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1、牙周病的分类第1页，共22页，编辑于2022年，星期日1.-why 世界临床牙周病学专题讨论会（1989年）1999年AAP新分类第2页，共22页，编辑于2022年，星期日Why?legal ramifications affects treatment plan and prognosis for communication with patients 第3页，共22页，编辑于2022年，星期日History:Last classification system was devised at the 1989 World Workshop in Clinical Periodontology
2、 Improved understanding of etiology of periodontal diseases Inclusion of gingival diseases第4页，共22页，编辑于2022年，星期日The Periodontium:supporting apparatus of the tooth and its associated components alveolar bone periodontal ligament cementum gingival attachment 第5页，共22页，编辑于2022年，星期日Gingival Diseases:-Can
3、occur on a periodontium with no attachment loss,or on a periodontium with attachment loss that is not progressing-Dental plaque induced-Non-plaque induced第6页，共22页，编辑于2022年，星期日Gingivitis:general information-DEFN:inflammation of the givgiva-ubiquitous-occlusion analysis-major cause:accumulation of pla
4、que-other causes-tx:removal of the cause-doesnt inevitably lead to periodontitis第7页，共22页，编辑于2022年，星期日Gingivitis:pathology-4 stages:initial,early,established,advanced lesion -Summary:PMNs,exudate,collagen breakdown,plasma cells,proliferation of epithelium-Major cause:accumulation of plaque第8页，共22页，编辑
5、于2022年，星期日Dental plaque-induced gingival diseasesI.Gingivitis associated with dental plaque only a.without other local contributing factors b.with local contributing factors 第9页，共22页，编辑于2022年，星期日Dental plaque-induced gingival diseasesII.Gingival diseases modified by systemic factors a.associated wit
6、h the endocrine system 1.puberty-associated gingivtis 2.menstrual cycle-associated gingivitis 3.Pregnancy-associated 4.diabetes mellitus-associated gingivitis第10页，共22页，编辑于2022年，星期日Periodontitis-Definition:Inflammation involving the gingival unit(gingiva and alveolar mucosa)and extending to the perio
7、dontal ligament,alveolar bone,and cementum.Periodontitis involves the loss of clinical attachment and radiographic evidence of bone loss.第11页，共22页，编辑于2022年，星期日Periodontitis-evidence of loss of periodontal attachment previously classified by age now classified by“nature”of diseases:progression,clinic
8、al presentation,associated systemic diseases 第12页，共22页，编辑于2022年，星期日Periodontitis:classification overview-chronic periodontitis-aggressive periodontitis-periodontitis as a manifestation of systemic diseasea-necrotizing periodontal diseases-abscesses of the periodontium-periodontitis associated with e
9、ndodontic lesions-developmental or acquired deformaties and conditions第13页，共22页，编辑于2022年，星期日Chronic Periodontitis-formerly“adult”periodontitis-can be:localized or generalized-usually slowly progressive disease-may have short periods of rapid progression第14页，共22页，编辑于2022年，星期日Aggressive Periodontitis-
10、formerly“early onset”periodontitis-can be:localized or generalized-highly destructive forms of periodontitis-not age dependment-diagnosis of“chronic”or“aggressive”depends on many criteria第15页，共22页，编辑于2022年，星期日Periodontitis as a Manifestation of Systemic Diseases1.Associated with haematological disor
11、ders2.Associated with genetic disorders3.Not otherwise specified第16页，共22页，编辑于2022年，星期日Necrotizing Periodontal Diseases1.Necrotizing ulcerative gingivitis(NUG)2.Necrotizing ulcerative periodontitis(NUP)第17页，共22页，编辑于2022年，星期日Abscesses of the Periodontium1.Gingival abscess2.Periodontal abscess3.Pericor
12、onal abscess第18页，共22页，编辑于2022年，星期日Periodontitis associated with Endodontic lesions-combined periodontic-endodontic lesions第19页，共22页，编辑于2022年，星期日Developmental or Acquired Deformaties and ConditionsA.Localized tooth-related factors 1.Tooth anatomic factors 2.Dental restorations/appliances 3.Root fract
13、ures 4.Cervical root resorption and cemental tears第20页，共22页，编辑于2022年，星期日Developmental or Acquired Deformaties and ConditionsB.Mucogingival deformaties,conditions 1.Gingival/soft tissue recession 2.Lack of keratinized gingiva 3.Decreased vestibular depth 4.Frenum/muscle position 5.Gingival excess 6.Abnormal colour第21页，共22页，编辑于2022年，星期日Developmental or Acquired Deformaties and ConditionsC.Mucogingival deformaties and conditions on edentulous ridgesD.Occlusal trauma第22页，共22页，编辑于2022年，星期日