CLASSIFICATION OF

PERIODONTAL
DISEASES

AAP (American Academy of Periodontology)

International for Classification of Periodontal
Workshop Disease 1999 :
------------------------------------------------------------A. Classification of Periodontal Disease :
1. Gingival Diseases*
- Plaque-induced gingival diseases
- Non-plaque-induced gingival lesions
2. Chronic Periodontitis**
- Localized
- Generalized

3. Aggressive Periodontitis
- Localized
- Generalized

4. Periodontitis as manifes. of systemic

diseases
5. Necrotizing Periodontal Diseases
- Necrotizing ulcerative gingivitis (NUG)
- Necrotizing ulcerative Periodontitis (NUP)

6. Abscesses of the periodontium

- Gingival Abscess
- Periodontal absces
- Pericoronal abscess

7. Periodontitis assoc. with Endodontic Lesions

- Endodontic-periodontal lesion
- Periodontal-endodontic lesion
- Combined lesion

8. Developmental or Acquired Deformities and

Conditions
- Localized tooth-related factors that predispose to plaqueinduced gingival or periodontitis
- Mucogingival deformities and conditions around teeth
- Mucogingival deformities and conditions on edentulous
ridge
- Occlusal trauma

* Penyakit yg tjd hanya pd ggv tanpa ada kehilangan

perlekatan Or tjd pd ggv dgn kehilangan perlekatan
yg stabil dan tdk berkembang.
** Dpt diklasifikasikan menurut :
1. Luas daerah :
- Localized (< 30% terlibat)
- Generalized (> 30% terlibat)
2. Keparahan CAL (clinical attachment loss):
- Slight
= 1 or 2 mm CAL
- Moderate = 3 or 4 mm CAL
- Severe > 5 mm CAL

B. Gingival Diseases
Dental Plaque-Induced Gingival Diseases

I. Gingivitis associated with dental plaque only

A. Without local contributing factor
B. With local contributing factors

II. Gingival diseases modified by systemic factors

A. Associated with the endocrine system :
1. Puberty-associated gingivitis
2. Menstrual cycle-associated gingivitis
3. Pregnancy associated
a. Gingivitis
b. Pyogenic granuloma

4. Diabetes mellitus-associated gingivitis

B. Associated with blood dyscrasias

1. Leukemia-associated gingivitis
2. Other

III. Gingival diseases modified by medications

A. Drug-influences gingival diseases
1. Drug-influences gingival enlargement
2. Drug-influences gingivitis
a. Oral contraceptive-associated. G.
b. Other

IV. Gingival diseases modified by malnutrition

A. Ascorbic acid deficiency gingivitis
B. Other
______________________

Non-Plaque-Induced Gingival Lesions

I. Gingival diseases of spesific bacterial origin
A. Neisseria gonorrhoe
B. Treponema pallidum
C. Streptococcal species
D. Other
II. Gingival diseases of viral origin
A. Herpesvirus infections
1. Primary herpetic gingivostomatitic
2. Recurrent oral herpes
3. Vericella Zoster

B.Other

III. Gingival diseases of fungal origin

A. Candida-species infections:
- Generalized
- gingival candidosis
B. Linier gingival erythema
C. Histoplasmosis
D. Other

IV. Gingival lesions of genetic origin

A. Hereditery gingival fibromatosis
B. Other

V. Gingival manifestations of systemic condition

V. Gingival manifestations of systemic conditions

A. Mucocutaneous lesions
1. Lichen planus
2. Pemphigoid
3. Pemphigus vulgaris
4. erythema multiforme
5. Lupus erythematosus
6. Drug induced
7. Other

B. Allergic reactions
1. Dental restorative material: Mercury, nickel, acrylic, other

2. Reactions attributable to
a. Toothpaste or dentrifices
b. Mouthrinses or mouthwashes
c. Chewing gum additive
d. Food and additive

3. Other
VI. Traumatic lesions (Factitious, iatrogenic, or accidental)
A. Chemical injury
B. Physical injury
C. Thermal injury

VII. Foreign body reactions

VIII.Not otherwise specified

C. Periodontitis :
- keradangan jar. pendukung gigi
- bakteri periodontopatogen
- kerusakan period. ligamen & tlg alveolar
- terbentuk poket, resesi ggv atau keduanya
- kehilangan perlekatan klinis
Klasifikasi Periodontitis:
1. Chronic Periodontitis
2. Aggressive Periodontitis
3. Periodontitis as a Manifestation of Systemic
Diseases
________________________________________

1. Chronic Periodontitis
- umum pd usia dewasa > 35 th (anak-anak bs tjd)
- banyaknya kerusakan faktor lokal
- mikrobial variable
- Kalkulus subgingival sering ditemukan
- perkembangan penyakit slow moderat
kemungkinan bisa cepat
- predisposisi: - p. sistemik (DM, HIV),
- faktor lokal
- faktor lingkungan (merokok, stres)

2. Aggressive Periodontitis
- 10 30 th
- klinis: sehat t ada akumulasi yg besar
dr plak & kalkulus
- kerusakan tulang & loss attachment cepat
- Jml deposit mikrobial keparahan
- Genetik familial history
- Actinobacillus actinomycetemcomitans

a. Localized Aggressive Periodontitis :

- usia muda (pubertal)
- molar pertama or insisive dgn proksimal
loss attachment sedikitnya 2 gigi permanen (M1)
- respon antibodi serum kuat

b. Generalized Aggressive Periodontitis :

- < 30 th (atau lebih )
- sedikitnya pd 3 gigi permanen lain selain
dr molar pertama dan insisive
- respon antibodi serum lemah