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1、牙周病的分类第1页，本讲稿共22页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，本讲稿共22页Why?legal ramifications affects treatment plan and prognosis for communication with patients 第3页，本讲稿共22页History:Last classification system was devised at the 1989 World Workshop in Clinical Periodontology Improved understanding of eti
2、ology of periodontal diseases Inclusion of gingival diseases第4页，本讲稿共22页The Periodontium:supporting apparatus of the tooth and its associated components alveolar bone periodontal ligament cementum gingival attachment 第5页，本讲稿共22页Gingival Diseases:-Can occur on a periodontium with no attachment loss,or
3、 on a periodontium with attachment loss that is not progressing-Dental plaque induced-Non-plaque induced第6页，本讲稿共22页Gingivitis:general information-DEFN:inflammation of the givgiva-ubiquitous-occlusion analysis-major cause:accumulation of plaque-other causes-tx:removal of the cause-doesnt inevitably l
4、ead to periodontitis第7页，本讲稿共22页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，本讲稿共22页Dental plaque-induced gingival diseasesI.Gingivitis associated with de
5、ntal plaque only a.without other local contributing factors b.with local contributing factors 第9页，本讲稿共22页Dental plaque-induced gingival diseasesII.Gingival diseases modified by systemic factors a.associated with the endocrine system 1.puberty-associated gingivtis 2.menstrual cycle-associated gingivi
6、tis 3.Pregnancy-associated 4.diabetes mellitus-associated gingivitis第10页，本讲稿共22页Periodontitis-Definition:Inflammation involving the gingival unit(gingiva and alveolar mucosa)and extending to the periodontal ligament,alveolar bone,and cementum.Periodontitis involves the loss of clinical attachment an
7、d radiographic evidence of bone loss.第11页，本讲稿共22页Periodontitis-evidence of loss of periodontal attachment previously classified by age now classified by“nature”of diseases:progression,clinical presentation,associated systemic diseases 第12页，本讲稿共22页Periodontitis:classification overview-chronic periodo
8、ntitis-aggressive periodontitis-periodontitis as a manifestation of systemic diseasea-necrotizing periodontal diseases-abscesses of the periodontium-periodontitis associated with endodontic lesions-developmental or acquired deformaties and conditions第13页，本讲稿共22页Chronic Periodontitis-formerly“adult”p
9、eriodontitis-can be:localized or generalized-usually slowly progressive disease-may have short periods of rapid progression第14页，本讲稿共22页Aggressive Periodontitis-formerly“early onset”periodontitis-can be:localized or generalized-highly destructive forms of periodontitis-not age dependment-diagnosis of
10、“chronic”or“aggressive”depends on many criteria第15页，本讲稿共22页Periodontitis as a Manifestation of Systemic Diseases1.Associated with haematological disorders2.Associated with genetic disorders3.Not otherwise specified第16页，本讲稿共22页Necrotizing Periodontal Diseases1.Necrotizing ulcerative gingivitis(NUG)2.
11、Necrotizing ulcerative periodontitis(NUP)第17页，本讲稿共22页Abscesses of the Periodontium1.Gingival abscess2.Periodontal abscess3.Pericoronal abscess第18页，本讲稿共22页Periodontitis associated with Endodontic lesions-combined periodontic-endodontic lesions第19页，本讲稿共22页Developmental or Acquired Deformaties and Cond
12、itionsA.Localized tooth-related factors 1.Tooth anatomic factors 2.Dental restorations/appliances 3.Root fractures 4.Cervical root resorption and cemental tears第20页，本讲稿共22页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，本讲稿共22页Developmental or Acquired Deformaties and ConditionsC.Mucogingival deformaties and conditions on edentulous ridgesD.Occlusal trauma第22页，本讲稿共22页