Periodontal manifestations of systemic diseases and developmental and acquired conditions: Consensus report of workgroup 3 of the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions

Søren Jepsen, Jack G. Caton, Jasim M. Albandar, Nabil F. Bissada, Philippe Bouchard, Pierpaolo Cortellini, Korkud Demirel, Massimo de Sanctis, Carlo Ercoli, Jingyuan Fan, Nicolaas C. Geurs, Francis J. Hughes, Lijian Jin, Alpdogan Kantarci, Evanthia Lalla, Phoebus N. Madianos, Debora Matthews, Michael K. McGuire, Michael P. Mills, Philip M. PreshawMark A. Reynolds, Anton Sculean, Cristiano Susin, Nicola X. West, Kazuhisa Yamazaki

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Background: A variety of systemic diseases and conditions can affect the course of periodontitis or have a negative impact on the periodontal attachment apparatus. Gingival recessions are highly prevalent and often associated with hypersensitivity, the development of caries and non-carious cervical lesions on the exposed root surface and impaired esthetics. Occlusal forces can result in injury of teeth and periodontal attachment apparatus. Several developmental or acquired conditions associated with teeth or prostheses may predispose to diseases of the periodontium. The aim of this working group was to review and update the 1999 classification with regard to these diseases and conditions, and to develop case definitions and diagnostic considerations. Methods: Discussions were informed by four reviews on 1) periodontal manifestions of systemic diseases and conditions; 2) mucogingival conditions around natural teeth; 3) traumatic occlusal forces and occlusal trauma; and 4) dental prostheses and tooth related factors. This consensus report is based on the results of these reviews and on expert opinion of the participants. Results: Key findings included the following: 1) there are mainly rare systemic conditions (such as Papillon-Lefevre Syndrome, leucocyte adhesion deficiency, and others) with a major effect on the course of periodontitis and more common conditions (such as diabetes mellitus) with variable effects, as well as conditions affecting the periodontal apparatus independently of dental plaque biofilm-induced inflammation (such as neoplastic diseases); 2) diabetes-associated periodontitis should not be regarded as a distinct diagnosis, but diabetes should be recognized as an important modifying factor and included in a clinical diagnosis of periodontitis as a descriptor; 3) likewise, tobacco smoking – now considered a dependence to nicotine and a chronic relapsing medical disorder with major adverse effects on the periodontal supporting tissues – is an important modifier to be included in a clinical diagnosis of periodontitis as a descriptor; 4) the importance of the gingival phenotype, encompassing gingival thickness and width in the context of mucogingival conditions, is recognized and a novel classification for gingival recessions is introduced; 5) there is no evidence that traumatic occlusal forces lead to periodontal attachment loss, non-carious cervical lesions, or gingival recessions; 6) traumatic occlusal forces lead to adaptive mobility in teeth with normal support, whereas they lead to progressive mobility in teeth with reduced support, usually requiring splinting; 7) the term biologic width is replaced by supracrestal tissue attachment consisting of junctional epithelium and supracrestal connective tissue; 8) infringement of restorative margins within the supracrestal connective tissue attachment is associated with inflammation and/or loss of periodontal supporting tissue. However, it is not evident whether the negative effects on the periodontium are caused by dental plaque biofilm, trauma, toxicity of dental materials or a combination of these factors; 9) tooth anatomical factors are related to dental plaque biofilm-induced gingival inflammation and loss of periodontal supporting tissues. Conclusion: An updated classification of the periodontal manifestations and conditions affecting the course of periodontitis and the periodontal attachment apparatus, as well as of developmental and acquired conditions, is introduced. Case definitions and diagnostic considerations are also presented.

Original languageEnglish (US)
Pages (from-to)S219-S229
JournalJournal of Clinical Periodontology
Volume45
DOIs
StatePublished - Jun 1 2018

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Periodontitis
Bite Force
Consensus
Gingival Recession
Education
Dental Plaque
Tooth
Biofilms
Tooth Mobility
Periodontium
Inflammation
Connective Tissue
Periodontal Attachment Loss
Papillon-Lefevre Disease
Tooth Injuries
Epithelial Attachment
Dental Prosthesis
Dental Materials
Tobacco Use Disorder
Wounds and Injuries

Keywords

  • anatomy
  • attachment loss
  • bruxism
  • classification
  • dental prostheses
  • dental restorations
  • diagnosis
  • genetic disease
  • gingival inflammation
  • gingival recession
  • gingival thickness
  • gingivitis
  • mucogingival surgery
  • occlusal trauma
  • periodontal disease
  • periodontitis
  • plastic periodontal surgery
  • systemic disease
  • tooth

ASJC Scopus subject areas

  • Periodontics

Cite this

Periodontal manifestations of systemic diseases and developmental and acquired conditions : Consensus report of workgroup 3 of the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions. / Jepsen, Søren; Caton, Jack G.; Albandar, Jasim M.; Bissada, Nabil F.; Bouchard, Philippe; Cortellini, Pierpaolo; Demirel, Korkud; de Sanctis, Massimo; Ercoli, Carlo; Fan, Jingyuan; Geurs, Nicolaas C.; Hughes, Francis J.; Jin, Lijian; Kantarci, Alpdogan; Lalla, Evanthia; Madianos, Phoebus N.; Matthews, Debora; McGuire, Michael K.; Mills, Michael P.; Preshaw, Philip M.; Reynolds, Mark A.; Sculean, Anton; Susin, Cristiano; West, Nicola X.; Yamazaki, Kazuhisa.

In: Journal of Clinical Periodontology, Vol. 45, 01.06.2018, p. S219-S229.

Research output: Contribution to journalArticle

Jepsen, S, Caton, JG, Albandar, JM, Bissada, NF, Bouchard, P, Cortellini, P, Demirel, K, de Sanctis, M, Ercoli, C, Fan, J, Geurs, NC, Hughes, FJ, Jin, L, Kantarci, A, Lalla, E, Madianos, PN, Matthews, D, McGuire, MK, Mills, MP, Preshaw, PM, Reynolds, MA, Sculean, A, Susin, C, West, NX & Yamazaki, K 2018, 'Periodontal manifestations of systemic diseases and developmental and acquired conditions: Consensus report of workgroup 3 of the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions', Journal of Clinical Periodontology, vol. 45, pp. S219-S229. https://doi.org/10.1111/jcpe.12951
Jepsen, Søren ; Caton, Jack G. ; Albandar, Jasim M. ; Bissada, Nabil F. ; Bouchard, Philippe ; Cortellini, Pierpaolo ; Demirel, Korkud ; de Sanctis, Massimo ; Ercoli, Carlo ; Fan, Jingyuan ; Geurs, Nicolaas C. ; Hughes, Francis J. ; Jin, Lijian ; Kantarci, Alpdogan ; Lalla, Evanthia ; Madianos, Phoebus N. ; Matthews, Debora ; McGuire, Michael K. ; Mills, Michael P. ; Preshaw, Philip M. ; Reynolds, Mark A. ; Sculean, Anton ; Susin, Cristiano ; West, Nicola X. ; Yamazaki, Kazuhisa. / Periodontal manifestations of systemic diseases and developmental and acquired conditions : Consensus report of workgroup 3 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. S219-S229.
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abstract = "Background: A variety of systemic diseases and conditions can affect the course of periodontitis or have a negative impact on the periodontal attachment apparatus. Gingival recessions are highly prevalent and often associated with hypersensitivity, the development of caries and non-carious cervical lesions on the exposed root surface and impaired esthetics. Occlusal forces can result in injury of teeth and periodontal attachment apparatus. Several developmental or acquired conditions associated with teeth or prostheses may predispose to diseases of the periodontium. The aim of this working group was to review and update the 1999 classification with regard to these diseases and conditions, and to develop case definitions and diagnostic considerations. Methods: Discussions were informed by four reviews on 1) periodontal manifestions of systemic diseases and conditions; 2) mucogingival conditions around natural teeth; 3) traumatic occlusal forces and occlusal trauma; and 4) dental prostheses and tooth related factors. This consensus report is based on the results of these reviews and on expert opinion of the participants. Results: Key findings included the following: 1) there are mainly rare systemic conditions (such as Papillon-Lefevre Syndrome, leucocyte adhesion deficiency, and others) with a major effect on the course of periodontitis and more common conditions (such as diabetes mellitus) with variable effects, as well as conditions affecting the periodontal apparatus independently of dental plaque biofilm-induced inflammation (such as neoplastic diseases); 2) diabetes-associated periodontitis should not be regarded as a distinct diagnosis, but diabetes should be recognized as an important modifying factor and included in a clinical diagnosis of periodontitis as a descriptor; 3) likewise, tobacco smoking – now considered a dependence to nicotine and a chronic relapsing medical disorder with major adverse effects on the periodontal supporting tissues – is an important modifier to be included in a clinical diagnosis of periodontitis as a descriptor; 4) the importance of the gingival phenotype, encompassing gingival thickness and width in the context of mucogingival conditions, is recognized and a novel classification for gingival recessions is introduced; 5) there is no evidence that traumatic occlusal forces lead to periodontal attachment loss, non-carious cervical lesions, or gingival recessions; 6) traumatic occlusal forces lead to adaptive mobility in teeth with normal support, whereas they lead to progressive mobility in teeth with reduced support, usually requiring splinting; 7) the term biologic width is replaced by supracrestal tissue attachment consisting of junctional epithelium and supracrestal connective tissue; 8) infringement of restorative margins within the supracrestal connective tissue attachment is associated with inflammation and/or loss of periodontal supporting tissue. However, it is not evident whether the negative effects on the periodontium are caused by dental plaque biofilm, trauma, toxicity of dental materials or a combination of these factors; 9) tooth anatomical factors are related to dental plaque biofilm-induced gingival inflammation and loss of periodontal supporting tissues. Conclusion: An updated classification of the periodontal manifestations and conditions affecting the course of periodontitis and the periodontal attachment apparatus, as well as of developmental and acquired conditions, is introduced. Case definitions and diagnostic considerations are also presented.",
keywords = "anatomy, attachment loss, bruxism, classification, dental prostheses, dental restorations, diagnosis, genetic disease, gingival inflammation, gingival recession, gingival thickness, gingivitis, mucogingival surgery, occlusal trauma, periodontal disease, periodontitis, plastic periodontal surgery, systemic disease, tooth",
author = "S{\o}ren Jepsen and Caton, {Jack G.} and Albandar, {Jasim M.} and Bissada, {Nabil F.} and Philippe Bouchard and Pierpaolo Cortellini and Korkud Demirel and {de Sanctis}, Massimo and Carlo Ercoli and Jingyuan Fan and Geurs, {Nicolaas C.} and Hughes, {Francis J.} and Lijian Jin and Alpdogan Kantarci and Evanthia Lalla and Madianos, {Phoebus N.} and Debora Matthews and McGuire, {Michael K.} and Mills, {Michael P.} and Preshaw, {Philip M.} and Reynolds, {Mark A.} and Anton Sculean and Cristiano Susin and West, {Nicola X.} and Kazuhisa Yamazaki",
year = "2018",
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TY - JOUR

T1 - Periodontal manifestations of systemic diseases and developmental and acquired conditions

T2 - Consensus report of workgroup 3 of the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions

AU - Jepsen, Søren

AU - Caton, Jack G.

AU - Albandar, Jasim M.

AU - Bissada, Nabil F.

AU - Bouchard, Philippe

AU - Cortellini, Pierpaolo

AU - Demirel, Korkud

AU - de Sanctis, Massimo

AU - Ercoli, Carlo

AU - Fan, Jingyuan

AU - Geurs, Nicolaas C.

AU - Hughes, Francis J.

AU - Jin, Lijian

AU - Kantarci, Alpdogan

AU - Lalla, Evanthia

AU - Madianos, Phoebus N.

AU - Matthews, Debora

AU - McGuire, Michael K.

AU - Mills, Michael P.

AU - Preshaw, Philip M.

AU - Reynolds, Mark A.

AU - Sculean, Anton

AU - Susin, Cristiano

AU - West, Nicola X.

AU - Yamazaki, Kazuhisa

PY - 2018/6/1

Y1 - 2018/6/1

N2 - Background: A variety of systemic diseases and conditions can affect the course of periodontitis or have a negative impact on the periodontal attachment apparatus. Gingival recessions are highly prevalent and often associated with hypersensitivity, the development of caries and non-carious cervical lesions on the exposed root surface and impaired esthetics. Occlusal forces can result in injury of teeth and periodontal attachment apparatus. Several developmental or acquired conditions associated with teeth or prostheses may predispose to diseases of the periodontium. The aim of this working group was to review and update the 1999 classification with regard to these diseases and conditions, and to develop case definitions and diagnostic considerations. Methods: Discussions were informed by four reviews on 1) periodontal manifestions of systemic diseases and conditions; 2) mucogingival conditions around natural teeth; 3) traumatic occlusal forces and occlusal trauma; and 4) dental prostheses and tooth related factors. This consensus report is based on the results of these reviews and on expert opinion of the participants. Results: Key findings included the following: 1) there are mainly rare systemic conditions (such as Papillon-Lefevre Syndrome, leucocyte adhesion deficiency, and others) with a major effect on the course of periodontitis and more common conditions (such as diabetes mellitus) with variable effects, as well as conditions affecting the periodontal apparatus independently of dental plaque biofilm-induced inflammation (such as neoplastic diseases); 2) diabetes-associated periodontitis should not be regarded as a distinct diagnosis, but diabetes should be recognized as an important modifying factor and included in a clinical diagnosis of periodontitis as a descriptor; 3) likewise, tobacco smoking – now considered a dependence to nicotine and a chronic relapsing medical disorder with major adverse effects on the periodontal supporting tissues – is an important modifier to be included in a clinical diagnosis of periodontitis as a descriptor; 4) the importance of the gingival phenotype, encompassing gingival thickness and width in the context of mucogingival conditions, is recognized and a novel classification for gingival recessions is introduced; 5) there is no evidence that traumatic occlusal forces lead to periodontal attachment loss, non-carious cervical lesions, or gingival recessions; 6) traumatic occlusal forces lead to adaptive mobility in teeth with normal support, whereas they lead to progressive mobility in teeth with reduced support, usually requiring splinting; 7) the term biologic width is replaced by supracrestal tissue attachment consisting of junctional epithelium and supracrestal connective tissue; 8) infringement of restorative margins within the supracrestal connective tissue attachment is associated with inflammation and/or loss of periodontal supporting tissue. However, it is not evident whether the negative effects on the periodontium are caused by dental plaque biofilm, trauma, toxicity of dental materials or a combination of these factors; 9) tooth anatomical factors are related to dental plaque biofilm-induced gingival inflammation and loss of periodontal supporting tissues. Conclusion: An updated classification of the periodontal manifestations and conditions affecting the course of periodontitis and the periodontal attachment apparatus, as well as of developmental and acquired conditions, is introduced. Case definitions and diagnostic considerations are also presented.

AB - Background: A variety of systemic diseases and conditions can affect the course of periodontitis or have a negative impact on the periodontal attachment apparatus. Gingival recessions are highly prevalent and often associated with hypersensitivity, the development of caries and non-carious cervical lesions on the exposed root surface and impaired esthetics. Occlusal forces can result in injury of teeth and periodontal attachment apparatus. Several developmental or acquired conditions associated with teeth or prostheses may predispose to diseases of the periodontium. The aim of this working group was to review and update the 1999 classification with regard to these diseases and conditions, and to develop case definitions and diagnostic considerations. Methods: Discussions were informed by four reviews on 1) periodontal manifestions of systemic diseases and conditions; 2) mucogingival conditions around natural teeth; 3) traumatic occlusal forces and occlusal trauma; and 4) dental prostheses and tooth related factors. This consensus report is based on the results of these reviews and on expert opinion of the participants. Results: Key findings included the following: 1) there are mainly rare systemic conditions (such as Papillon-Lefevre Syndrome, leucocyte adhesion deficiency, and others) with a major effect on the course of periodontitis and more common conditions (such as diabetes mellitus) with variable effects, as well as conditions affecting the periodontal apparatus independently of dental plaque biofilm-induced inflammation (such as neoplastic diseases); 2) diabetes-associated periodontitis should not be regarded as a distinct diagnosis, but diabetes should be recognized as an important modifying factor and included in a clinical diagnosis of periodontitis as a descriptor; 3) likewise, tobacco smoking – now considered a dependence to nicotine and a chronic relapsing medical disorder with major adverse effects on the periodontal supporting tissues – is an important modifier to be included in a clinical diagnosis of periodontitis as a descriptor; 4) the importance of the gingival phenotype, encompassing gingival thickness and width in the context of mucogingival conditions, is recognized and a novel classification for gingival recessions is introduced; 5) there is no evidence that traumatic occlusal forces lead to periodontal attachment loss, non-carious cervical lesions, or gingival recessions; 6) traumatic occlusal forces lead to adaptive mobility in teeth with normal support, whereas they lead to progressive mobility in teeth with reduced support, usually requiring splinting; 7) the term biologic width is replaced by supracrestal tissue attachment consisting of junctional epithelium and supracrestal connective tissue; 8) infringement of restorative margins within the supracrestal connective tissue attachment is associated with inflammation and/or loss of periodontal supporting tissue. However, it is not evident whether the negative effects on the periodontium are caused by dental plaque biofilm, trauma, toxicity of dental materials or a combination of these factors; 9) tooth anatomical factors are related to dental plaque biofilm-induced gingival inflammation and loss of periodontal supporting tissues. Conclusion: An updated classification of the periodontal manifestations and conditions affecting the course of periodontitis and the periodontal attachment apparatus, as well as of developmental and acquired conditions, is introduced. Case definitions and diagnostic considerations are also presented.

KW - anatomy

KW - attachment loss

KW - bruxism

KW - classification

KW - dental prostheses

KW - dental restorations

KW - diagnosis

KW - genetic disease

KW - gingival inflammation

KW - gingival recession

KW - gingival thickness

KW - gingivitis

KW - mucogingival surgery

KW - occlusal trauma

KW - periodontal disease

KW - periodontitis

KW - plastic periodontal surgery

KW - systemic disease

KW - tooth

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