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obesity and periodontitis. 11,12 However there are relatively few studies with longitudinal design, and the overall effect appears to be modest. 13,14
Periodontitis associated with smoking : Periodontitis (see Workgroup 2 case definition, Papapanou et al., 8 Tonetti et al. 9 ) and previous or current smoking in pack‐years. 2. Conditions affecting the periodontal apparatus independently of dental plaque biofilm‐induced inflammation Periodontal attachment loss occurring in: Neoplastic diseases Other diseases
Can osteoporosis affect the course of periodontitis? There is conflicting evidence regarding the association between osteo‐ porosis and periodontitis. A recent systematic review concluded that postmenopausal women with osteoporosis or osteopenia exhibit a modest but statistically significant greater loss of periodontal attach‐ ment compared with women with normal bone mineral density. 15
The full list, case definitions, and diagnostic considerations are shown in Albandar et al. 1 (Tables 9 and 10).
Can rheumatoid arthritis affect the course of periodontitis?
MUCOGINGIVAL CONDITIONS AROUND THE NATURAL DENTITION
A recent meta‐analysis found a statistically significant but weak positive association between rheumatoid arthritis and periodonti‐ tis. 16 There is some evidence that periodontitis may contribute to the pathogenesis of rheumatoid arthritis, and therefore, longitudinal studies are required to clarify this association. Should smoking‐associated periodontitis be a distinct diagnosis? Tobacco smoking is a prevalent behavior with severe health con‐ sequences. Although tobacco use was once classified as a habit, it is now considered a dependence to nicotine and a chronic relaps‐ ing medical disorder (International Classification of Diseases, Tenth Revision [ICD‐10 F17]). It is well established that smoking has a major adverse ef‐ fect on the periodontal supporting tissues, increasing the risk of periodontitis by 2‐ to 5‐fold. 17 There are no unique periodon‐ tal phenotypic features of periodontitis in smokers. On this basis smoking‐associated periodontitis is not a distinct disease. Nevertheless, tobacco smoking is an important modifying factor of periodontitis, and should be included in a clinical diagnosis of periodontitis as a descriptor. According to the new classification of periodontitis, 8,9 the current level of tobacco use influences the grading of periodontitis.
This consensus focuses on single and multiple facial/lingual re‐ cessions that could be related to various periodontal conditions/ diseases. Clinical aspects such as mucogingival conditions and thera‐ peutic interventions that are associated with gingival recessions are evaluated. The accompanying narrative review 2 reports data sup‐ porting this consensus paper on nine focused questions, case defini‐ tions, and a novel classification for gingival recessions. What is the definition of recession? Recession is defined as an apical shift of the gingival margin caused by different conditions/pathologies. It is associated with clinical attach‐ ment loss. This may apply to all surfaces (buccal/lingual/interproximal).
What are the possible consequences of gingival recession and root surface exposure to oral
environment? Impaired esthetics
Dentin hypersensitivity Caries/non‐carious cervical lesions (NCCL)
Besides the esthetic impairment caused by the apical shift of the gingival margin, the group also highlights the impact of the oral en‐ vironment on the exposed root surface. The prevalence of dentin hypersensitivity, cervical caries, and especially non‐carious cervical lesions, is very high and the latter is increasing with age. Is the development of gingival recession associated with the gingival phenotype? The group strongly suggests the adoption of the definition “periodon‐ tal phenotype” 18 to describe the combination of gingival phenotype (three‐dimensional gingival volume) and the thickness of the buccal bone plate (bone morphotype). Most papers use the term “biotype”.
Case definitions and diagnostic considerations
1a. Rare conditions that may have major effects on the course of periodontitis . Periodontitis (see Workgroup 2 case definition, Papapanou et al. 8 ) is a manifestation of these conditions. Cases are defined as periodontitis in the presence of the condition. The full list, case definitions, and diagnostic considerations are shown in Albandar et al. 1 (Tables 2 to 6). 1b. Common conditions with variable effects on the course of periodontitis . Periodontitis associated with diabetes mellitus : Periodontitis (see Workgroup 2 case definition, Papapanou et al., 8 Tonetti et al. 9 ) and diagnosis of diabetes mellitus.
a. Biotype: (Genetics) group of organs having the same specific genotype.
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