Dental Tribune Europe

New classification of periodontal and peri-implant diseases and conditions

AMSTERDAM, Netherlands: A new global classification system for periodontal health, diseases and conditions, as well as peri-implant diseases and conditions, was announced today at EuroPerio9. The outcome of a joint workshop held by the EFP and the American Academy of Periodontology (AAP) in Chicago in the US in 2017, the updated system comes almost two decades after the last comprehensive classification of these conditions and builds upon the significant amount of new evidence and knowledge that has been gained in that time.

Chaired by Prof. Maurizio Tonetti and Dr Kenneth Kornman in front of a packed house, “News from the world workshop on classification: Critical factors in periodontology” provided attendees with an in-depth look at the findings from this workshop and their clinical implications. The workshop included over 100 experts from Europe, America, Australia and Asia who reviewed existing literature to create a global consensus that enables care to be standardised for patients around the world. Praising the experts’ workflow as a “robust, inclusive and open process”, Tonetti emphasised that the findings, through their unbiased nature, were intended to be as credible as possible and hopefully “project a vision that will shape the future of periodontal treatment”.

Kornman highlighted how the new classification system could help to shape the direction of periodontal education and university curricula, as it recognises and debunks some common misconceptions about how periodontitis develops. “We now know that the severity of periodontitis is not just a simple function of how much plaque is on your teeth and how long it has been there, and that not everyone is equally susceptible to this disease,” Kornman said.

The comprehensive classification is based upon contemporary evidence and includes a staging and grading system for periodontitis, indicating severity and extent of disease, accounting for lifetime disease experience and taking into account the patient’s overall health status. Clinical health is defined for the first time in the classification, and periodontitis is described in four stages, ranging from least severe to most severe. The risk and rate of disease progression has been categorised into three grades, from lowest risk of progression to the highest. This grading takes into account risk factors like smoking and the presence of concomitant diseases such as diabetes.

The complete review and consensus reports have been published simultaneously in the EFP’s Journal of Clinical Periodontology and the AAP’s Journal of Periodontology.

“The AAP and EFP are proud of this global, collaborative accomplishment,” said Dr Steven R. Daniel, President of the AAP. “The result of this landmark workshop is a redesigned disease classification that guides comprehensive treatment planning and allows for a personalised approach to patient care. These proceedings will make an indelible impact on the scientific advancement of periodontal care and practice.”

“This was a huge undertaking, but one of vital importance, ensuring that an international language for clinical care, research and education is established, and updating the 1999 classification system to account for rapid advances in scientific knowledge over the last 20 years,” said Prof. Iain Chapple, EFP Secretary General and co-chair of Group 1 of the workshop.

“The new classification should provide a globally consistent approach to diagnosis and management and ultimately improve outcomes for our patients,” said Chapple.

“The next steps include careful education of the oral health care team to ensure its simplicity is recognised, as at first glance, the classification may appear complex, but it is actually quite pragmatic, and to make sure we train effectively in its implementation.”

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