Classification of periodontitis

The general classification of periodontitis, which helps in dental practice, is based on the following unifying categories:

• Clinical signs of the disease.
• Etiological factors of the disease.
• Morphology of the inflammatory process.
• Topographic features.

In general, periodontal inflammation can be divided by the nature of the process - acute or chronic periodontitis. Each form in turn is subdivided into serous or purulent, and is also divided by the zone of localization of the process:

• Apical periodontitis.
• Marginal periodontitis.
• Diffuse periodontitis.

Chronic apical processes have their own division criteria:

• Fibrous.
• Granulating.
• Granulomatous.

It should be noted that so-called marginal periodontitis is often classified as a periodontal disease and this is just one example of some inconsistency in the standardization of the diagnosis.

Today, there are several classification forms used by dentists in different countries. ICD-10 is officially recognized in almost all countries of the former CIS. However, many doctors use other, more detailed standards in clinical terms in their practice.

Let us list the classifications that exist today:

• Lukomsky's classification, compiled on the basis of general clinical signs of the process:
  • Acute periodontitis is serous or purulent.
  • Chronic periodontitis – granulating, granulomatous, fibrous.
  • Chronic periodontitis in the acute stage.
• In the practice of pediatric dentistry, Groshikov's classification is often used:
  • Petiodontitis acuta – acute periodontitis.
  • Petiodontitis acuta apicalis – acute apical periodontitis.
  • Petiodontitis acuta marginalis – acute marginal periodontitis.
  • Petiodontitis chronica fibrosa – fibrous chronic periodontitis.
  • Petiodontitis chronica granulans – granulating chronic periodontitis.
  • Petiodontitis chronica granulomatosa – granulomatous chronic periodontitis.
  • Petiodontitis chronica exacerbation – exacerbation of chronic periodontitis.
• Dedova's classification (2002) by types:
  • I – an acute, rapidly developing process with clearly expressed symptoms.
  • II – a chronic process that develops over many years and rarely worsens.
  • III – exacerbation of the chronic form of periodontitis due to changes in the bacterial background and flora in the periodontal tissues.
  • IV – rapidly progressing periodontitis, which within a short period leads to the loss of several teeth at once.
  • V – a reversible inflammatory process in which there is a high recovery process of periodontal tissues.

The course of the process	Form of periodontitis	Prevalence	Degree of damage
Acute periodontitis	Simple	Localized	Easy
Chronic periodontitis	Complex	Generalized	Moderate to severe
Exacerbation of chronic periodontitis with abscess	Juvenile		Heavy
Rapidly progressive periodontitis	Post-juvenile
Periodontitis in remission	Symptomatic		Easy

In addition, there is a classification edited by R. Shur from 1976, a systematization of the Moscow Medical Dental Institute, the WHO classification and the ICD-10 classification officially recognized in medical institutions.

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