This document discusses the evolution of classification systems for periodontal diseases. It began with clinicians classifying diseases based on clinical characteristics from 1870-1920. From 1920-1970, the focus shifted to classical pathology, categorizing diseases as inflammatory or non-inflammatory. Since 1970, the dominant paradigm has been infection and host response. The document outlines several influential classification systems from 1989 onward that categorized diseases based on factors like age of onset, progression rate, and presence of systemic influences.

1. CLASSIFICATION
OF
PERIODONTAL
DISEASE

2. The concept of classification systems is considered as uninteresting by many, but it
provides us with a framework to come to a diagnosis.
The intricacy of periodontal diseases can be understood by classifying various
diseases.
Its goals are
Need for a classification system
1. To provide a foundation to study the etiology, susceptibility traits, pathogenesis, and
treatment of diseases in an organized manner.
2. To give clinicians a way to organize the health care needs of their patients.
3. Assemble similar disease phenotypes in more homogeneous syndromes.
CLASSIFICATION OF PERIODONTAL DISEASE

3. Researchers had insufficient information
about the etiopathogenesis of periodontal
diseases.
There was dispute about the nature of
periodontal diseases; whether they were
caused by local or systemic factors.
Opinions were divided.
Various researchers depended on case
descriptions and personal interpretations of
clinical cases to classify periodontal diseases.
(~1870–1920): Clinical characteristics paradigm
CLASSIFICATION OF PERIODONTAL DISEASE
Dominant paradigms in the evolution of classification systems

4. (~1920–1970): Classical pathology paradigm
CLASSIFICATION OF PERIODONTAL DISEASE
During this time a new concept developed
that periodontal diseases can be of 2 types-
inflammatory and non-inflammatory
(‘degenerative’ or ‘dystrophic’)
This was based on the observation that certain
forms of periodontal diseases were due to
degenerative changes in the periodontium
As a result most of the classification systems
in this era included disease categories such as
‘dystrophic’, ‘atrophic’ or ‘degenerative’.

5. (~1970–present): Infection/ host response paradigm
CLASSIFICATION OF PERIODONTAL DISEASE
After the publication of Robert Koch’s
postulates (1876), researchers stressed upon
the infectious nature of periodontal
diseases.
W.D. Miller, in particular, was an early
proponent of the infectious nature of
periodontal diseases.
He stated three factors which were to be
taken into consideration in every case of
pyorrhea alveolar is:
Miller also recognized that certain systemic
conditions (e.g. diabetes, pregnancy) could
modify the course of the disease
(1) predisposing circumstances
(2) local irritation
(3) bacteria.

6. CLASSIFICATION OF PERIODONTAL DISEASE
World Workshop
in Clinical Periodontics
(1989) Classification
European Workshop in
Periodontology (1993)
Classification
American Academy
of Periodontology
(1999) Classification
1. Localized
2. Generalized
1. Localized
2. Generalised
I.Early- onset Periodontitis
A. Prepubertal Periodontitis
B. Juvenile Periodontitis
II. Adult Periodontitis
III. Necrotising Ulcerative
Periodontitis
IV. Refractory Periodontitis
V. Periodontitis associated
with Systemic diseases
Begins at the 4th decade of life
Slow rate of progression of
disease.
Begins before the 4 th decade
of life
Rapid rate of progression of
disease,
Altered host response is seen.
Tissue necrosis with clinical
attachment
Bone loss is seen.
I.Adult Periodontitis
III.Early onset Periodontitis
III.Necrotizing Periodontitis
I. Gingival diseases
II. Chronic periodontitis
III. Aggressive periodontitis
IV. Periodontitis as a manifestation
of systemic diseases
V. Necrotizing periodontal diseases
VI. Periodontal abscesses
VII. Periodontitis with endodontal
lesions
VIII. Developmental and acquired
deformation and conditions