Periodontal diagnosis and classification

In dentistry, numerous types of classification schemes have been developed to describe the teeth and gum tissue in a way that categorizes various defects. All of these classification schemes combine to provide the periodontal diagnosis of the aforementioned tissues in their various states of health and disease.

Alveolar ridge deficiency

In 1983, Seibert classified alveolar crestal defects:[1]

Class I: buccolingual loss of tissue with normal apicocoronal ridge height

Class II: apicocoronal loss of tissue with normal buccolingual ridge width

Class III: combination-type defects (loss of both height and width)

Furcation defect

Gingival recession

The magnitude of a receding gumline, commonly referred to as the measurement of gingival recession, is most often described using Miller's classification:[2]

Class I: Recession that does not extend to the mucogingival junction
Class II: Recession that extends to or beyond the mucogingival junction, but without loss of interproximal clinical attachment
Class III: Recession that extends to or beyond the mucogingival junction, with either loss of interproximal clinical attachment or tooth rotation
Class IV: Recession that extends to or beyond the mucogingival junction, with either interproximal clinical attachment or tooth rotation that is severe

A new classification has been proposed to classify gingival and palatal recessions. The new classification system gives a comprehensive depiction of recession defect that can be used to include cases that cannot be classified according to earlier classifications. A separate classification system for palatal recessions (PR) is also proposed. The new classification system is more detailed, informative and tries to overcome the limitations of Miller's classification system. A wide array of cases which cannot be classified by application of Miller's classification, can be classified by application of Kumar & Masamatti's Classification.[3]

Tooth mobility

As a general rule, mobility is graded clinically by applying firm pressure with either two metal instruments or one metal instrument and a gloved finger.[4]

Normal mobility
Grade I: Slightly more than normal (<0.2mm horizontal movement)
Grade II: Moderately more than normal (1-2mm horizontal movement)
Grade III: Severe mobility (>2mm horizontal or any vertical movement)

References

  1. ↑ Seibert JS. Reconstruction of deformed partially edentulous ridges using full thickness onlay grafts: Part I - technique and wound healing. Compend Contin Educ Dent 1983;4:437-453
  2. ↑ Miller PD Jr. A classification of marginal tissue recession. Int J Perio Rest Dent 1985;5(2):9-13.
  3. ↑ Kumar A, Masamatti SS. A new classification system for gingival and palatal recession. J Indian Soc Periodontol 2013;17:175-81.
  4. ↑ Carranza, FA: Clinical Diagnosis. In Newman, MG; Takei, HH; Carrana FA, editors: Carranza's Clinical Periodontology, 9th Edition. Philadelphia: W.B. Saunders Company, 2002. page 439.
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