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We examine the new periodontitis classification system and talk to the experts who are using it By Margaret Galvin
T
o fully understand the new Periodontitis Classification System it is worth taking a moment to appreciate it’s history and why an update was needed. The 1999 classification system of periodontitis was based on research that emphasised the individual features of periodontitis, and therefore the differences in phenotype. The research impacted the 1999 classification system, and thus four different periodontitis phenotypes were recognised: 1. Necrotising periodontitis 2. Chronic periodontitis 3. Aggressive periodontitis 4. Periodontitis as a manifestation of systemic diseases As more research in the field has been
carried out it has been found that the original classification system has a few issues that include: • No clear communication regarding the differences between chronic and aggressive periodontitis • Difficulty applying the criteria of aggressive periodontitis in everyday clinical practice • A substantial overlap between the diagnostic categories • A lack of validity of the criteria for aggressive periodontitis being confirmed by well-designed studies • A classification system based purely on the severity of the disease failing to capture the complexity of the case The 2017 World Workshop was held to develop a new classification scheme for
periodontal and peri-implant disease and conditions so that clinicians can properly diagnose and treat patients. The new system allows scientists and researchers to investigate aetiology, pathogenesis, natural history, and treatment. In accordance with current knowledge, the new classification system recognises three forms of periodontitis: 1. Necrotising periodontitis 2. Periodontitis manifested by systemic diseases 3. Periodontitis (formerly ‘chronic’ and ‘aggressive’, now combined) The World Workshop also agreed on a classification system based on a ‘staging’ and ‘grading’ framework that is able to be adapted as new evidence emerges.
