Shinya Murakami1, Brian L Mealey2, Angelo Mariotti3, Iain L C Chapple4. 1. Osaka University, Graduate School of Dentistry-Department of Periodontology, Osaka, Japan. 2. Department of Periodontics, The University of Texas Health Science Center at San Antonio, San Antonio, TX, USA. 3. Division of Periodontology, College of Dentistry, The Ohio State University, Columbus, OH, USA. 4. Department of Periodontology, University of Birmingham School of Dentistry, Birmingham, UK.
Abstract
OBJECTIVE: This review proposes revisions to the current classification system for gingival diseases and provides a rationale for how it differs from the 1999 classification system. IMPORTANCE: Gingival inflammation in response to bacterial plaque accumulation (microbial biofilms) is considered the key risk factor for the onset of periodontitis. Thus, control of gingival inflammation is essential for the primary prevention of periodontitis. FINDINGS: The clinical characteristics common to dental plaque-induced inflammatory gingival conditions include: a) clinical signs and symptoms of inflammation that are confined to the gingiva: b) reversibility of the inflammation by removing or disrupting the biofilm; c) the presence of a high bacterial plaque burden to initiate the inflammation; d) systemic modifying factors (e.g., hormones, systemic disorders, drugs) which can alter the severity of the plaque-induced inflammation and; e) stable (i.e., non-changing) attachment levels on a periodontium which may or may not have experienced a loss of attachment or alveolar bone. The simplified taxonomy of gingival conditions includes: 1) introduction of the term "incipient gingivitis;" 2) a description of the extent and severity of gingival inflammation; 3) a description of the extent and severity of gingival enlargement and; 4) a reduction of categories in the dental plaque-induced gingival disease taxonomy. CONCLUSIONS: Dental plaque-induced gingival inflammation is modified by various systemic and oral factors. The appropriate intervention is crucial for the prevention of periodontitis.
OBJECTIVE: This review proposes revisions to the current classification system for gingival diseases and provides a rationale for how it differs from the 1999 classification system. IMPORTANCE: Gingival inflammation in response to bacterial plaque accumulation (microbial biofilms) is considered the key risk factor for the onset of periodontitis. Thus, control of gingival inflammation is essential for the primary prevention of periodontitis. FINDINGS: The clinical characteristics common to dental plaque-induced inflammatory gingival conditions include: a) clinical signs and symptoms of inflammation that are confined to the gingiva: b) reversibility of the inflammation by removing or disrupting the biofilm; c) the presence of a high bacterial plaque burden to initiate the inflammation; d) systemic modifying factors (e.g., hormones, systemic disorders, drugs) which can alter the severity of the plaque-induced inflammation and; e) stable (i.e., non-changing) attachment levels on a periodontium which may or may not have experienced a loss of attachment or alveolar bone. The simplified taxonomy of gingival conditions includes: 1) introduction of the term "incipient gingivitis;" 2) a description of the extent and severity of gingival inflammation; 3) a description of the extent and severity of gingival enlargement and; 4) a reduction of categories in the dental plaque-induced gingival disease taxonomy. CONCLUSIONS: Dental plaque-induced gingival inflammation is modified by various systemic and oral factors. The appropriate intervention is crucial for the prevention of periodontitis.
Authors: Paula Frid; Divyashri Baraniya; Josefine Halbig; Veronika Rypdal; Nils Thomas Songstad; Annika Rosèn; Johanna Rykke Berstad; Berit Flatø; Fadhl Alakwaa; Elisabeth Grut Gil; Lena Cetrelli; Tsute Chen; Nezar Noor Al-Hebshi; Ellen Nordal; Mohammed Al-Haroni Journal: Front Cell Infect Microbiol Date: 2020-11-04 Impact factor: 5.293