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PAPAPANOU et al .
TABLE 2 Classification of necrotizing periodontal diseases (NPD)
NG, necrotizing gingivitis; NP, necrotizing periodontitis; NS, necrotizing stomatitis. a Mean plasma and serum concentrations of retinol, total ascorbic acid, zinc, and albumin markedly reduced, or very marked depletion of plasma retinol, zinc, and ascorbate; and saliva levels of albumin and cortisol, as well as plasma cortisol concentrations, significantly increased. b Living in substandard accommodations, exposure to debilitating childhood diseases, living near livestock, poor oral hygiene, limited access to potable water and poor sanitary disposal of human and animal fecal waste. c Measles, herpes viruses (cytomegalovirus, Epstein‐Barr virus‐1, herpes simplex virus), chicken pox, malaria, febrile illness.
TABLE 3 Classification of endo‐periodontal lesions
the clinical presentation and other elements that affect clinical man - agement, prognosis, and potentially broader influences on both oral and systemic health. A framework for developing a multi‐dimen - sional periodontitis staging and grading system was proposed, in which staging (Table 1A) is largely dependent upon the severity of disease at presentation as well as on the complexity of disease man - agement, while grading (Table 1B) provides supplemental informa - tion about biological features of the disease including a history‐based
analysis of the rate of periodontitis progression; assessment of the risk for further progression; analysis of possible poor outcomes of treatment; and assessment of the risk that the disease or its treat - ment may negatively affect the general health of the patient. During the workgroup deliberations, the following questions were formulated and addressed in order to clarify and substantiate the need for a new classification system for periodontitis:
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