAL >5mm CAI >5mm CAI 3-4mm C

RBL apical third of root RBL middle third of RBL coronal third RBL
root and beyond 15%-30% T
teeth 5>
teeth loss 4> No tooth loss
NO

stabilization/ restoration does not require many cases as co

of application of m
.masticatory function complex standard biofil
rehabilitation of an
treatment
.function pharm
principles
involving
d
professional
mechanical or

plaque removal as
well as patient
self care

more intensive

management for
specific cases may
be indicated

depending on the
.patient’s grading

more intensive
management for
specific cases may
be indicated
depending on the
.patient’s grading
 Grading is identified mainly by assessment of radio
graphic bone loss over a period of five years if not
available then grading can be done indirectly by
assessment of bone loss in relation to the patients
age this is done while you majoring radio graphic
bone loss and percentage of root length divided by
the age of the patient in the case of radiographs
not available then clinic attachment loss can be
used instead

Grade a Grade b Grade c

slow moderate Rapide

ssion
NO LOSS OVER 5 YEARS 2MM OVER 5 YEARS< 2MM OVER 5 YEARS>
CAI

0.25< 1 - 0.25 1>

TAGE
ONE
AGE
heavy biofuel deposits destruction destruction exceeds expectations g given
case with low levels of commensurate with by biofilm deposits specific clinical
type destruction biofilm deposits patterns suggestive of. Of rapid
progression and early onset disease

non-smoker less than 10 cigarettes more than 10 cigarettes per day

king per day

no diagnosis of diabetes HBA 1C less than 7% and HBA 1C more than 7% in patient with
betes patient with diabetes diabetes