Periodontal health and gingival diseases and conditions on an intact and a reduced periodontium

Consensus report of workgroup 1 of the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions

Iain L.C. Chapple, Brian L Mealey, Thomas E. Van Dyke, P. Mark Bartold, Henrik Dommisch, Peter Eickholz, Maria L. Geisinger, Robert J. Genco, Michael Glogauer, Moshe Goldstein, Terrence J. Griffin, Palle Holmstrup, Georgia K. Johnson, Yvonne Kapila, Niklaus P. Lang, Joerg Meyle, Shinya Murakami, Jacqueline Plemons, Giuseppe A. Romito, Lior Shapira & 7 others Dimitris N. Tatakis, Wim Teughels, Leonardo Trombelli, Clemens Walter, Gernot Wimmer, Pinelopi Xenoudi, Hiromasa Yoshie

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

Periodontal health is defined by absence of clinically detectable inflammation. There is a biological level of immune surveillance that is consistent with clinical gingival health and homeostasis. Clinical gingival health may be found in a periodontium that is intact, i.e. without clinical attachment loss or bone loss, and on a reduced periodontium in either a non-periodontitis patient (e.g. in patients with some form of gingival recession or following crown lengthening surgery) or in a patient with a history of periodontitis who is currently periodontally stable. Clinical gingival health can be restored following treatment of gingivitis and periodontitis. However, the treated and stable periodontitis patient with current gingival health remains at increased risk of recurrent periodontitis, and accordingly, must be closely monitored. Two broad categories of gingival diseases include non-dental plaque biofilm–induced gingival diseases and dental plaque-induced gingivitis. Non-dental plaque biofilm-induced gingival diseases include a variety of conditions that are not caused by plaque and usually do not resolve following plaque removal. Such lesions may be manifestations of a systemic condition or may be localized to the oral cavity. Dental plaque-induced gingivitis has a variety of clinical signs and symptoms, and both local predisposing factors and systemic modifying factors can affect its extent, severity, and progression. Dental plaque-induced gingivitis may arise on an intact periodontium or on a reduced periodontium in either a non-periodontitis patient or in a currently stable “periodontitis patient” i.e. successfully treated, in whom clinical inflammation has been eliminated (or substantially reduced). A periodontitis patient with gingival inflammation remains a periodontitis patient (Figure 1), and comprehensive risk assessment and management are imperative to ensure early prevention and/or treatment of recurrent/progressive periodontitis. Precision dental medicine defines a patient-centered approach to care, and therefore, creates differences in the way in which a “case” of gingival health or gingivitis is defined for clinical practice as opposed to epidemiologically in population prevalence surveys. Thus, case definitions of gingival health and gingivitis are presented for both purposes. While gingival health and gingivitis have many clinical features, case definitions are primarily predicated on presence or absence of bleeding on probing. Here we classify gingival health and gingival diseases/conditions, along with a summary table of diagnostic features for defining health and gingivitis in various clinical situations.

Original languageEnglish (US)
Pages (from-to)S68-S77
JournalJournal of Clinical Periodontology
Volume45
DOIs
StatePublished - Jun 1 2018

Fingerprint

Gingival Diseases
Periodontium
Periodontal Diseases
Gingivitis
Periodontitis
Education
Health
Dental Plaque
Inflammation
Crown Lengthening
Gingival Recession
Precision Medicine
Risk Management
Biofilms
Causality
Signs and Symptoms
Mouth
Tooth
Homeostasis

Keywords

  • allergic reaction
  • amalgam tattoo
  • aspergillosis
  • biofilm
  • blastomycosis
  • calcifying fibroblastic granuloma
  • candidosis
  • chemical trauma
  • clinical health
  • coccidioidomycosis
  • condylomata acuminatum
  • contact allergy
  • coxsackie virus
  • Crohn's disease
  • dental plaque-induced gingivitis
  • disease control
  • disease remission
  • disease stability
  • drug-induced gingival enlargement
  • drug-induced pigmentation
  • dysbiosis
  • erythema multiforme
  • erythroplakia
  • factitious injury
  • fibrous epulis
  • focal epithelial hyperplasia
  • frictional keratosis
  • geotricosis
  • gingival pigmentation
  • hand foot and mouth
  • hereditary gingival fibromatosis
  • herpangina
  • herpes simplex
  • histoplasmosis
  • Hodgkin lymphoma
  • hyperglycemia
  • hyposalivation
  • intact periodontium
  • leukemia
  • leukoplakia
  • lichen planus
  • local risk factors
  • lupus erythematosus
  • melanoplakia
  • Melkersson-Rosenthal
  • menstrual cycle
  • modifying factors
  • molluscum contagiosum
  • mucormycosis
  • Mycobacterium tuberculosis
  • necrotizing periodontal diseases
  • Neisseria gonorrhoeae
  • non-Hodgkin lymphoma
  • non–dental plaque-induced gingival conditions
  • oral contraceptive
  • orofacial granulomatosis
  • paracoccidioidomycosis
  • pemphigoid
  • pemphigus vulgaris
  • periodontal disease
  • peripheral giant cell granuloma
  • plasma cell gingivitis
  • predisposing factors
  • pregnancy
  • puberty
  • pyogenic granuloma
  • reduced periodontium
  • resolution of inflammation
  • restoration margins
  • sarcoidosis
  • scurvy
  • smoker's melanosis
  • smoking
  • squamous cell carcinoma
  • squamous cell papilloma
  • stable periodontitis
  • streptoccocal gingivitis
  • symbiosis
  • systemic risk factors
  • thermal trauma
  • toothbrush trauma
  • Treponema pallidum
  • varicella zoster
  • vascular epulis
  • verruca vulgaris

ASJC Scopus subject areas

  • Periodontics

Cite this

Periodontal health and gingival diseases and conditions on an intact and a reduced periodontium : Consensus report of workgroup 1 of the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions. / Chapple, Iain L.C.; Mealey, Brian L; Van Dyke, Thomas E.; Bartold, P. Mark; Dommisch, Henrik; Eickholz, Peter; Geisinger, Maria L.; Genco, Robert J.; Glogauer, Michael; Goldstein, Moshe; Griffin, Terrence J.; Holmstrup, Palle; Johnson, Georgia K.; Kapila, Yvonne; Lang, Niklaus P.; Meyle, Joerg; Murakami, Shinya; Plemons, Jacqueline; Romito, Giuseppe A.; Shapira, Lior; Tatakis, Dimitris N.; Teughels, Wim; Trombelli, Leonardo; Walter, Clemens; Wimmer, Gernot; Xenoudi, Pinelopi; Yoshie, Hiromasa.

In: Journal of Clinical Periodontology, Vol. 45, 01.06.2018, p. S68-S77.

Research output: Contribution to journalArticle

Chapple, ILC, Mealey, BL, Van Dyke, TE, Bartold, PM, Dommisch, H, Eickholz, P, Geisinger, ML, Genco, RJ, Glogauer, M, Goldstein, M, Griffin, TJ, Holmstrup, P, Johnson, GK, Kapila, Y, Lang, NP, Meyle, J, Murakami, S, Plemons, J, Romito, GA, Shapira, L, Tatakis, DN, Teughels, W, Trombelli, L, Walter, C, Wimmer, G, Xenoudi, P & Yoshie, H 2018, 'Periodontal health and gingival diseases and conditions on an intact and a reduced periodontium: Consensus report of workgroup 1 of the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions', Journal of Clinical Periodontology, vol. 45, pp. S68-S77. https://doi.org/10.1111/jcpe.12940
Chapple, Iain L.C. ; Mealey, Brian L ; Van Dyke, Thomas E. ; Bartold, P. Mark ; Dommisch, Henrik ; Eickholz, Peter ; Geisinger, Maria L. ; Genco, Robert J. ; Glogauer, Michael ; Goldstein, Moshe ; Griffin, Terrence J. ; Holmstrup, Palle ; Johnson, Georgia K. ; Kapila, Yvonne ; Lang, Niklaus P. ; Meyle, Joerg ; Murakami, Shinya ; Plemons, Jacqueline ; Romito, Giuseppe A. ; Shapira, Lior ; Tatakis, Dimitris N. ; Teughels, Wim ; Trombelli, Leonardo ; Walter, Clemens ; Wimmer, Gernot ; Xenoudi, Pinelopi ; Yoshie, Hiromasa. / Periodontal health and gingival diseases and conditions on an intact and a reduced periodontium : Consensus report of workgroup 1 of the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions. In: Journal of Clinical Periodontology. 2018 ; Vol. 45. pp. S68-S77.
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abstract = "Periodontal health is defined by absence of clinically detectable inflammation. There is a biological level of immune surveillance that is consistent with clinical gingival health and homeostasis. Clinical gingival health may be found in a periodontium that is intact, i.e. without clinical attachment loss or bone loss, and on a reduced periodontium in either a non-periodontitis patient (e.g. in patients with some form of gingival recession or following crown lengthening surgery) or in a patient with a history of periodontitis who is currently periodontally stable. Clinical gingival health can be restored following treatment of gingivitis and periodontitis. However, the treated and stable periodontitis patient with current gingival health remains at increased risk of recurrent periodontitis, and accordingly, must be closely monitored. Two broad categories of gingival diseases include non-dental plaque biofilm–induced gingival diseases and dental plaque-induced gingivitis. Non-dental plaque biofilm-induced gingival diseases include a variety of conditions that are not caused by plaque and usually do not resolve following plaque removal. Such lesions may be manifestations of a systemic condition or may be localized to the oral cavity. Dental plaque-induced gingivitis has a variety of clinical signs and symptoms, and both local predisposing factors and systemic modifying factors can affect its extent, severity, and progression. Dental plaque-induced gingivitis may arise on an intact periodontium or on a reduced periodontium in either a non-periodontitis patient or in a currently stable “periodontitis patient” i.e. successfully treated, in whom clinical inflammation has been eliminated (or substantially reduced). A periodontitis patient with gingival inflammation remains a periodontitis patient (Figure 1), and comprehensive risk assessment and management are imperative to ensure early prevention and/or treatment of recurrent/progressive periodontitis. Precision dental medicine defines a patient-centered approach to care, and therefore, creates differences in the way in which a “case” of gingival health or gingivitis is defined for clinical practice as opposed to epidemiologically in population prevalence surveys. Thus, case definitions of gingival health and gingivitis are presented for both purposes. While gingival health and gingivitis have many clinical features, case definitions are primarily predicated on presence or absence of bleeding on probing. Here we classify gingival health and gingival diseases/conditions, along with a summary table of diagnostic features for defining health and gingivitis in various clinical situations.",
keywords = "allergic reaction, amalgam tattoo, aspergillosis, biofilm, blastomycosis, calcifying fibroblastic granuloma, candidosis, chemical trauma, clinical health, coccidioidomycosis, condylomata acuminatum, contact allergy, coxsackie virus, Crohn's disease, dental plaque-induced gingivitis, disease control, disease remission, disease stability, drug-induced gingival enlargement, drug-induced pigmentation, dysbiosis, erythema multiforme, erythroplakia, factitious injury, fibrous epulis, focal epithelial hyperplasia, frictional keratosis, geotricosis, gingival pigmentation, hand foot and mouth, hereditary gingival fibromatosis, herpangina, herpes simplex, histoplasmosis, Hodgkin lymphoma, hyperglycemia, hyposalivation, intact periodontium, leukemia, leukoplakia, lichen planus, local risk factors, lupus erythematosus, melanoplakia, Melkersson-Rosenthal, menstrual cycle, modifying factors, molluscum contagiosum, mucormycosis, Mycobacterium tuberculosis, necrotizing periodontal diseases, Neisseria gonorrhoeae, non-Hodgkin lymphoma, non–dental plaque-induced gingival conditions, oral contraceptive, orofacial granulomatosis, paracoccidioidomycosis, pemphigoid, pemphigus vulgaris, periodontal disease, peripheral giant cell granuloma, plasma cell gingivitis, predisposing factors, pregnancy, puberty, pyogenic granuloma, reduced periodontium, resolution of inflammation, restoration margins, sarcoidosis, scurvy, smoker's melanosis, smoking, squamous cell carcinoma, squamous cell papilloma, stable periodontitis, streptoccocal gingivitis, symbiosis, systemic risk factors, thermal trauma, toothbrush trauma, Treponema pallidum, varicella zoster, vascular epulis, verruca vulgaris",
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TY - JOUR

T1 - Periodontal health and gingival diseases and conditions on an intact and a reduced periodontium

T2 - Consensus report of workgroup 1 of the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions

AU - Chapple, Iain L.C.

AU - Mealey, Brian L

AU - Van Dyke, Thomas E.

AU - Bartold, P. Mark

AU - Dommisch, Henrik

AU - Eickholz, Peter

AU - Geisinger, Maria L.

AU - Genco, Robert J.

AU - Glogauer, Michael

AU - Goldstein, Moshe

AU - Griffin, Terrence J.

AU - Holmstrup, Palle

AU - Johnson, Georgia K.

AU - Kapila, Yvonne

AU - Lang, Niklaus P.

AU - Meyle, Joerg

AU - Murakami, Shinya

AU - Plemons, Jacqueline

AU - Romito, Giuseppe A.

AU - Shapira, Lior

AU - Tatakis, Dimitris N.

AU - Teughels, Wim

AU - Trombelli, Leonardo

AU - Walter, Clemens

AU - Wimmer, Gernot

AU - Xenoudi, Pinelopi

AU - Yoshie, Hiromasa

PY - 2018/6/1

Y1 - 2018/6/1

N2 - Periodontal health is defined by absence of clinically detectable inflammation. There is a biological level of immune surveillance that is consistent with clinical gingival health and homeostasis. Clinical gingival health may be found in a periodontium that is intact, i.e. without clinical attachment loss or bone loss, and on a reduced periodontium in either a non-periodontitis patient (e.g. in patients with some form of gingival recession or following crown lengthening surgery) or in a patient with a history of periodontitis who is currently periodontally stable. Clinical gingival health can be restored following treatment of gingivitis and periodontitis. However, the treated and stable periodontitis patient with current gingival health remains at increased risk of recurrent periodontitis, and accordingly, must be closely monitored. Two broad categories of gingival diseases include non-dental plaque biofilm–induced gingival diseases and dental plaque-induced gingivitis. Non-dental plaque biofilm-induced gingival diseases include a variety of conditions that are not caused by plaque and usually do not resolve following plaque removal. Such lesions may be manifestations of a systemic condition or may be localized to the oral cavity. Dental plaque-induced gingivitis has a variety of clinical signs and symptoms, and both local predisposing factors and systemic modifying factors can affect its extent, severity, and progression. Dental plaque-induced gingivitis may arise on an intact periodontium or on a reduced periodontium in either a non-periodontitis patient or in a currently stable “periodontitis patient” i.e. successfully treated, in whom clinical inflammation has been eliminated (or substantially reduced). A periodontitis patient with gingival inflammation remains a periodontitis patient (Figure 1), and comprehensive risk assessment and management are imperative to ensure early prevention and/or treatment of recurrent/progressive periodontitis. Precision dental medicine defines a patient-centered approach to care, and therefore, creates differences in the way in which a “case” of gingival health or gingivitis is defined for clinical practice as opposed to epidemiologically in population prevalence surveys. Thus, case definitions of gingival health and gingivitis are presented for both purposes. While gingival health and gingivitis have many clinical features, case definitions are primarily predicated on presence or absence of bleeding on probing. Here we classify gingival health and gingival diseases/conditions, along with a summary table of diagnostic features for defining health and gingivitis in various clinical situations.

AB - Periodontal health is defined by absence of clinically detectable inflammation. There is a biological level of immune surveillance that is consistent with clinical gingival health and homeostasis. Clinical gingival health may be found in a periodontium that is intact, i.e. without clinical attachment loss or bone loss, and on a reduced periodontium in either a non-periodontitis patient (e.g. in patients with some form of gingival recession or following crown lengthening surgery) or in a patient with a history of periodontitis who is currently periodontally stable. Clinical gingival health can be restored following treatment of gingivitis and periodontitis. However, the treated and stable periodontitis patient with current gingival health remains at increased risk of recurrent periodontitis, and accordingly, must be closely monitored. Two broad categories of gingival diseases include non-dental plaque biofilm–induced gingival diseases and dental plaque-induced gingivitis. Non-dental plaque biofilm-induced gingival diseases include a variety of conditions that are not caused by plaque and usually do not resolve following plaque removal. Such lesions may be manifestations of a systemic condition or may be localized to the oral cavity. Dental plaque-induced gingivitis has a variety of clinical signs and symptoms, and both local predisposing factors and systemic modifying factors can affect its extent, severity, and progression. Dental plaque-induced gingivitis may arise on an intact periodontium or on a reduced periodontium in either a non-periodontitis patient or in a currently stable “periodontitis patient” i.e. successfully treated, in whom clinical inflammation has been eliminated (or substantially reduced). A periodontitis patient with gingival inflammation remains a periodontitis patient (Figure 1), and comprehensive risk assessment and management are imperative to ensure early prevention and/or treatment of recurrent/progressive periodontitis. Precision dental medicine defines a patient-centered approach to care, and therefore, creates differences in the way in which a “case” of gingival health or gingivitis is defined for clinical practice as opposed to epidemiologically in population prevalence surveys. Thus, case definitions of gingival health and gingivitis are presented for both purposes. While gingival health and gingivitis have many clinical features, case definitions are primarily predicated on presence or absence of bleeding on probing. Here we classify gingival health and gingival diseases/conditions, along with a summary table of diagnostic features for defining health and gingivitis in various clinical situations.

KW - allergic reaction

KW - amalgam tattoo

KW - aspergillosis

KW - biofilm

KW - blastomycosis

KW - calcifying fibroblastic granuloma

KW - candidosis

KW - chemical trauma

KW - clinical health

KW - coccidioidomycosis

KW - condylomata acuminatum

KW - contact allergy

KW - coxsackie virus

KW - Crohn's disease

KW - dental plaque-induced gingivitis

KW - disease control

KW - disease remission

KW - disease stability

KW - drug-induced gingival enlargement

KW - drug-induced pigmentation

KW - dysbiosis

KW - erythema multiforme

KW - erythroplakia

KW - factitious injury

KW - fibrous epulis

KW - focal epithelial hyperplasia

KW - frictional keratosis

KW - geotricosis

KW - gingival pigmentation

KW - hand foot and mouth

KW - hereditary gingival fibromatosis

KW - herpangina

KW - herpes simplex

KW - histoplasmosis

KW - Hodgkin lymphoma

KW - hyperglycemia

KW - hyposalivation

KW - intact periodontium

KW - leukemia

KW - leukoplakia

KW - lichen planus

KW - local risk factors

KW - lupus erythematosus

KW - melanoplakia

KW - Melkersson-Rosenthal

KW - menstrual cycle

KW - modifying factors

KW - molluscum contagiosum

KW - mucormycosis

KW - Mycobacterium tuberculosis

KW - necrotizing periodontal diseases

KW - Neisseria gonorrhoeae

KW - non-Hodgkin lymphoma

KW - non–dental plaque-induced gingival conditions

KW - oral contraceptive

KW - orofacial granulomatosis

KW - paracoccidioidomycosis

KW - pemphigoid

KW - pemphigus vulgaris

KW - periodontal disease

KW - peripheral giant cell granuloma

KW - plasma cell gingivitis

KW - predisposing factors

KW - pregnancy

KW - puberty

KW - pyogenic granuloma

KW - reduced periodontium

KW - resolution of inflammation

KW - restoration margins

KW - sarcoidosis

KW - scurvy

KW - smoker's melanosis

KW - smoking

KW - squamous cell carcinoma

KW - squamous cell papilloma

KW - stable periodontitis

KW - streptoccocal gingivitis

KW - symbiosis

KW - systemic risk factors

KW - thermal trauma

KW - toothbrush trauma

KW - Treponema pallidum

KW - varicella zoster

KW - vascular epulis

KW - verruca vulgaris

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