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CATON et al .
PERIODONTAL HEALTH, GINGIVITIS, AND GINGIVAL CONDITIONS 2‒6
broad spectrum of non‐plaque induced gingival diseases and condi‐ tions based on primary etiology (Table 2). 4
The workshop addressed unresolved issues with the previous clas‐ sification by identifying the difference between presence of gingival inflammation at one or more sites and the definition of a gingivitis case. It agreed that bleeding on probing should be the primary pa‐ rameter to set thresholds for gingivitis. 2,5 The workshop also char‐ acterized periodontal health and gingival inflammation in a reduced periodontium after completion of successful treatment of a patient with periodontitis. Specific definitions were agreed to with regard to cases of gingival health or inflammation after completion of peri‐ odontitis treatment based on bleeding on probing and depth of the residual sulcus/pocket. This distinction was made to emphasize the need for a more comprehensive maintenance and surveillance of the successfully treated patient with periodontitis. It was accepted that a patient with gingivitis can revert to a state of health, but a periodontitis patient remains a periodontitis patient for life, even fol‐ lowing successful therapy, and requires life‐long supportive care to prevent recurrence of disease. 6 The workshop also reorganized the
A NEW CLASSIFICATION OF PERIODONTITIS
The 1989 workshop recognized that periodontitis had several distinct clinical presentations, different ages of onset and rates of progres‐ sion. 7,8 Based on these variables the workshop categorized peri‐ odontitis as prepubertal, juvenile (localized and generalized), adult, and rapidly progressive. The 1993 European Workshop determined that the classification should be simplified and proposed grouping of periodontitis into two major headings: adult and early onset peri‐ odontitis. 9 The 1996 workshop participants determined that there was insufficient new evidence to change the classification. 10 Major changes were made in the 1999 classification of periodontitis, 11‒13 which has been in use for the last 19 years. Periodontitis was reclas‐ sified as chronic, aggressive (localized and generalized), necrotizing and as a manifestation of systemic disease.
TABLE 2
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